Dermatology News

Smoking Raises Risk Of Squamous Cell Carcinoma Of The Skin In Women
Regular female smokers have a threefold higher risk of developing squamous cell carcinoma of the skin, researchers from Moffitt Cancer Center reported in Cancer Causes and Control. The authors said they found a slight increase in risk among regular male smokers, but a statistically insignificant one.

Hair greying is associated with active hair growth
Hair greying is an obvious sign of ageing in humans. White (nonpigmented) hair is thicker than black (pigmented) hair. The growth rate of white hair is also significantly higher than that of black hair. However, the mechanism underlying this is largely unknown. This article examined the association between hair greying and hair growth patterns by evaluating expression of the genes or proteins related to hair growth in white and black hairs. Overall it found that Expression of genes and proteins associated with active hair growth is upregulated in white (nonpigmented) hair compared with black (pigmented) hair. These results suggest that hair greying is associated with active hair growth.

Vitamin D status in patients with chronic plaque psoriasis
Vitamin D could have important immuno-modulatory effects in psoriasis. This was a cross-sectional study conducted over 1 year including 145 patients with chronic plaque psoriasis, 112 patients with rheumatoid arthritis (RA) and 141 healthy controls that measured 25-hydroxyvitamin D [25(OH)D], parathyroid hormone (PTH) and calcium serum levels in patients with psoriasis and the associations with some relevant clinical features. The prevalence of vitamin D deficiency (25(OH)D levels <20 ng/mL) in patients with psoriasis was 57.8% versus 37.5% in patients with RA and 29.7% in healthy controls (p=0.001). In winter, the prevalence of vitamin D deficiency rose to 80.9% in patients with psoriasis, to 41.3% in those with RA and to 30.3% in healthy controls (p=0.001). 

Propranolol vs Corticosteroids for Infantile Hemangiomas
The authors of this article sought to determine whether propranolol therapy is safe and effective and superior to oral corticosteroids for treating infantile hemangiomas (IHs). They found that Propranolol therapy was more clinically effective and more cost-effective than oral corticosteroids in treating IHs. It also resulted in fewer surgical interventions and demonstrated better tolerance, with minimal adverse effects, compared with oral corticosteroids. Therefore, propranolol should be considered a first-line agent given its safety and efficacy in the treatment of IHs.

Paraneoplastic Autoimmune Multiorgan Syndrome Proves Rapidly Fatal
The skin may hold the key to differentiating classic pemphigus from the heterogenous autoimmune syndrome known as paraneoplastic autoimmune multiorgan syndrome. It is a distinction of critical prognostic importance, because paraneoplastic autoimmune multiorgan syndrome (PAMS) typically is rapidly fatal, according to Dr. Sergei A. Grando, professor of dermatology and biologic chemistry at the University of California, Irvine. "The vast majority of patients die within several months of diagnosis, usually due to infections or respiratory failure, often taking the form of multiorgan system failure.

Ustekinumab a Strong Option for Moderate to Severe Psoriasis
Ongoing studies of the novel interleukin (IL)12/23 monoclonal antibody ustekinumab (Stelara; Janssen Biotech, Inc [formerly Centocor]; Horsham, Pennsylvania) continue to show sustained efficacy and a high benefit-to-risk ratio, with a number needed to treat (NNT) of less than 2. Results were reported here at the American Academy of Dermatology (AAD) Summer Academy Meeting. Ustekinumab has been approved for the treatment of moderate to severe psoriasis. The AAD included this drug in its treatment guidelines, published in the February issue of the Journal of the American Academy of Dermatology,for the treatment of moderate to severe psoriasis. At the AAD Annual Meeting, also in February, new study findings showed that the drug achieves a high resolution of symptoms but does not affect the underlying disease process.

Long-term NSAID use lowers risk for melanoma
Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) appears to reduce the risk for cutaneous melanoma, suggest study findings. NSAIDs have been shown to have a chemoprotective effect against colorectal cancer when taken frequently over an extended period of time. Although some observational and animal studies have suggested this effect might also exist for melanoma, others have produced conflicting results. Overall The researchers found that after adjusting for age, gender, and town, any use of NSAIDs decreased the risk for melanoma by a significant 27% compared with no use.

Melanoma Survival Benefit Called 'Astounding'
 Patients with metastatic melanoma had an "astounding" 63% reduction in the risk of death when treated with an investigational agent that targets a mutation found in about half of the tumors, data from a large international trial showed. Treatment with the BRAF inhibitor vemurafenib improved progression-free survival (PFS) by 74%. Analysis of six-month overall survival (OS) showed a 20% absolute difference between patients treated with vemurafenib versus dacarbazine. Though follow up is brief, the results already make a case for vemurafenib as the comparator for future trials of new agents for advanced melanoma, Paul. B. Chapman, MD, of Memorial Sloan-Kettering Cancer Center in New York City, said at the American Society of Clinical Oncology meeting.

The use of topical phenytoin for healing of chronic venous ulcerations
Many topical agents have been used for promotion of healing of chronic venous ulcers. One such agent that has been tried is phenytoin. The effect of phenytoin on cutaneous healing has been suggested. This study was designed to evaluate the efficacy of topical phenytoin in healing of venous ulcerations. One hundred and four patients with chronic venous ulcers were recruited in this study. They were divided into study group and control group. The study group was 54 patients while control group was 50 patients. Patients in the study group were subjected to dressing of their ulcers with topical phenytoin once daily while patients in the control group were subjected to dressing with normal saline. All patients were followed up for eight weeks and assessed for their ulcer status and recorded as: complete healing, partial healing, no improvement or worsening of the condition. By the end of the eight weeks, complete healing was evident in 35/54 of the patients (64.8%) in the study group and 26/50 of the patients (52%) in the control group. It was statistically significant (p=.04). The rate of reduction in the mean surface area of the ulcers was faster in the study group than control group. Minor side effects were reported among 4 patients (7.4%) of the study group in the form of burning sensation. By the end of the eight weeks, complete healing was evident in 35/54 of the patients (64.8%) in the study group and 26/50 of the patients (52%) in the control group. This article showed that Topical phenytoin can be used to enhance healing of chronic venous ulcers in conjunction with the established treatment. It has favorable results and tolerable local side effects.

Recurrence After Treatment of Nonmelanoma Skin Cancer
This authors of this article sought to determine long-term tumor recurrence rates after treatment of primary nonmelanoma skin cancer (NMSC). Data are currently insufficient to permit evidence-based choices among treatments for NMSC. This article was a prospective study of an inception cohort observed for a median of 6.6 years after treatment. Consecutive sample of all 495 patients with 616 primary NMSCs diagnosed in 1999 and 2000 and treated with electrodessication and curettage (ED&C), excision, or Mohs surgery. Follow-up was available for 608 tumors (99%). Overall the recurrence of primary NMSC after treatment occurred in less than 5% of tumors. The recurrence rate after ED&C was lower than expected, and the recurrence rate after Mohs surgery was higher than expected. These findings may be related to the risk for recurrence in the treatment groups.

Comorbidity profiles among patients with bullous pemphigoid: a nationwide population-based study
 It has been described that bullous pemphigoid (BP) is associated with neurological and psychiatric diseases. However, large-scale population-based study of different comorbid diseases in BP patients is quite limited. The authors sought to analyze the prevalence of neurological, psychiatric, autoimmune, and inflammatory skin diseases before the diagnosis of BP and their associations with BP among patients with BP from a nationwide database in Taiwan. Overall it was shown that patients with BP are more likely to have various neurological diseases, schizophrenia, and psoriasis before the diagnosis of BP, supporting associations found in other studies. Further research is required to elucidate the tentative causal association with BP.

Blood Test May Help Predict Spread of Melanoma
It's possible that a blood test could be used to predict the risk of cancer spreading, or metastasizing, in people who have melanoma skin cancer, a new study suggests. Researchers from Yale University tested the blood of 108 people with metastatic melanoma and 108 people with stage 1 or 2 melanoma and found that those with metastatic disease had higher levels of several biomarkers. Though 83 percent of people with metastatic cancer had elevations of at least one of the markers, there were no elevations in 76 percent of those with early-stage cancer, the investigators found. The study findings are reported in the April 15 issue of Clinical Cancer Research.

A Randomized Comparison of Methods of Selecting Narrowband UV-B Starting Dose to Treat Chronic Psoriasis
The authors compared narrowband UV-B (TL-01 lamp) phototherapy for psoriasis with individual patient starting doses based on minimal erythemal dose (MED) determination vs a standard fixed starting dose and to compare the efficacy of 70% of MED vs 50% of MED starting dose regimens. A total of 210 adult patients (207 of skin phototypes I to III) referred for narrowband UV-B to treat chronic psoriasis. The study was designed to have 90% power to detect a difference of 3 or more treatments to clearance and/or minimal residual activity (MRA) between groups. Overall The methods of determining the starting dose in this predominantly skin phototype I and II population, treated 3 times weekly, with a 20% followed by 10% incremental reduction in dose, did not significantly influence the effectiveness of treatment. Had there been a clinically important difference in efficacy, we would have expected to identify this. Thus, basing starting dose on individual MED assessments may not influence the treatment's efficacy in a skin phototype I to III population, although it remains important for patient safety. It remains possible that in populations containing individuals with a broader range of erythemal sensitivity, basing the starting dose on MED testing could have an important impact on treatment effectiveness.

Staphylococcus epidermidis: A possible role in the pustules of rosacea
Rosacea is a common skin and ocular disease. Cutaneous rosacea is characterized by facial flushing, telangiectasia, papules, and pustules. It is generally regarded as inflammatory in nature. This article sought to ascertain whether there is an increase in the bacteria isolated from the (1) pustules of rosacea; and (2) eyelid margins of persons with cutaneous pustular rosacea. A pure growth of Staphylococcus epidermidis was isolated from a pustule of 9 of 15 patients with pustular rosacea, and no pure growth of S epidermidis was isolated from their ipsilateral cheek skin. This was a highly statistically significant increase (P = .0003). A pure growth of S epidermidis was isolated from the eyelid margins of 4 of 15 patients with pustular rosacea, and no pure growth was isolated from the eyelids of age- and sex-matched control subjects. This was a statistically significant increase (P = .05). These findings findings suggest S epidermidis may play a role in pustular and ocular rosacea.

Combination strategy may change psoriasis treatment 
In early testing, an experimental protocol combining excimer laser (XTRAC Velocity, PhotoMedex), clobetasol spray and topical calcitriol ointment achieves fast, impressive results in patients with severe, generalized psoriasis.

Vitamin D: a novel therapeutic approach for keloid
Vitamin D and its metabolites play an important role in calcium homeostasis; bone remodeling, hormone secretion, cell proliferation, and differentiation. Recent studies also suggest a beneficial role of vitamin D in slowing the progression of tissue fibrosis. However their effects on dermal fibrosis-keloid are unknown. This study highlights key mechanistic pathways through which vitamin D decreases fibrosis, and provides a rationale for studies to test vitamin D supplementation as a preventive and/or early treatment strategy for keloid and related fibrotic disorders.

Celecoxib May Prevent Non-Melanoma Skin Cancers
In patients with extensive actinic keratosis, celecoxib may help prevent non-melanoma skin cancers, according to findings from a randomised clinical trial published online November 29 inThe Journal of the National Cancer Institute. Non-melanoma skin cancers, including cutaneous squamous cell carcinomas (SCCs) and basal cell carcinomas (BCCs), are among the most common cancers in the United States. Actinic keratosis is often a precursor to these cancers.

IgM in lesional skin of adults with Henoch-Schönlein purpura is an indication of renal involvement
Henoch-Schönlein purpura (HSP) is a multisystem disease believed to be a consequence of the entrapment of circulating IgA-containing immune complexes in blood vessel walls throughout the skin, kidneys, and gastrointestinal tract. The skin manifestations are characterized by nonthrombocytopenic palpable purpura over the lower extremities. This article assessed adult patients with HSP who had nonthrombocytopenic palpable purpura on the extensor surfaces of their lower limbs, and had no associated connective tissue disease. Patient medical records, including clinical presentation, laboratory data, and direct immunofluorescence (DIF) reports, were reviewed retrospectively. This study suggests that IgM deposition in palpable purpura based on DIF provides an indicator of nephritis in adult patients with HSP. We believe that IgM deposition could be related to the pathogenic factors that trigger the development of renal involvement.

Malignant transformation of nevi unlikely in pregnant patients
Melanocytic nevi always have the potential to change in size, shape and color regardless of when they first appear in the skin, or the age of the patient. A recent study shows that though some nevi demonstrate dynamic change throughout a pregnancy, there does not appear to be an increased risk of malignant transformation of these nevi, nor is there an association between changing nevi and melanoma.

Acitretin Therapy For Hidradenitis Suppurativa
Hidradenitis suppurativa (HS) is a distressing chronic inflammatory skin disorder which affects predominantly the groins and axillae. In analogy to acne, oral isotretinoin has been considered in the treatment of HS, although there are strong indications that this drug has only a very limited therapeutic effect. This article evaluated the long-term efficacy of acitretin monotherapy and found thataAcitretin appears to be an effective treatment for refractory HS, leading to reduction of pain from painful nodules and the extent of the disease for a prolonged period.

Serious mental illnesses increased in psoriasis patients
Patients with psoriasis have an increased risk for clinical depression, anxiety, and suicidal behavior, including ideation and attempt, compared with the general population, study findings indicate. Shanu Kohli Kurd and colleagues, from the University of Pennsylvania in Philadelphia, estimate that in the UK, in excess of 10,400 diagnoses of depression, 7100 diagnoses of anxiety, and 350 diagnoses of suicidality are attributable to psoriasis annually.. "It is important to identify these psychiatric disorders because they represent substantial morbidity that can be improved with a variety of pharmacological and nonpharmalogical approaches," the researchers note in the Archives of Dermatology. For More Medicine News Visit Our Dermatology Archives