eightY-Sixth issue
May 28, 2025
Neighborhood socioeconomic status and new hidradenitis suppurative diagnoses in a single health system
JAMA Dermatology
JAMA Dermatology
From ZIP codes to ICD-10 codes: how neighborhoods shape diagnoses
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease associated with pain, scarring, and systemic inflammation. Prior research has linked individual socioeconomic status (SES) to HS, but this study uniquely explores whether neighborhood-level SES (nSES) influences new HS diagnoses using a large cohort of dermatology patients in the San Francisco Bay Area.
What did they find?
Main Takeaway: Lower neighborhood-level socioeconomic status is independently associated with new hidradenitis suppurativa diagnosis.
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease associated with pain, scarring, and systemic inflammation. Prior research has linked individual socioeconomic status (SES) to HS, but this study uniquely explores whether neighborhood-level SES (nSES) influences new HS diagnoses using a large cohort of dermatology patients in the San Francisco Bay Area.
What did they find?
- Among 65,766 dermatology patients seen at UCSF between 2019 and 2024, 485 (0.7%) were diagnosed with HS for the first time.
- Patients living in neighborhoods with lower nSES had significantly greater odds of a new HS diagnosis compared to those in the highest-nSES areas. After adjusting for age, sex, and race/ethnicity the odds ratios (OR) for each nSES quintile (Q1-Q5), were 3.32 (95% CI, 2.46-4.49), 2.25 (95% CI, 1.62-3.12), 1.97 (95% CI, 1.46-2.66), 1.44 (95% CI, 1.06-1.96), and 1 (reference), respectively.
- Obesity partially mediated this relationship across all quintiles, while smoking and insurance status had inconsistent effects. Racial and ethnic subgroup analyses showed a similar trend, though some did not reach statistical significance, likely due to small sample sizes.
Main Takeaway: Lower neighborhood-level socioeconomic status is independently associated with new hidradenitis suppurativa diagnosis.
Risk of major adverse cardiovascular events and venous thromboembolic events between patients with psoriasis or psoriatic arthritis treated with biologics
Journal of the American Academy of Dermatology
Journal of the American Academy of Dermatology
Biologic battles without cardiovascular casualties!
Psoriasis and psoriatic arthritis are chronic inflammatory conditions associated with an increased risk of cardiometabolic and venous thromboembolic comorbidities. Biologic therapies targeting tumor necrosis factor (TNF), interleukin (IL)-17, IL-12/23, and IL-23 are commonly used treatments, but their impact on major adverse cardiovascular events (MACEs) and venous thromboembolic events (VTEs) remains uncertain. This database study using TriNetX evaluated the real-world risk of MACEs and VTEs in biologic-naive patients with psoriasis initiating biologic therapy.
What did they find?
Main Takeaway: In this large real-world study of biologic-naive patients with psoriatic disease, no significant differences in MACE or VTE risk were observed across individuals managed with TNF-ɑ, IL-17, IL-12/23, and IL-23 inhibitor classes.
Psoriasis and psoriatic arthritis are chronic inflammatory conditions associated with an increased risk of cardiometabolic and venous thromboembolic comorbidities. Biologic therapies targeting tumor necrosis factor (TNF), interleukin (IL)-17, IL-12/23, and IL-23 are commonly used treatments, but their impact on major adverse cardiovascular events (MACEs) and venous thromboembolic events (VTEs) remains uncertain. This database study using TriNetX evaluated the real-world risk of MACEs and VTEs in biologic-naive patients with psoriasis initiating biologic therapy.
What did they find?
- A total of 403,298 biologic-naive adults with psoriasis or psoriatic arthritis were included; among those, 34,728 initiated biologic therapy with TNFis (21,389), IL-17is (6,125), IL-12/23is (3,870), or IL-23is (3,344).
- No significant differences in MACE risk were observed in individuals using IL-17is (IRR 1.14, 95% CI 0.86–1.52), IL-12/23i (IRR 1.24, 95% CI 0.84–1.78, p<0.05), or IL-23i (IRR 0.93, 95% CI 0.61–1.38, p<0.05) compared to TNFi.
- No significant differences in VTE risk were observed in individuals using IL-17is (IRR 1.12, 95% CI 0.63–2.08), IL-12/23i (IRR 1.51, 95% CI 0.73–3.19), or IL-23i (IRR 1.42, 95% CI 0.64–3.25) compared to those using TNFis.
- Cumulative MACE and VTE probabilities over 1-, 3-, and 5-year follow-ups were similar across all biologic treatment groups.
- Among patients with hyperlipidemia or diabetes, newer biologics (IL-17i, IL-12/23i, IL-23i) were associated with lower MACE and VTE risk than TNFis.
Main Takeaway: In this large real-world study of biologic-naive patients with psoriatic disease, no significant differences in MACE or VTE risk were observed across individuals managed with TNF-ɑ, IL-17, IL-12/23, and IL-23 inhibitor classes.
Microbe-host interaction in rosacea and its modulation through topical ivermectin
Journal of Investigative Dermatology
Journal of Investigative Dermatology
Ivermectin tames the flames, but dysbiosis lingers on
Rosacea is a chronic inflammatory condition associated with increased Demodex folliculorum density. While topical ivermectin is a commonly used treatment, its mechanism of action remains unclear. This study evaluated changes in mite density, the cutaneous microbiome, and host transcriptome over a 30-day course of topical 1% ivermectin cream.
What did they find?
Main Takeaway: While topical ivermectin effectively treats rosacea symptoms and reduces Demodex mites, the skin’s bacterial imbalance remains, potentially indicating that microbial dysbiosis is a consequence of rosacea inflammation, not its primary cause.
Rosacea is a chronic inflammatory condition associated with increased Demodex folliculorum density. While topical ivermectin is a commonly used treatment, its mechanism of action remains unclear. This study evaluated changes in mite density, the cutaneous microbiome, and host transcriptome over a 30-day course of topical 1% ivermectin cream.
What did they find?
- After 30 days of treatment, 87.5% of patients (n = 24, P < 0.007) showed marked reduction or complete clearance of Demodex mites.
- By the end of treatment, 43.9% of patients had improved clinical severity scores.
- Despite clinical improvement and mite clearance, microbial dysbiosis persisted throughout treatment.
- In responders, ivermectin treatment normalized inflammatory gene expression, with downregulation of 118 genes.
Main Takeaway: While topical ivermectin effectively treats rosacea symptoms and reduces Demodex mites, the skin’s bacterial imbalance remains, potentially indicating that microbial dysbiosis is a consequence of rosacea inflammation, not its primary cause.
You wanted a sculpted nose, not a guest role in Avatar 3
Nonsurgical rhinoplasty (NSR) with dermal fillers offers immediate results and minimal downtime, but filler migration can lead to a bulbous, widened “Avatar nose.” This cadaveric study introduced the nasofrontal ligament, a previously unrecognized structure, and measured the penetration force required to traverse it using a standardized cannula and a motorized force tester on two fresh-frozen cadavers.
What did they find?
Main Takeaway: The newly identified nasofrontal ligament may play a key role in filler migration during nonsurgical rhinoplasty, and subcision of this structure may help prevent the development of the “Avatar nose.”
Nonsurgical rhinoplasty (NSR) with dermal fillers offers immediate results and minimal downtime, but filler migration can lead to a bulbous, widened “Avatar nose.” This cadaveric study introduced the nasofrontal ligament, a previously unrecognized structure, and measured the penetration force required to traverse it using a standardized cannula and a motorized force tester on two fresh-frozen cadavers.
What did they find?
- The nasofrontal ligament required 6.90 ± 0.57 N of force to penetrate, compared to 2.27 ± 0.36 N at control sites (P < 0.05).
- The ligament tethers the periosteum to the dermal layer, contributing to filler entrapment and the classic “Avatar nose” deformity.
- Subcision of the ligament may reduce filler migration and improve NSR outcomes.
- Prior literature shows that NSR has a 7.6% adverse event rate, with migration being a known complication.
Main Takeaway: The newly identified nasofrontal ligament may play a key role in filler migration during nonsurgical rhinoplasty, and subcision of this structure may help prevent the development of the “Avatar nose.”
Silver-infused breathable fabric for intertrigo in patients with obesity
Journal of Cosmetic Dermatology
Journal of Cosmetic Dermatology
From rash to relief: Let silver do the heavy lifting!
Intertrigo is a chronic inflammatory condition of the skin folds, often seen in patients with obesity due to friction and moisture. In this prospective study, 40 patients with severe obesity were randomized to receive either a moisture-wicking fabric (MWF) infused with antimicrobial silver or a standard regimen of antiseptic/antifungal treatment. Treatment efficacy and clinical improvement were assessed at baseline and daily through day 5, with extended evaluation through day 10 for those needing prolonged treatment.
What did they find?
Main Takeaway: Moisture-wicking fabric infused with antimicrobial silver rapidly improves intertrigo symptoms among patients with severe obesity.
Intertrigo is a chronic inflammatory condition of the skin folds, often seen in patients with obesity due to friction and moisture. In this prospective study, 40 patients with severe obesity were randomized to receive either a moisture-wicking fabric (MWF) infused with antimicrobial silver or a standard regimen of antiseptic/antifungal treatment. Treatment efficacy and clinical improvement were assessed at baseline and daily through day 5, with extended evaluation through day 10 for those needing prolonged treatment.
What did they find?
- 45% of MWF-treated patients had symptom resolution within 5 days vs 20% in the control group.
- 100% of MWF-treated patients achieved full symptom resolution by the end of day 5 vs only 45% in the control group (P = 0.0001).
- Patients with MWF treatment experience significantly faster mean time to full resolution (5.8 ± 2.4 days vs 10.8 ± 3.9 days in the control group; P<0.001).
- Maceration resolved in 100% of MWF patients by day 5, but persisted in 70% of patients in the control group, decreasing to 60% by day 10.
Main Takeaway: Moisture-wicking fabric infused with antimicrobial silver rapidly improves intertrigo symptoms among patients with severe obesity.
GLP-1 agonists and CCCA: Could metabolic health influence hair regrowth?
Journal of the American Academy of Dermatology
Journal of the American Academy of Dermatology
Blood sugar, weight loss, and now hair growth — we’ve WON with GLP-1s!
Central centrifugal cicatricial alopecia (CCCA) is a scarring hair loss condition primarily affecting women of African descent. This retrospective study evaluated whether GLP-1 receptor agonists (GLP1As) might influence clinical outcomes in CCCA.
What did they find?
Central centrifugal cicatricial alopecia (CCCA) is a scarring hair loss condition primarily affecting women of African descent. This retrospective study evaluated whether GLP-1 receptor agonists (GLP1As) might influence clinical outcomes in CCCA.
What did they find?
- 47/81 patients (58%) showed improvement in CCCA symptoms.
- Patients with improved CCCA symptoms used GLP1As longer (3.04 vs. 2.42 years, P = 0.04) and had greater HbA1c reduction (−0.5 vs. +0.1; P = 0.01).
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