The latest medical research on Dermatology

The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about dermatology gathered by our medical AI research bot.

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HLA-Cw1 and Psoriasis.

American Journal of Clinical Dermatology

Psoriasis is a chronic inflammatory skin condition with regional and ethnic differences in its prevalence and clinical manifestations. Human leukoc...

Association between hospital-diagnosed atopic dermatitis and psychiatric disorders and medication use in childhood.

British Journal of Dermatology

While adult atopic dermatitis (AD) is associated with anxiety and depression and pediatric AD is linked to attention deficit hyperactivity disorder, the relationship between AD in childhood and other psychiatric disorders is largely unknown.

To determine the relationship between AD and diagnosis and treatment of psychiatric disorders in children.

All Danish children born between January 1st , 1995 and December 31st , 2012 with a hospital diagnosis of AD (n=14,283) were matched 1:10 with children without a hospital diagnosis of AD. Endpoints were psychotropic medication use, hospital diagnoses of depression, anxiety, ADHD, or self-harming behavior, accidental/suicidal death, and consultation with a psychiatrist or psychologist.

Significant associations were observed between hospital-diagnosed AD and antidepressant [adjusted hazard ratio (aHR) 1.19; 95% confidence interval (CI) 1.04-1.36], anxiolytic (aHR 1.72; 95% CI 1.57-1.90), and centrally acting sympathomimetic (aHR 1.29; 95% CI 1.18-1.42) medication use. Consultation with a psychiatrist (aHR 1.33; 95% CI 1.16-1.52) or psychologist (aHR 1.25; 95% CI 1.11-1.41) were also associated with AD. No association with a hospital-diagnosis of depression (aHR 0.58; 95% CI 0.21-1.56), anxiety (aHR 1.47; 95% CI 0.98-2.22) or self-harming behavior (aHR 0.88; 95% CI 0.27-2.88) was observed, but a diagnosis of attention deficit hyperactivity disorder (aHR 1.91; 95% CI 1.56-2.32) was significantly associated with AD. The absolute risks were generally low.

The increased risk of treatment, but not of hospital-diagnosis of psychiatric disorders in children with hospital-diagnosed AD, suggests that psychiatric issues in children with AD could be of transient, reversible or mild-moderate nature.

Hand Eczema in Children Referred for Patch Testing: North American Contact Dermatitis Group Data, 2000-2016.

British Journal of Dermatology

Little is known about the etiologies and relevant allergens in pediatric patients with hand eczema (HE).

To characterize the etiologies and determine proportion of positive and currently relevant allergens in children/adolescents (age <18 years) with HE referred for patch testing.

Retrospective analysis (2000-2016) of North American Contact Dermatitis Group data.

Of 1,634 pediatric patients, 237 (14.5%) had any involvement of the hands. Final physician-diagnoses included allergic contact (49.4%), atopic (37.1%) and irritant contact dermatitis (16.9%). In multivariable logistic regression models, employment was the only association with increased odds of any HE or primary HE. Children with vs. without HE had similar proportions of positive patch tests (56.1% vs. 61.7%; Chi-square, P=0.11). The five most common currently relevant allergens were nickel, methylisothiazolinone, propylene glycol, decyl glucoside and lanolin. In multivariable logistic regression models of the top 20 relevant allergens, HE was associated with significantly higher odds of currently relevant reactions to lanolin, quaternium-15, Compositae mix, thiuram mix, 2-mercaptobenzathiazole and colophony. Allergens with highest mean SPIN were methylisothiazolinone, carba mix, thiuram mix, nickel, methylchloroisothiazolinone/methylisothiazolinone.

Children with HE who were referred for patch testing had a high proportion of positive patch tests, which was similar to children without HE. Children with HE had a distinct and fairly narrow profile of currently relevant allergens.

Black in the ivory.

British Journal of Dermatology

To be Black in the United States is to be a minority in almost every context, including in medicine. I will be part of the 2% of physicians who are...

A multicenter study of nevus-associated melanoma versus de novo melanoma, tumor thickness and body site differences.

British Journal of Dermatology

Whether melanoma in histological contiguity with a nevus (nevus-associated melanoma, NAM) is distinctly different from melanoma arising de novo remains unclear.

To determine whether the characteristics of de novo melanoma differ from NAM and are not due to nevus obliteration in thicker tumors.

A multicenter retrospective study of de novo melanoma and NAM in 7 referral centers in Europe, Australia and the USA, between 2006 and 2015.

In a total of 9,474 localized melanomas, de novo melanoma compared to NAM was associated with thicker tumors and body-site differences. In the subset of T1 melanomas (n=5,307), similar body-site differences were found in multivariate analysis by body site: de novo melanoma compared to NAM, was more likely to affect older individuals (≥70 years) when located on the head/neck (OR: 4.65, 95% CI: 2.55-8.46), on the trunk (OR: 1.82, 95% CI:1.40-2.36), or on the upper extremity (OR: 1.69, 95% CI: 1.14-2.50), to affect females when located on the lower extremities (OR:1.36, 95% CI: 1.03-1.80), to be of the NM subtype (OR: 2.23, 95% CI: 1.14-4.35) when located on the trunk, while it was less likely to have regression present.

Clinicopathological and body site differences between de novo melanoma and NAM support divergent pathways of development. These differences were also found in thin melanomas, suggesting that de novo melanomas are different from NAM and their differences are not due to the obliteration of nevus remnants in thicker tumors.

Identification of compound heterozygous mutations in AP1B1 leading to the newly-described recessive keratitis-ichthyosis-deafness (KIDAR) syndrome.

British Journal of Dermatology

Recently, mutations in Adaptor Related Protein Complex 1 Subunit Beta 1 (AP1B1) have been identified as the cause of a new form of syndromic ichthy...

Relationship between type 2 diabetes mellitus and markers of cutaneous melanoma aggressiveness: An observational multi-centric study in 443 patients with melanoma.

British Journal of Dermatology

Some studies have suggested a relationship between type 2 diabetes mellitus (T2DM) and increased incidence of melanoma. Efforts are underway to identify preventable and treatable factors associated with greater melanoma aggressiveness, but no studies to date have examined the relationship between T2DM and the aggressiveness of cutaneous melanoma at diagnosis.

To explore potential associations between T2DM, glycaemic control and metformin treatment and the aggressiveness of cutaneous melanoma.

Cross-sectional multi-centric study in 443 patients diagnosed with cutaneous melanoma. At diagnosis, all patients completed a standardised protocol and a fasting blood sample was extract to analyse their glucose levels, glycated haemoglobin concentration and markers of systemic inflammation. Melanoma characteristics and aggressiveness factors (Breslow thickness, ulceration, tumour mitotic rate (TMR), sentinel lymph node (SLN) involvement and tumour stage) were also recorded.

The patients' mean age was 55.9±15.5 (SD) years and 50.6% were male. Their median Breslow thickness was 0.85, with 56% at ≤ 1 mm, 21.7% at >1-2 mm, 14.2% at >2-4 mm and 8.1 at >4 mm. Forty-eight (10.8%) patients were diagnosed with T2DM. and this finding was associated with a Breslow thickness >2 (OR 2.6; 95%CI: 1.4-4.9; p=0.004) and > 4 mm (OR 3.6; 95%CI: 1.7-7.9; p=0.001), TMR >5/mm2 (OR 4.5; 95%CI: 1.4-13.7; p=0.009), SLN involvement (OR 2.3; 95%CI: 1-5.7; p=0.038) and tumour stages III-IV (vs. I-II) (OR 3.4; 95%CI: 1.6-7.4; p=0.002), after adjusting for age, gender, obesity, alcohol intake and smoking habits. No significant associations emerged between glycated haemoglobin levels, metformin treatment and melanoma aggressiveness.

T2DM, rather than glycaemic control and metformin treatment, is associated with increased cutaneous melanoma aggressiveness at diagnosis.

Interventions for basal cell carcinoma: abridged Cochrane systematic review and grade assessments.

British Journal of Dermatology

Basal cell carcinoma (BCC) is the commonest cancer affecting white-skinned individuals, and worldwide incidence is increasing. Although rarely fatal, BCC is associated with significant morbidity and costs.

To assess the effects of interventions for primary BCC in immunocompetent adults.

We updated our searches of the following databases to November 2019: Cochrane Skin Group Specialised Register, CENTRAL, MEDLINE, Embase, CINAHL, and LILACS. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method. We used standard methodological procedures expected by Cochrane.

We included 52 RCTs with 6990 participants (median age 65 years, range 20-95). Mean study duration was 13 months (range 6 weeks to 10 years). Ninety-two percent (48/52) of studies exclusively included histologically low-risk BCC (nodular and superficial subtypes). The certainty of evidence was predominantly low or moderate for the outcomes of interest. Overall, surgical interventions have the lowest recurrence rates, and there may be slightly fewer recurrences with MMS over SE for primary, facial BCC (high-risk histological subtype or located in the 'H-zone' or both) (low-certainty evidence). Non-surgical treatments, when used for low-risk BCC, are less effective than surgical treatments, but recurrence rates are acceptable and cosmetic outcomes are probably superior.

Surgical interventions have lower recurrence rates and remain the gold-standard for high-risk BCC. Of the non-surgical treatments, topical imiquimod has the best evidence to support its efficacy for low-risk BCC. Priorities for future research include agreement on core outcome measures and studies with longer follow-up.

Mitochondrial DNA-depleter mouse as a model to study human pigmentary skin disorders.

Pigment Cell and Melanoma Research

Pigmentation abnormalities are reported in the spectrum of phenotypes associated with aging and in patients with mitochondrial DNA depletion syndro...

Germline variants in exonic regions have limited impact on immune checkpoint blockade clinical outcomes in advanced melanoma.

Pigment Cell and Melanoma Research

Immune-checkpoint inhibition (ICI) treatments improve outcomes for metastatic melanoma; however, up to 60% of treated patients do not respond to IC...

A 1% glycopyrronium bromide cream for the topical treatment of primary axillary hyperhidrosis: Efficacy and Safety Results from a Phase 3a Randomised Controlled Study.

British Journal of Dermatology

Effective topical treatment options for patients with primary axillary hyperhidrosis are limited. Recent phase 1 trial showed promising results regarding efficacy and safety for topical cream containing glycopyrronium bromide (GPB).

To assess efficacy, safety and tolerability of a 4-week topical treatment with 1% GPB cream in subjects with primary axillary hyperhidrosis compared to placebo.

171 patients (84 placebo; 87 1% GPB) with primary axillary hyperhidrosis were included in this 4 week, multicenter, randomised, double-blind, placebo-controlled Phase 3a part of the pivotal study. Sweat production was measured by gravimetry. Patients rated disease impact using the Hyperhidrosis Disease Severity Scale (HDSS) and Hyperhidrosis Quality of Life Index (HidroQoL© ).

Absolute change in sweat production from baseline to day 29 in logarithmic values was significantly larger in the 1% GPB group than in the placebo group (p=0.0038). The improvement in HidroQoL© exceeded minimal clinically important difference of 4. The proportion of responders was two-fold higher than for placebo for sweat reduction, HDSS and HidroQoL© (-197.08 mg GPB vs. -83.49 mg placebo; 23% GPB vs 11.9% placebo and 59.8% GPB vs. 26.2% placebo respectively). Treatment was safe, most TEAEs were mild or moderate and transient. Local tolerability was very good with 9.2% of patients having only mild or moderate application site reactions. The most reported ADR was dry mouth (16.1%), an expected anticholinergic effect of the treatment.

1% GPB cream may provide an effective new treatment option exhibiting a good safety profile for patients with primary axillary hyperhidrosis. The long-term open-label part (Phase 3b) is ongoing.

Myron Gordon Award paper: Microbes, T-cell diversity and pigmentation.

Pigment Cell and Melanoma Research

Melanocytes are static, minimally proliferative cells. This leaves them vulnerable in vitiligo. Yet upon malignant transformation, they form viciou...