seventy-First issue
October 16, 2024
Genetic susceptibility to Hidradenitis Suppurativa and predisposition to cardiometabolic disease
JAMA Dermatology
JAMA Dermatology
When you think hidradenitis suppurativa is just a skin condition, but then you find out it increases your risk of heart disease & diabetes 😳
Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition associated with a higher prevalence of cardiovascular diseases compared to the general population. However, the relationship between genetic predisposition to HS, the risk of cardiometabolic conditions, and plasma protein changes is poorly understood. This cohort study analyzed 391,481 individuals (median age 58 years; 53% female) of European ancestry from the UK Biobank to explore the genetic correlation between HS and cardiometabolic diseases using a polygenic risk score (PRS) for evaluating the risks of coronary artery disease (CAD) and diabetes.
What did they find?
Main Takeaway: This study reveals that individuals with a high genetic risk for HS also have increased risk of developing CAD and diabetes, along with distinct changes in their plasma protein profiles.
Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition associated with a higher prevalence of cardiovascular diseases compared to the general population. However, the relationship between genetic predisposition to HS, the risk of cardiometabolic conditions, and plasma protein changes is poorly understood. This cohort study analyzed 391,481 individuals (median age 58 years; 53% female) of European ancestry from the UK Biobank to explore the genetic correlation between HS and cardiometabolic diseases using a polygenic risk score (PRS) for evaluating the risks of coronary artery disease (CAD) and diabetes.
What did they find?
- Individuals with a higher PRS for HS (75th percentile) had 9% higher odds of developing CAD (OR 1.09, 95% CI, 1.06-1.12; P < 0.001) and 13% higher odds of developing diabetes (OR 1.13, 95% CI, 1.10-1.17; P < 0.001) when compared to those with a lower genetic risk.
- The PRS for HS was linked to changes in the expression of 58 plasma proteins, many of which are involved in inflammatory and metabolic processes, including high-density lipoprotein cholesterol, triglycerides, and C-reactive protein.
Main Takeaway: This study reveals that individuals with a high genetic risk for HS also have increased risk of developing CAD and diabetes, along with distinct changes in their plasma protein profiles.
A clinical trial assessing the clinical similarity of a proposed ustekinumab biosimilar to ustekinumab in subjects with moderate-to-severe plaque psoriasis
Journal of the American Academy of Dermatology
Journal of the American Academy of Dermatology
Biosimilar, or biosuperior? Ustekinumab biosimilar, SB17, holds its weight when compared to the OG ustekinumab for treating psoriasis!
Many biologic medications have high costs, limiting their use. Efforts to create biosimilars, biological products that are highly similar to an approved biologic and designed to have no clinically meaningful differences in safety, efficacy, and quality, can address barriers to accessing biologics. Psoriasis is commonly treated with biologics, among them ustekinumab. This randomized, double-blind, phase III multicenter study evaluated the efficacy, safety, pharmacokinetics, and immunogenicity of SB17, an ustekinumab biosimilar, in subjects with systemic therapy-eligible plaque psoriasis.
What did they find?
Main Takeaway: The ustekinumab biosimilar SB17 demonstrates similar efficacy, safety pharmacokinetics, and lower immunogenicity compared to ustekinumab for treating moderate-to-severe psoriasis.
Many biologic medications have high costs, limiting their use. Efforts to create biosimilars, biological products that are highly similar to an approved biologic and designed to have no clinically meaningful differences in safety, efficacy, and quality, can address barriers to accessing biologics. Psoriasis is commonly treated with biologics, among them ustekinumab. This randomized, double-blind, phase III multicenter study evaluated the efficacy, safety, pharmacokinetics, and immunogenicity of SB17, an ustekinumab biosimilar, in subjects with systemic therapy-eligible plaque psoriasis.
What did they find?
- A total of 503 subjects were included; 249 received the ustekinumab biosimilar (SB17), and 254 received ustekinumab (UST).
- By week 12, the percent change in Psoriasis Area and Severity Index (PASI) from baseline was -0.6% (95% confidence interval: -3.780, -2.579) in those receiving SB17, which was within the equivalence margin of UST to be considered equivalent in efficacy.
- Changes in the Physician’s Global Assessment (SB17: 93.7% vs. UST: 92.2%) and Dermatology Life Quality Index (SB17: 7.5% vs. UST: 6.9%) were comparable between SB17 and UST.
- 48.2% of SB17 subjects and 48.8% of UST subjects had treatment-emergent adverse events (TEAEs), demonstrating a comparable safety profile.
- The pharmacokinetic profiles of SB17 and UST were comparable; however, the immunogenicity differed up to week 28, as the incidence of antidrug antibodies was 13.3% with SB17 and 39.4% with UST.
Main Takeaway: The ustekinumab biosimilar SB17 demonstrates similar efficacy, safety pharmacokinetics, and lower immunogenicity compared to ustekinumab for treating moderate-to-severe psoriasis.
Investigating the transcriptomic signature of conjunctival cells in Dupilumab-treated atopic dermatitis patients with ocular adverse events
Journal of Investigative Dermatology
Journal of Investigative Dermatology
Eyeing the Risk: Unraveling the genes behind Dupilumab’s ocular side effects
Dupilumab, an effective treatment for atopic dermatitis (AD), has been associated with ocular adverse events (OAE) with an unknown mechanism. This bicentric study aimed to investigate the possible mechanisms involved in dupilumab-induced OAE using comparative transcriptomic analysis of superficial conjunctival cells from 36 adult patients with AD both before and four months after starting dupilumab.
What did they find?
Main Takeaway: Specific immunological profiles may predispose certain patients with AD to develop OAE during dupilumab treatment. Identifying patients at risk for OAE can help tailor care to prevent adverse outcomes.
Dupilumab, an effective treatment for atopic dermatitis (AD), has been associated with ocular adverse events (OAE) with an unknown mechanism. This bicentric study aimed to investigate the possible mechanisms involved in dupilumab-induced OAE using comparative transcriptomic analysis of superficial conjunctival cells from 36 adult patients with AD both before and four months after starting dupilumab.
What did they find?
- Of the patients with OAE, 66.7% had corneal superficial punctate keratitis, and 50% had conjunctivitis.
- At baseline, 52 differentially expressed genes (DEG) between patients with and without eventual OAE increased to 113 DEGs four months after starting dupilumab.
- Several genes associated with epidermal keratinocyte differentiation were found to be overexpressed in patients with OAE (P < 0.05).
Main Takeaway: Specific immunological profiles may predispose certain patients with AD to develop OAE during dupilumab treatment. Identifying patients at risk for OAE can help tailor care to prevent adverse outcomes.
Association between patient outcomes, histopathology, and tissue cultures in supposed cellulitis
The American Journal of Dermatopathology
The American Journal of Dermatopathology
Let’s get cultured.
Cellulitis is a bacterial infection of the deep layers of the skin that lacks a gold standard for diagnosis. Skin biopsies have long been used to aid in diagnosis as histopathologic features of infection and positive tissue cultures can be diagnostic.
Researchers retrospectively evaluated the histopathologic characteristics of tissue samples from hospitalized patients with cellulitis (n=105). The presence of infectious features on histopathology and patient outcomes were compared between patients with positive (n=23) and negative tissue cultures (n=65).
What did they find?
Main Takeaway: Positive tissue culture and histopathology showing acute interstitial inflammation are associated with increased mortality and may indicate poor prognosis in cellulitis.
Cellulitis is a bacterial infection of the deep layers of the skin that lacks a gold standard for diagnosis. Skin biopsies have long been used to aid in diagnosis as histopathologic features of infection and positive tissue cultures can be diagnostic.
Researchers retrospectively evaluated the histopathologic characteristics of tissue samples from hospitalized patients with cellulitis (n=105). The presence of infectious features on histopathology and patient outcomes were compared between patients with positive (n=23) and negative tissue cultures (n=65).
What did they find?
- Infectious features were identified in 37 samples (35%) on histopathology.
- Acute perivascular inflammation was the most commonly identified infectious feature (40%).
- Patients with a positive tissue culture were more likely to die within 30 days compared to patients with a negative tissue culture (26% vs. 6%, P = 0.048).
- Patients who died within 30 days were more likely to have acute interstitial inflammation on histopathology (38%, P = 0.03).
Main Takeaway: Positive tissue culture and histopathology showing acute interstitial inflammation are associated with increased mortality and may indicate poor prognosis in cellulitis.
Are your cheek fillers secretly moving to your temples?
Dermatologic Surgery
Dermatologic Surgery
Looks like your cheek fillers are taking a detour!
Post-treatment migration of soft tissue fillers in facial regions is not uncommon, but its impact on aesthetics and safety warrants further investigation. This retrospective study used ultrasound imaging to track the migration of facial fillers from the zygomatic region to the temples. Data from 382 zygomatic areas of 200 patients was collected to assess filler distribution patterns.
What did they find?
Post-treatment migration of soft tissue fillers in facial regions is not uncommon, but its impact on aesthetics and safety warrants further investigation. This retrospective study used ultrasound imaging to track the migration of facial fillers from the zygomatic region to the temples. Data from 382 zygomatic areas of 200 patients was collected to assess filler distribution patterns.
What did they find?
- 89.5% of fillers placed between the fascia/superficial muscular aponeurotic system (SMAS) layers on the zygoma were found to migrate to the superficial temporal fascia.
- 94.7% of fillers placed on the supraperiosteal level shifted to the superficial temporal fat pad.
- Displacement patterns from the zygoma included the superficial temporal fat pad (44.5%), the deep interfascial plane of the temple (30.6%), superficial temporal fascia (21.7%), and other areas (3.1%).
- Redistribution was linked to placement technique, anatomy, and muscular activity.
High frequency neuromuscular electrical stimulation improves facial skin elasticity and reduces wrinkles
Journal of Cosmetic Dermatology
Journal of Cosmetic Dermatology
Who needs wrinkles when high-frequency neuromuscular electrical stimulation can zap them away–like a gym workout for your face, minus the sweat!
Neuromuscular electrical stimulation (NMES) is a non-invasive therapy that induces facial muscle contractions to improve skin elasticity. While most studies focus on low-frequency waves for facial aging, this prospective, single-blind, split-face study assessed the effects of high-frequency NMES on facial aging. Participants (n=24) used an NMES device with basic cosmetic products on the right side of the face, while only the same basic cosmetic products were applied to the left side for two months. Facial wrinkles, sagging, hydration, and skin elasticity were measured at 4 and 8 weeks.
What did they find?
Main Takeaway: High-frequency neuromuscular electrical stimulation shows promising improvement in wrinkles and skin elasticity after 8 weeks of therapy.
Neuromuscular electrical stimulation (NMES) is a non-invasive therapy that induces facial muscle contractions to improve skin elasticity. While most studies focus on low-frequency waves for facial aging, this prospective, single-blind, split-face study assessed the effects of high-frequency NMES on facial aging. Participants (n=24) used an NMES device with basic cosmetic products on the right side of the face, while only the same basic cosmetic products were applied to the left side for two months. Facial wrinkles, sagging, hydration, and skin elasticity were measured at 4 and 8 weeks.
What did they find?
- Net skin elasticity, measured using a Cutometer device, significantly improved with NMES use after 4 weeks (7.06 ± 3.54% vs. −6.00 ± 3.60%, P < 0.01) and 8 weeks (2.31 ± 3.48% vs. −15.84 ± 2.83%, P < 0.01) compared to control.
- At baseline and 4 weeks, there was no difference in wrinkle grade between the intervention and control groups, but by week 8, the intervention group showed significantly lower wrinkle grades (2.67 ± 0.24 vs. 3.50 ± 0.35, P = 0.002).
- No significant difference in skin hydration was observed between the intervention and control groups.
Main Takeaway: High-frequency neuromuscular electrical stimulation shows promising improvement in wrinkles and skin elasticity after 8 weeks of therapy.
Going head-to-head in confronting head and neck melanoma’s racial divide
Cutaneous melanoma of the head and neck presents distinct challenges, with this high-risk area linked to significantly poorer outcomes than other anatomical locations. This study explored differences in disease stage and survival rates among racial and ethnic groups diagnosed with invasive head and neck melanoma.
What did they find?
Cutaneous melanoma of the head and neck presents distinct challenges, with this high-risk area linked to significantly poorer outcomes than other anatomical locations. This study explored differences in disease stage and survival rates among racial and ethnic groups diagnosed with invasive head and neck melanoma.
What did they find?
- Black patients showed the highest rates of distant disease (10.4%) and tumor ulceration (28.1%), compared to lower rates among White (2.5% distant disease, 15.6% ulceration) and Hispanic patients (3.3% distant disease, 17.5% ulceration).
- Survival outcomes were worse for Black patients, with a 68% 5-year survival rate, significantly lower than the 83% observed in White patients.
- After controlling for disease stage, Black patients still faced the highest risk of disease-specific mortality, followed by American Indian/Alaska Native and Hispanic patients.
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Copyright © 2023 - All Rights Reserved.