Highlights of noteworthy, peer-reviewed, evidence-based articles in dermatology.
Acne and social media: a cross-sectional study of content quality on TikTok
Zheng DX, Ning AY, Levoska MA, et al. Pediatr Dermatol. 2020 Nov 28. Online ahead of print.
Summary. Many adolescents are gathering acne-relation information from TikTok, a social media platform that has quickly gained popularity. For this study, researchers explored approximately 100 videos under the tag “#acne” on the social media platform to analyze the acne-related content being presented. Criteria for quality (and identification of any shortcomings) of the acne-related content was determined by the DISCERN instrument, as described by the researchers. The authors found the quality of acne information on TikTok was generally poor, recommending that dermatologists “prioritize acne education in this patient demographic” due to the generally low quality of available information on this social network.
The challenge of nanovesicles for selective topical delivery for acne treatment: enhancing absorption whilst avoiding toxicity
Mancuso A, Cristiano MC, Fresta M, Paolino D. Int J Nanomedicine. 2020 Nov 19;15:9197–9210.
Summary. According to Mancuso et al, 80 percent of adolescents are affected by acne, with several available treatment options. Unfortunately, many treatment methods have side effects, ranging in severity. Previously published literature has shown that there are drug delivery systems that can mitigate some of these side effects. Here, researchers analyzed the benefits and limitations of drug delivery systems used in acne therapies.
Efficacy and safety of topical clascoterone cream for treatment of acne vulgaris: a systematic review and meta-analysis of randomized placebo-controlled trials
Alkhodaidi ST, Al Hawsawi KA, Alkhudaidi IT, Magzoub D, Abu-Zaid A. Dermatol Ther. 2020 Dec 1:e14609. Online ahead of print.
Summary. Using published data from relevant trials, Alkhodaidi et al assessed the efficacy and safety of clascoterone cream, a topical acne therapy, in patients with acne vulgaris. The researchers used the Investigator’s Global Assessment (IGA) success scores, absolute change in inflammatory and noninflammatory lesion counts, and any treatment-emergent adverse events in their assessment. Of the five clinical trials reviewed, patients who were given clascoterone cream had greater improvement in IGA scores and lower noninflammatory lesion counts compared to those who received a placebo.
The effect of water hardness on atopic eczema and skin barrier function: a systematic review and meta-analysis
Jabbar-Lopez ZK, Ung CY, Alexander H, et al. Clin Exp Allergy. 2020 Dec 1. Online ahead of print.
Summary. Due to a correlation between hard domestic water, defined by high calcium carbonate; CaCO3, and the worsening (and early development) of atopic eczema, researchers used the published data of 16 studies to evaluate the atopic eczema development risk, treatment of the skin condition, and skin barrier function in both humans and animals. By utilizing the grading of recommendations, assessment, development and evaluations approach, Jabbar-Lopez et al found a positive relationship between residing in a hard-water area and atopic eczema in children but noted there was no evidence to suggest water softeners could improve its severity in cases where the skin condition was already existent.
Eczema in elderly people
Tétart F, Joly P. Eur J Dermatol. 2020 Nov 30. Online ahead of print.
Summary. Here, the authors described the differential diagnoses, comorbidities, drug-induced effects, and management and treatment options for elderly patients with eczema. They began their review by exploring which differential diagnoses should be eliminated when it pertains to consultation of elderly patients with eczema, noting that contact dermatitis and any interaction with quotidian chemicals influence any potential comorbidities. Some of the management and therapeutic options examined included emollients, dermocorticosteroids, local corticosteroids, and phototherapy.
Childhood rosacea and related disorders
Noguera-Morel L, Hernández-Martín A, Torrelo A. Clin Exp Dermatol. 2020 Nov 20. Online ahead of print.
Summary. Noguera-Morel et al reviewed the pathogenesis, clinical manifestations, therapies, and management of rosacea in children. The researchers highlighted that genetic and environmental factors, as well as immune system function and neurovascular modifications, all influence the development of the skin and eye condition. Additionally, the researchers suggested that the focus of management is to determine triggers, use topical therapies in children with mild cases, and use oral agents combined with topical treatments for more severe cases.
Updates on the risk of neuropsychiatric and gastrointestinal comorbidities in rosacea and its possible relationship with the gut-brain-skin axis
Woo YR, Han YJ, Kim HS, Cho SH, Lee JD. Int J Mol Sci. 2020 Nov 10;21(22):8427.
Summary. According to Woo et al, a heightened risk of developing comorbidities, such as cardiovascular, psychiatric, neurologic, and/or gastrointestinal disorders, is present in patients with rosacea, though why this occurs is not clear. In this review, the researchers offered the most recent data regarding neuropsychiatric and gastrointestinal comorbidities risk in patients with rosacea. The authors explored how gut-brain-skin axis relates to the development of comorbitities in patients with rosacea.
Facial flushing and erythema of rosacea improved by carvedilol
Seo BH, Kim DH, Suh HS, Choi YS. Dermatol Ther. 2020 Nov 11:e14520.
Summary. Management of flushing and erythema, which are common symptoms of rosacea, is challenging. Investigators evaluated the effectiveness of carvedilol for treating facial flushing and erythema in 24 participants with rosacea.Each participant received 6.25mg of carvedilol once or twice daily, which eventually was increased to 12.5mg. Throughout the study, erythema assessment and patient self-assessment scale scores were used identify any changes in erythema severity, as well as form comparisons to baseline. The scores indicated improvement in erythema, with no serious adverse effects or variances between sex, disease duration, and previous therapy exposure. The investigators concluded that carvedilol was an “effective and safe treatment option for rosacea patients suffering from facial flushing and erythema.”
Integrated molecular drivers coordinate biological and clinical states in melanoma
Conway JR, Dietlein F, Taylor-Weiner A, et al. Nat Genet. 2020 Dec;52(12):1373–1383
Summary. Conway et al identified various global genomic properties within subtypes (BRAF, (N)RAS, NF1, and triple wild type) involved in the mutation process of 1,048 melanomas. The researchers claimed to have identified the environment of the triple wild-type subtype and discovered its DNA-repair-defect signatures, which have been correlated to cellular reduction of essential DNA-repair genes. The investigators highlighted that this might “revive previously discarded or currently unconsidered therapeutic modalities for genomically stratified melanoma patient subsets.”
Physical plasma-treated skin cancer cells amplify tumor cytotoxicity of human natural killer (nk) cells
Clemen R, Heirman P, Lin A, Bogaerts A, Bekeschus S. Cancers (Basel). 2020 Nov 30;12(12):E3575.
Summary. Squamous cell carcinoma and malignant melanoma are the most fatal forms of skin cancer. Alongside surgery and radiotherapy, cold physical plasma therapy, which produces reactive oxygen species, is a becoming another anticancer method, given its ability to reduce inflammation and adaptive immunity. Here, Clemen et al examined the influence of cold physical plasma on two cancer cells (with nonmalignant HaCaT keratinocytes as controls) and determined the prominence of its treatment time-dependent toxicity in cancer cells. Researchers found this type of therapy regulated activating and inhibiting receptors better than HaCaT cells, and increased the killing rates of natural killer cells.
Wearable bracelet monitoring the solar ultraviolet radiation for skin health based on hybrid ipn hydrogels
Hu N, Lin L, Tan J, et al. ACS Appl Mater Interfaces. 2020 Dec 2. Online ahead of print.
Summary. Extensive solar ultraviolet radiation exposure can accelerate skin aging and solar erythema and heighten one’s risk of developing skin cancer. Because of typical overexposure to sunlight, researchers believe that monitoring solar ultraviolet radiation can be beneficial for skin health. Hu et al analyzed a wearable bracelet that can perform such a function, with discoloration being the key indicator of too much sunshine, for example. After thoroughly discussing its innerworkings and how it gathers data, researchers concluded that it is a “promising candidate for wearable devices for skin health management.”
Effect of very low-calorie ketogenic diet on psoriasis patients: a nuclear magnetic resonance-based metabolomic study
Castaldo G, Pagano I, Grimaldi M, et al. J Proteome Res. 2020 No 9. Online ahead of print.
Summary: Research has indicated there is a link between psoriasis and obesity due to the overabundance of adipose tissue in obesity that causes an inflammatory response. Castaldo et al evaluated the effects of a ketogenetic diet on the inflammatory response in 30 patients with psoriasis after four weeks of following the relative nutritional regimen.
Quality of life, treatment goals, preferences and satisfaction in older adults with psoriasis: a patient survey comparing age groups
van Winden MEC, Ter Haar ELM, Groenewoud JMM, et al. Br J Dermatol. 2020 Nov 5. Online ahead of print.
Summary: Researchers reviewed published data to determine factors that impact the effectiveness of psoriasis management in geriatric patients. The authors found that while past studies have reported comparable disease severity in patients 65 years of age or older and those under the age of 65, the psoriasis treatments used in these studies differed between age groups, which, the authors postulate, could be due to differences in comorbidities and comedication, disease perception, and/or patient preferences. Because little is known about these topics in the geriatric population and because the currently available quality of life (QoL) assessment tools do not always appropriately reflect true QoL impairment in older adults, the authors acknowledged the complexity of managing psoriaris in this older population.
Evaluation of the correlation between scales determining disease severity in patients with moderate-severe, chronic, plaque-type psoriasis
Gundogdu M, Kundakci N. J Cosmet Dermatol. 2020 Nov 3. Online ahead of print.
Summary: Gundogdu et al analyzed the correlation between physical assessment methods (Psoriasis Area and Severity Index [PASI] and body surface area [BSA] involvement) and quality of life scales (Dermatology Life Quality Index [DLQI] and Psoriasis Disability Index [PDI]) when determining the severity of psoriasis. The PASI, BSA, DLQI, and PDI scores were collected from 51 participants, but researchers were unable to find any correlations.
Oxidized lipids and lipoprotein dysfunction in psoriasis
Sorokin AV, Remaley AT, Mehta NN. J Psoriasis Psoriatic Arthritis. 2020;5(4):139–146.
Summary: Using data from relevant, previously published review and research articles, Sorokin et al sought to determine the correlation between psoriatic inflammation, lipid oxidation, and heighted cardiovascular disease risk. Researchers found that the systemic inflammation that influences psoriasis is linked to an accretion of pro-inflammatory oxidized lipids, which eventually forms the proatherogenic oxidized low- and high-density lipoproteins linked to cardiovascular disease. Though anti-inflammatory therapies are effective in treating psoriasis, more research is needed to determine how to moderate cardiometabolic triggers.
Impact of smoking on psoriasis risk and treatment efficacy: a meta-analysis
Zhou H, Wu R, Kong Y, et al. J Int Med Res. 2020;48(10):300060520964024.
Summary: Zhou et al assessed the correlation between smoking and psoriasis, including the impact smoking may have on risk of developing psoriaris and the effectiveness of psoriasis therapies. The authors analyzed published data using a fixed-effects model to collect odds ratios with 95-percent confidence intervals. Analyzed data indicated that smoking lessens the effectiveness of biologic agents used in the treatment of psoriasis, as well as increases the risk of psoriasis development.