Sixty-Fifth issue
July 24, 2024
The global prevalence of seborrheic dermatitis: A systematic review and meta-analysis
JAMA Dermatology
JAMA Dermatology
Scratching the surface: Uncovering the global prevalence of seborrheic dermatitis.
Seborrheic dermatitis is a common chronic inflammatory skin disease with an unclear global prevalence, pathogenesis, and epidemiology. This meta-analysis provided a detailed estimation of the global prevalence of seborrheic dermatitis, examining demographic variations from nine countries, with most being from India, Turkey, and the United States.
What did they find?
Main Takeaway: This comprehensive meta-analysis reveals a higher global prevalence of seborrheic dermatitis than previously estimated, with significant demographic and geographic variability, underscoring the influence of environmental factors and cultural practices on the condition.
Seborrheic dermatitis is a common chronic inflammatory skin disease with an unclear global prevalence, pathogenesis, and epidemiology. This meta-analysis provided a detailed estimation of the global prevalence of seborrheic dermatitis, examining demographic variations from nine countries, with most being from India, Turkey, and the United States.
What did they find?
- The pooled global prevalence of seborrheic dermatitis is 4.38%.
- There are significant variations across age groups, with the highest prevalence amongst adults (5.64%) compared to children (3.70%) and neonates (0.23%).
- A significant variation was observed across countries, with South Africa having the highest prevalence at 8.82%, followed by the United States at 5.86% and Turkey at 3.74%, while India had the lowest prevalence at 2.62%.
Main Takeaway: This comprehensive meta-analysis reveals a higher global prevalence of seborrheic dermatitis than previously estimated, with significant demographic and geographic variability, underscoring the influence of environmental factors and cultural practices on the condition.
Effects of oral roflumilast therapy on body weight and cardiometabolic parameters in patients with psoriasis
Journal of the American Academy of Dermatology
Journal of the American Academy of Dermatology
Patients with psoriasis are shedding both scales and pounds , thanks to roflumilast!
Psoriasis has been linked to various cardiometabolic conditions, including obesity, which often affects the efficacy of psoriasis management. This multicenter placebo-controlled clinical trial investigated the impact of oral roflumilast, a phosphodiesterase-4 inhibitor with the potential to treat inflammatory skin conditions, on body weight and cardiometabolic parameters in 46 patients with moderate-to-severe plaque psoriasis. Participants were blinded until week 12, at which point open-label roflumilast treatment was given until week 24.
What did they find?
Main Takeaway: Oral roflumilast shows promise as an alternative treatment for moderate-to-severe plaque psoriasis, potentially promoting weight loss and reducing appetite.Autoimmune blistering disorders (ABDs) are chronic conditions marked by skin and/or mucous membrane blisters resulting from autoantibodies against structural proteins. ABDs are classically grouped based on the location of blisters, either epidermal (pemphigus) or subepidermal (pemphigoid). This population-based cohort study examined if ABDs are associated with increased risk of major adverse cardiovascular events such as atherosclerotic cardiovascular disease (ASCVD), heart failure, arrhythmia, venous thromboembolism (VTE), and cardiovascular death.
Psoriasis has been linked to various cardiometabolic conditions, including obesity, which often affects the efficacy of psoriasis management. This multicenter placebo-controlled clinical trial investigated the impact of oral roflumilast, a phosphodiesterase-4 inhibitor with the potential to treat inflammatory skin conditions, on body weight and cardiometabolic parameters in 46 patients with moderate-to-severe plaque psoriasis. Participants were blinded until week 12, at which point open-label roflumilast treatment was given until week 24.
What did they find?
- Participants had a mean body weight of 103.6 kg, BMI of 32.7 kg/m2, and waist circumference of 107.9 cm. 10.8% of participants had T2DM.
- At week 12, the roflumilast treatment group had a median weight reduction of 2.6% (-2.3 kg; IQR = -6.3; -0.8) compared to no change (0.0 kg) in the placebo group (P < 0.01).
- At week 24, participants receiving roflumilast since baseline had a median weight reduction of 4.0% (-3.2 kg; IQR = -7.7; -1.9 ), while participants initially in the placebo group had a median weight reduction of 1.3% (1.3 kg; IQR = -3.6; -0.3).
- Weight loss in the roflumilast treatment group was correlated with a change in psoriasis and severity index (PASI) at week 12 (coefficient 0.52, P = 0.0004) but not at week 24.
- More patients in the roflumilast group reported reduced appetite compared to the placebo group at week 4 (61% vs. 26%, P = 0.02); by week 24, incidences were the same between the two groups (35% vs. 35%, P = 1.0).
Main Takeaway: Oral roflumilast shows promise as an alternative treatment for moderate-to-severe plaque psoriasis, potentially promoting weight loss and reducing appetite.Autoimmune blistering disorders (ABDs) are chronic conditions marked by skin and/or mucous membrane blisters resulting from autoantibodies against structural proteins. ABDs are classically grouped based on the location of blisters, either epidermal (pemphigus) or subepidermal (pemphigoid). This population-based cohort study examined if ABDs are associated with increased risk of major adverse cardiovascular events such as atherosclerotic cardiovascular disease (ASCVD), heart failure, arrhythmia, venous thromboembolism (VTE), and cardiovascular death.
Investigating the use of topical nitrate for systemic sclerosis
Journal of Investigative Dermatology
Journal of Investigative Dermatology
Systemic sclerosis not feeling great? Use nitrates to alleviate!
Systemic sclerosis is a complex disorder with few effective treatments. It is characterized by widespread fibrosis affecting multiple organs. Nitrate, often abundant in one’s diet, has shown therapeutic potential for several diseases. As such, this study investigated nitrate as a possible treatment for systemic sclerosis.
Male mice were injected with bleomycin to induce significant dermal sclerosis. Nitrate was topically administered via dissolving microneedles daily for 2 weeks. After the treatment period, skin biopsies were compared between those mice receiving nitrate therapy and those who did not.
What did they find?
Main Takeaway: Topical nitrate reduced dermal thickening and proinflammatory mediators associated with systemic sclerosis, suggesting it may be a potential therapeutic approach.
Systemic sclerosis is a complex disorder with few effective treatments. It is characterized by widespread fibrosis affecting multiple organs. Nitrate, often abundant in one’s diet, has shown therapeutic potential for several diseases. As such, this study investigated nitrate as a possible treatment for systemic sclerosis.
Male mice were injected with bleomycin to induce significant dermal sclerosis. Nitrate was topically administered via dissolving microneedles daily for 2 weeks. After the treatment period, skin biopsies were compared between those mice receiving nitrate therapy and those who did not.
What did they find?
- Dermal thickness was reduced in mice treated with nitrate and bleomycin compared to those treated with bleomycin alone (P < 0.001).
- Mice treated with nitrate and bleomycin had lower levels of proinflammatory and profibrotic mediators than those treated with bleomycin alone (P < 0.05).
- The expression of ST2, a gene that promotes T cell differentiation, was decreased in mice treated with nitrate and bleomycin (P < 0.001).
Main Takeaway: Topical nitrate reduced dermal thickening and proinflammatory mediators associated with systemic sclerosis, suggesting it may be a potential therapeutic approach.
Clinicopathological features and patient management of follicular squamous cell carcinoma, a new WHO entity
The American Journal of Dermatopathology
The American Journal of Dermatopathology
What’s new with the WHO?
Cutaneous follicular squamous cell carcinoma (FSCC) is a subtype of squamous cell carcinoma (SCC) that arises from the hair follicle. FSCC is a new World Health Organization (WHO) entity with outlined diagnostic criteria. Researchers aimed to classify the histologic features and clinical implications of FSCC. Using WHO diagnostic criteria, 103 cases of FSCC were retrospectively identified and analyzed.
What did they find?
Main Takeaway: FSCC is a cutaneous malignancy with distinct histologic features. Accurate invasion classification is crucial for patient management.
Cutaneous follicular squamous cell carcinoma (FSCC) is a subtype of squamous cell carcinoma (SCC) that arises from the hair follicle. FSCC is a new World Health Organization (WHO) entity with outlined diagnostic criteria. Researchers aimed to classify the histologic features and clinical implications of FSCC. Using WHO diagnostic criteria, 103 cases of FSCC were retrospectively identified and analyzed.
What did they find?
- 50 tumors (48.5%) were classified as in situ with circumscript borders, 40 tumors (38.8%) were invasive, and 13 tumors (12.6%) were borderline invasive.
- Follicular mucin in acantholytic spaces within the tumor epithelium was a distinctive histologic finding in 59 tumors (57.2%).
- Of the 82 cases with follow-up data, 5 tumors (6.1%) showed local recurrence.
- 3 of 45 follow-up patients (6.7%) with invasive or borderline invasive tumors developed lymph node metastases.
Main Takeaway: FSCC is a cutaneous malignancy with distinct histologic features. Accurate invasion classification is crucial for patient management.
How much does Hidradenitis Suppurativa impact quality of life?
Dermatologic Surgery
Dermatologic Surgery
Living with HS? Spoiler: It's a real pain in the abscess!
Hidradenitis suppurativa (HS), a chronic inflammatory skin condition, can significantly diminish one’s quality of life (QoL). Improving QoL has become an important treatment goal for HS. This single-center, cross-sectional study assessed the demographic and clinical factors that may influence QoL using the Dermatology Life Quality Index (DLQI) and the relationship of Hurley stage with these characteristics in 176 patients with HS.
What did they find?
Main Takeaway: Early and appropriate treatment, tailored to objective disease severity and subjective patient experiences, can significantly improve QoL for HS patients.
Hidradenitis suppurativa (HS), a chronic inflammatory skin condition, can significantly diminish one’s quality of life (QoL). Improving QoL has become an important treatment goal for HS. This single-center, cross-sectional study assessed the demographic and clinical factors that may influence QoL using the Dermatology Life Quality Index (DLQI) and the relationship of Hurley stage with these characteristics in 176 patients with HS.
What did they find?
- 86 patients were female (48.9%), and 90 were male (51.1%), with a mean age of HS onset of 24.7 ± 10 years. 67.6% of patients were active smokers, and 40.3% were classified as obese.
- Advanced Hurley stages correlate with higher DLQI scores (mean DLQI: 11.9 in Stage 3, P < .001).
- Lesions in the gluteal region and legs, and having more than 2 affected areas correspond to worse quality of life (P < .001).
- Early Hurley Stage patients reported more benefit from treatments like laser epilation and surgical excision (P = .003 and P = .047, respectively).
Main Takeaway: Early and appropriate treatment, tailored to objective disease severity and subjective patient experiences, can significantly improve QoL for HS patients.
Acetyl zingerone and tetrahexyldecyl ascorbate combined topical therapy improves signs of photoaging
Journal of Cosmetic Dermatology
Journal of Cosmetic Dermatology
Looking for an effective vitamin C? THDA and AZ are a dynamic duo!
Tetrahexyldecyl ascorbate (THDA), a lipid-soluble Vitamin C precursor, penetrates the stratum corneum and converts to ascorbic acid, offering antioxidant benefits. However, when exposed to oxygen, THDA degrades rapidly, requiring stabilization. Researchers assessed the effectiveness of combining THDA with acetyl zingerone (AZ), a stabilizing antioxidant, in improving the appearance of facial photoaging.
In this double-blind, randomized clinical study, 38 participants received either topical 1%AZ-5%THDA combination therapy or 5%THDA alone twice daily for 8 weeks. Wrinkle severity, pigment intensity, and redness intensity were assessed via high-resolution photos at baseline, week 4, and week 8.
What did they find?
Main Takeaway: Combined AZ-THDA therapy shows significant improvement in facial photoaging, including wrinkle severity, pigment intensity, and redness, compared to THDA therapy alone.
Tetrahexyldecyl ascorbate (THDA), a lipid-soluble Vitamin C precursor, penetrates the stratum corneum and converts to ascorbic acid, offering antioxidant benefits. However, when exposed to oxygen, THDA degrades rapidly, requiring stabilization. Researchers assessed the effectiveness of combining THDA with acetyl zingerone (AZ), a stabilizing antioxidant, in improving the appearance of facial photoaging.
In this double-blind, randomized clinical study, 38 participants received either topical 1%AZ-5%THDA combination therapy or 5%THDA alone twice daily for 8 weeks. Wrinkle severity, pigment intensity, and redness intensity were assessed via high-resolution photos at baseline, week 4, and week 8.
What did they find?
- Wrinkle severity reduced significantly in the AZ-THDA group by 0.75% (P=0.023) and 3.72% (P=0.048) at weeks 4 and 8, respectively, whereas the THDA group alone showed an increase in wrinkle severity.
- Pigment severity decreased in the AZ-THDA group by 1.68% and 4.10% at weeks 4 and 8, respectively (P=0.0002).
- Average redness intensity was significantly reduced by 3.75% (P<0.016) and 14.25% (P<0.045) at weeks 4 and 8, respectively, in the AZ-THDA group, versus an increase in redness intensity in the THDA only group.
Main Takeaway: Combined AZ-THDA therapy shows significant improvement in facial photoaging, including wrinkle severity, pigment intensity, and redness, compared to THDA therapy alone.
Historic and continued underrepresentation of the Hispanic/Latino ethnicity among dermatologic clinical trial participants
Journal of the American Academy of Dermatology
Journal of the American Academy of Dermatology
Your dermatology trial called—it needs more skin of color!
The Hispanic/Latino ethnicity (HLE) represents a diverse and rapidly growing segment of the US population, reaching 18.7% in 2020. Despite this, the HLE faces worse dermatologic outcomes, including diagnostic delays, lower insurance rates, and treatment biases. This study explores historical and current gaps in HLE representation in dermatologic clinical trials.
What did they find?
Main Takeaway: HLE remains underrepresented in dermatologic clinical trials, particularly in cutaneous oncology. Addressing these disparities requires overcoming logistical barriers, ensuring language concordance, and collaborating with community leaders.
The Hispanic/Latino ethnicity (HLE) represents a diverse and rapidly growing segment of the US population, reaching 18.7% in 2020. Despite this, the HLE faces worse dermatologic outcomes, including diagnostic delays, lower insurance rates, and treatment biases. This study explores historical and current gaps in HLE representation in dermatologic clinical trials.
What did they find?
- Out of 2608 unique trials, only 996 (38.19%) reported HLE demographic data.
- Disease categories where HLE clinical trial representation was >18.7% included acne, bullous diseases, infectious diseases, rosacea, and vitiligo.
- Cutaneous oncology had the lowest representation, with <5% HLE participation.
Main Takeaway: HLE remains underrepresented in dermatologic clinical trials, particularly in cutaneous oncology. Addressing these disparities requires overcoming logistical barriers, ensuring language concordance, and collaborating with community leaders.
Methicillin-resistant Staphylococcus aureus (MRSA) is a significant public health concern. This mixed-methods study aimed to bridge the gaps associated with clinicians’ understanding of MRSA’s clinical presentation, management, and outcomes. The study incorporated an extensive literature review and a single-center retrospective patient record review, including 44 patients who presented to an outpatient dermatology clinic.
What did they find?
Main Takeaway: The increasing prevalence of MRSA and the challenges in management highlight the need for greater awareness and proactive treatment. Effective antibiotic stewardship and continuous evaluation and reporting of microbial resistance are crucial to addressing this public health issue.
What did they find?
- 68.2% of MRSA patients were treated with both topical and oral medications.
- Antibiotic susceptibility tests displayed high resistance to penicillin (84.1%) and high susceptibility to linezolid (95.5%) and moxifloxacin (97.7%).
- The literature review findings emphasized the diversity of MRSA infections, various challenges in treatment, variations in antibiotic susceptibility, and the increased need for novel approaches for therapy.
Main Takeaway: The increasing prevalence of MRSA and the challenges in management highlight the need for greater awareness and proactive treatment. Effective antibiotic stewardship and continuous evaluation and reporting of microbial resistance are crucial to addressing this public health issue.