Dermatological Skin Research Articles

Artificial Intelligence and Machine Learning in Dermatological Research and Healthcare: British Society for Investigative Dermatology Skin Club Report - Southampton April 2024.

The British Society for Investigative Dermatology champions the development of clinical trainees and early career researchers and convenes the UK skin research community at its annual meeting. It is the privilege of the meeting organiser (Dr. Chester Lai) to invite key opinion leaders to speak at the “Skin Club” section of the meeting, a forum for dialogue with this young audience on disruptive advances that stand to shape skin science. This year in Southampton, the topic “Artificial Intelligence and Machine Learning in Dermatological Research and Healthcare”, was selected.

Analysis of registered clinical trials in Italy regarding dermatology (2003-2022): a cross-sectional study on historical trend and prospects for industry investments.

This cross-sectional analysis intends to evaluate trend and outlook of industry clinical research in Italy regarding dermatology and its prospects for the next few years. A computerized search of ClinicalTrial.gov database was carried out considering the 20-year period 2003-2022 using the following string: "Skin Diseases OR Skin cancer OR Skin Neoplasms OR Skin Infection OR Skin Lesion OR Skin Ulcer OR Skin Laxity OR Skin toxicity OR Dermatologic Complication OR Skin abnormalities". During the last 20 years 690 Industry Clinical Trials (IndCTs) were conducted in Italy regarding dermatological investigations, almost entirely funded by non-Italian pharmaceutical companies, involving 4497 centers, and recruiting an average of 13.0 subjects per site. The number of controlled and randomized studies has grown quite regularly and in the last 5 years they represented 79.6% of IndCTs initiated. Countries most frequently sharing with Italy international protocols were Spain (75.0%), Germany (71.8%), France (68.5%), the USA (67.4%), and the UK (54.8%). These data point to a historical involvement of Italy in dermatology IndCTs lower than in the major European countries. However, the war in Ukraine has deprived IndCTs of the contribution of Russia, Ukraine, and Belarus, meaning a mean of about 40 new IndCTs per year in a population of 200 million inhabitants. In contrast, many indicators point to Italy as a country with potential in dermatology wider than used in the past: an efficient health care system accessible to any citizen or resident, 4.6 million dermatological interventions per year, low density of IndCTs concerning dermatology, good production of scientific papers in indexed medical journals, relatively low cost of services and labour and geopolitical stability. The European Clinical Trials Information System's (CTIS), mandatory for the EU member states since early 2023 allows common, simplified, and harmonized regulatory procedures over the life cycle of clinical trials in Europe (EMA, 2023) and plays in favor of Italy's greater competitiveness in clinical research.

Abstract C012: Evaluation of skin cancer screening education provided by dermatologists with The Sun Bus for medical students

Abstract Introduction: Medical student curriculum is lacking in standardized training of skills for conducting the skin cancer screening examination. Dermatology is not a standard clinical rotation during medical school, and many medical students do not have much exposure to the specialty of dermatology for hands-on training in skin examinations by dermatologists. We sought to create an event in conjunction with the Sun Bus that included education about dermatology and skin examination for medical students. Objectives We sought to assess how the effects on knowledge of dermatology and skin cancer prevention and screening among participating medical students changed from participating in the educational event. Methods: The Health Education and Awareness Team of Texas Tech University Health Sciences Center El Paso collaborated with The Sun Bus to organize a training event for medical students. During this event, students had the opportunity to listen to a panel about dermatology as well as the basics of skin cancer screening from working dermatologists. Students also received a brief training on skin cancer screening provided by The Sun Bus and conducted screenings alongside dermatologists during a free skin cancer screening event. Students completed voluntary pre-event and post-event surveys. Results The vast majority of students did not feel confident in their ability to screen for skin cancer prior to attending the event. This research showed improved student confidence in providing skin cancer screenings and identifying suspicious skin lesions from the intervention. Conclusion: Medical students lack standardized training in dermatology and in the dermatologic skin cancer screening examination. This student educational event represents a meaningful intervention that improved medical students’ confidence in providing skin cancer screenings and identifying suspicious skin lesions. Bibliography The Sun Bus. https://www.thesunbus.org/about-us Accessed 11 Dec 2023. Compres E, Holzem K, Ibler E, Bierman JA, Rademaker AW, Kundu RV. A Brief Dermatology Curriculum in Skin Cancer Detection and Prevention to Improve Medical Student Knowledge and Confidence. MedEdPORTAL. 2020;16:11049. Published 2020 Dec 29. doi:10.15766/mep_2374-8265.11049 Moore MM, Geller AC, Zhang Z, et al. Skin cancer examination teaching in US medical education. Arch Dermatol. 2006;142(4):439-444. doi:10.1001/archderm.142.4.439 Ivanov NN, Swan A, Guseman EH, Whipps J, Jensen LL, Beverly EA. Medical Students' Knowledge, Attitudes, and Behaviors With Regard to Skin Cancer and Sun-Protective Behaviors. J Am Osteopath Assoc. 2018;118(7):444-454. doi:10.7556/jaoa.2018.098 Ivanov NN, Swan A, Guseman EH, Whipps J, Jensen LL, Beverly EA. Medical Students' Knowledge, Attitudes, and Behaviors With Regard to Skin Cancer and Sun-Protective Behaviors. J Am Osteopath Assoc. 2018;118(7):444-454. doi:10.7556/jaoa.2018.098 Citation Format: Elian A. Martin Lopez, Hannah Riva, Shravya Kichena Kichena, Daniel Lovasz, Brian Kan, Tannis Hogg, Jessica Chacon. Evaluation of skin cancer screening education provided by dermatologists with The Sun Bus for medical students [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C012

Low-Invasive Sampling Method with Tape-Disc Sampling for the Taxonomic Identification of Archeological and Paleontological Bones by Proteomics.

Collagen from paleontological bones is an important organic material for isotopic measurement, radiocarbon analysis, and paleoproteomic analysis to provide information on diet, dating, taxonomy, and phylogeny. Current paleoproteomic methods are destructive and require from a few milligrams to several tens of milligrams of bone for analysis. In many cultures, bones are raw materials for artifacts that are conserved in museums, which hampers damage to these precious objects during sampling. Here, we describe a low-invasive sampling method that identifies collagen, taxonomy, and post-translational modifications from Holocene and Upper Pleistocene bones dated to 130,000 and 150 BC using dermatological skin tape discs for sampling. The sampled bone micropowders were digested following our highly optimized enhanced filter-aided sample preparation protocol and then analyzed by MALDI FTICR MS and LC-MS/MS for identifying the genus taxa of the bones. We show that this low-invasive sampling does not deteriorate the bones and achieves results similar to those obtained by more destructive sampling. Moreover, this sampling method can be carried out at archeological sites or in museums.

Nano Transdermal Delivery Systems of Herbal Extracts for Dermatological Therapeutics and Skin Care

Nano Transdermal Delivery Systems of Herbal Extracts for Dermatological Therapeutics and Skin Care

Six-Month Real-World Study to Assess the Effectiveness of Ixekizumab After Switching from IL-23 Inhibitors and Other Biologic Therapies: The CorEvitas Psoriasis Registry.

Prior work showed that patients from the CorEvitas Psoriasis Registry who had previously failed a prior biologic and then initiated ixekizumab demonstrated improvements in disease severity and patient-reported outcomes after 6 months. However, newer therapies such as interleukin-23 inhibitors (IL-23i) were not considered. Here, with more recent data including IL-23i, 6-month effectiveness of ixekizumab following a switch from any biologic was assessed as well as whether 6-month effectiveness of ixekizumab was impacted by prior biologic class. We included CorEvitas Psoriasis Registry patients who initiated ixekizumab after discontinuing another biologic therapy and had a corresponding 6-month follow-up visit following ixekizumab initiation (N = 743, 2016-2023). Immediate prior biologic class was categorized as tumor necrosis factor inhibitor (TNFi) or interleukin-12/23 inhibitors (IL-12/23i, n = 405), non-ixekizumab interleukin-17i (IL-17i, n = 237), or IL-23i (n = 101). Adjusted mean changes in body surface area (BSA), Dermatology Life Quality Index (DLQI), itch, and skin pain were calculated for prior biologic class groups using analysis of covariance (ANCOVA). Proportions achieving ≥ 75%, ≥ 90%, and ≥ 100% improvement in Psoriasis Area and Severity Index (PASI75, PASI90, and PASI100, respectively), Investigator's Global Assessment (IGA) 0/1, and DLQI 0/1 were calculated for all patients and compared among prior biologic classes via relative risks (RRs) and 95% confidence intervals (CIs) using multivariable modified Poisson regression. Mean improvements in BSA, DLQI, itch, and skin pain, were 7.6, 3.6, 23.3, and 16.7, respectively, for ixekizumab patients who switched from TNFi or IL-12/23i (all p <0.05); 6.8, 3.3, 19.6, and 14.1, respectively, for those who switched from non-ixekizumab IL-17i (all p <0.05); and 7.8, 3.4, 22.2, and 12.8, respectively, for those who switched from IL-23i (all p <0.05). Overall, 54%, 41%, and 31% of ixekizumab initiators achieved PASI75, PASI90, and PASI100, respectively, 50% maintained or achieved IGA 0/1, and 48% maintained or achieved DLQI 0/1. The prior TNFi or IL-12/23i group was 31% more likely to achieve PASI100 (RR = 1.31, 95% CI 1.01, 1.69) and 32% more likely to maintain or achieve IGA 0/1 (RR = 1.32, 95% CI 1.11, 1.57), but not significantly more likely to achieve PASI90. The prior IL-23i group was 45% more likely to achieve PASI90 (RR = 1.45, 95% CI 1.10, 1.91), 55% more likely to achieve PASI100 (RR = 1.55, 95% CI 1.12, 2.13), and 39% more likely to maintain or achieve IGA 0/1 (RR = 1.39, 95% CI 1.12, 1.73) compared to the prior non-ixekizumab IL-17i group. Achievement of PASI75 and DLQI 0/1 was consistent across the prior TNFi or IL-12/23i, IL-23i, and non-ixekizumab IL-17i groups. These updated findings with IL-23i data reaffirm that patients with psoriasis who switch to ixekizumab after discontinuing another biologic demonstrate improvement in disease severity and patient-reported outcomes at 6 months in real-world settings. Compared to patients who switched from another IL-17i, patients who switched class from a TNFi or IL-12/23i were more likely to achieve PASI100 and IGA 0/1, and patients who switched class from an IL-23i were more likely to achieve PASI90 in addition to PASI100 and IGA 0/1.

North-south differences in incidence and surveillance of cutaneous malignant melanoma in Italy.

In Italy, the incidence of cutaneous malignant melanoma is two-fold higher in the north than in the south. This gradient might be associated with differences in incidence trends and disease surveillance. We compared the time trends in incidence rates, mortality rates, dermatologic office visit rates and skin biopsy rates between the Emilia-Romagna Region (northern Italy) and the Sicily Region (southern Italy). The cancer registries of Parma, Modena, Ferrara and Romagna (current population, 2,606,465) and Catania-Messina-Enna, Siracusa and Ragusa (2,775,019) provided incidence and mortality records for the years 2008-2017. The records of outpatient services delivered in public health facilities were obtained from the two Regional Administrations. Trends in rates were assessed with the estimated average annual percent change. North-south differences were expressed as age-standardised rate ratios. In the context of a generalised increasing incidence trend, which was more moderate in the female population of the Sicily Region, the standardised rate ratios were: 5.31 (males) and 5.20 (females) for in situ cutaneous malignant melanoma; 2.10 and 2.07 for invasive cutaneous malignant melanoma, with an excess incidence concentrated in lesions ⩽1.00 mm thick (3.58 and 3.05); 3.00 and 2.44 for dermatologic office visits; and 5.25 and 5.02 for skin biopsies. Mortality was stable in both Regions. In the Emilia-Romagna Region, as compared with the Sicily Region, a higher incidence of cutaneous malignant melanoma -especially of in situ and early invasive cutaneous malignant melanoma- coexisted with a higher level of clinical surveillance. The question of the direction of the cause-effect relationship between increased incidence and increased diagnostic scrutiny remains open.

Is Camphor the Future in Supporting Therapy for Skin Infections?

The aim of this review is to present the potential application of camphor-a bicyclic monoterpene ketone-in the prevention of skin infections. Skin diseases represent a heterogeneous group of disorders characterized by prolonged symptoms that significantly diminish the quality of life. They affect the dermis, the epidermis, and even subcutaneous tissue. They very often have a bacterial or fungal background. Therapy for dermatological skin disorders is difficult and long-term. Therefore, it is important to find a compound, preferably of natural origin, that (i) prevents the initiation of this infection and (ii) supports the skin's repair process. Based on its documented anti-inflammatory, antibacterial, antifungal, anti-acne, anesthetic, strengthening, and warming properties, camphor can be used as a preventative measure in dermatological infectious diseases and as a component in medical and cosmetic products. This work discusses the structure and physicochemical properties of camphor, its occurrence, and methods of obtaining it from natural sources as well as through chemical synthesis. The use of camphor in industrial preparations is also presented. Additionally, after a detailed review of the literature, the metabolism of camphor, its interactions with other medicinal substances, and its antimicrobial properties against bacteria and fungi involved in skin diseases are discussed with regard to their resistance.

Dystrophic Epidermolysis Bullosa (DEB): How Can Pregnancy Alter the Course of This Rare Disease? An Updated Literature Review on Obstetrical Management with an Additional Italian Experience.

Epidermolysis Bullosa (EB) is an extremely rare and disabling inherited genetic skin disease with a predisposition to develop bullous lesions on the skin and inner mucous membranes, occurring after mild friction or trauma, or even spontaneously. Within the spectrum of EB forms, dystrophic EB (DEB) represents the most intriguing and challenging in terms of clinical management, especially with regard to pregnancy, due to the highly disabling and life-threatening phenotype. Disappointingly, in the literature little focus has been directed towards pregnancy and childbirth in DEB patients, resulting in a lack of sound evidence and guidance for patients themselves and clinicians. The current study aims to contribute to the DEB literature with an updated summary of the existing evidence regarding the obstetrical and anesthesiological management of this rare disease. Furthermore, this literature review sought to answer the question of whether, and if so, in which way, the pregnancy condition may alter the course of the underlying dermatologic skin disease. Having all this information is indispensable when counseling a patient with DEB who desires a child or is expecting one. Finally, we reported own experience with a pregnant woman with a recessive DEB whom we recently managed, with a favorable outcome.

Running the Risk - Examining Dermatologic Concerns and Skin Neoplasms in Runners

This review summarizes the most prevalent dermatologic conditions encountered by runners and provides evidence-based recommendations for prevention and management. Due to high levels of ultraviolet radiation exposure, friction forces, specific environment of the activity and used garment runners are at the risk of various dermatologic complications, including skin neoplasms. Sun protection measures, such as applying sunscreen with sufficient SPF, wearing photoprotective clothing, and avoiding peak sun hours, are crucial for mitigating this risk. Friction-related injuries like blisters, calluses, and jogger's nipples are common among runners and can be prevented through proper footwear, moisture management, and lubrication. Educational interventions promoting safety practices are necessary to raise awareness and encourage behavioural change among runners.

Dermatological guide for primary care physicians: full body skin checks, skin cancer detection, and patient education on self-skin checks and sun protection

Dermatological conditions and skin cancers are common health concerns that require early detection and intervention. Primary care physicians play a crucial role in recognizing these conditions and serving as the first line of defense against skin cancers. This guide provides a systematic approach to conducting thorough skin examinations and enhancing understanding of common presentations of precancerous and cancerous lesions. We emphasize the importance of performing annual full-body skin exams to facilitate early detection and management of skin conditions, including a step-by-step, systematic protocol for conducting these exams, comprising preparing the patient, documenting findings, educating the patient, and considering biopsy or referral for suspicious lesions. Furthermore, we explore the atypical features of skin lesions that raise clinical suspicion and warrant further investigation. We describe the characteristics of common skin cancers, such as basal cell carcinoma, squamous cell carcinoma, and melanoma. We stress the importance of patient education on self-skin checks and sun protection measures. By incorporating the knowledge and skills presented in this guide, primary care physicians can confidently perform thorough full-body skin checks, identify common dermatological findings and early signs of skin cancers, and provide comprehensive care to patients. This will help ensure optimal outcomes in dermatological health.

Determining optimal surveillance techniques for the microbial community on human skin using RNAseq data analysis

Background: The largest organ in the human body, the skin, serves as a physical barrier to the outside world. It also houses millions of bacteria, viruses, and fungi that protect us against invading pathogens or result in altered physiology and disease. These microorganisms can contribute to normal skin health or predispose individuals to pathogenic disorders. Surveillance and observation of the microbiome can give insight into identifying common taxa that compose our skin and indications of new or changing pathogens. However, to do this effciently, it is important to understand what can be detected from skin samples and the differences we may see using various collection methods. Methods: We used publicly available NCBI SRA RNAseq bioprojects that queried “skin,” processing 132 bioprojects with 8,274 samples. Using FastQC, Salmon, KRAKEN2, and MiCXR/Immunarch, we aimed to analyze the quality, human gene transcripts, infections, and B/T- cell responses, respectively. We aimed to identify what skin sampling method provides the best data on the skin microbiome, human gene mapping, and B/T-cell immune repertoire. This project is based on observational methods, not a specific hypothesis. Results: From the KRAKEN2 data, there were 14,383 viruses and 14,691 bacteria assessed through all “skin” BioProjects. From the extensive data pool, we identified unique BioProject signatures for protest (Leishmania), bacteria (Mycoplasma), and viruses (HSV1 dose dependencies, HPV in human warts, Chinese transmitted tick viruses, Human T-cell lymphotropic virus, and the first-ever human case of equine infectious anemia virus). The use of read mapping and coverage is critical to confirming the presence of foreign species, noted through the observation of T4 DNA ligase RNA presence prior to 2018 RNA sequencing. Once pathogens were detected, cellular response mapping was developed, yielding insights into the pathophysiology of multiple viral infections of the skin and sex differences. Conclusion: Detecting a wide variety of microorganisms on the skin can give insight into dermatological pathologies and skin physiology. Using the publicly available skin datasets, we see many unique stories of microorganisms in the skin. This big data mapping strategy highlights the importance of broad observational mapping, possible with cutting-edge sequencing tools. This work was supported by the MI-SAPPHIRE program of MDHHS and the CDC. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Data on Demodex Ectoparasite Infestation in Patients Attending an Outpatient Clinic in Greece

Demodex mites are acari, common ectoparasites of humans and other mammalian pilosebaceous units. Demodicosis occurs when mites overpopulate the skin, causing several skin disorders. Our aim was to investigate the prevalence of demodicosis in patients with suspicious clinical features, such as cheek redness, itching, and skin sensitivity, who presented at the outpatient clinic of the Andreas Syggros Dermatology Hospital in Greece. We studied 184 individuals aged between 18 and 97 years and analyzed the content of pilosebaceous units by microscopy to determine the density of Demodex mites. Samples were evaluated as positive when Demodex spp. densities equaled or exceeded 5 mites per square cm. Sixty-six percent of the examined subjects were positive for demodicosis. The age distribution was statistically normal (p = 0.2), and the median age was 51.29 years. Seventy percent of the patients were females, and 30% were males, while 64.46% of the demodicosis-positive individuals were females, and 35.54% were males. We observed a rise in the percentage of males as the age of the patients increased. Demodicosis can be a challenging disease because it presents apart from the typical symptoms, with a variety of nonspecific symptoms mimicking other dermatological skin conditions. Therefore, it is important to investigate Demodex spp. in patients who present with common facial dermatological diseases to improve treatment results. Further studies could contribute to a better understanding of the pathogenic role of Demodex mites and how this role is affected by mite density, host sex and age.

The influence of social media on public attitudes and behaviors towards cosmetic dermatologic procedures and skin care practices: A study in Saudi Arabia.

Social media has fostered a landscape where trends, ideals, and beauty standards have significantly proliferated. Images of flawless skin, sculpted features, and curated aesthetics inundate user feeds, potentially shaping their self-perceptions and aspirations. The rise of influencers, dermatologist social media engagement, and beauty campaigns sharing skincare routines and product recommendations wield substantial influence over individual appearance-related decisions. The main aim of this study is to determine the pattern of behavior in using social media to seek dermatological procedures and skin care routine. We conducted a nationwide, online cross-sectional study targeting the general Saudi population. Our survey aimed to understand participant social media behaviors and gather insights into skincare products, cosmetic procedures, and makeup habits. Gender-related differences emerged in seeking skincare advice. Females preferred dermatologists on social media (p < 0.001) and beauty influencers (p < 0.001), whereas men leaned towards pharmacists (p < 0.001). Women displayed stronger engagement with dermatologist social media reputation regarding non-cosmetic concerns (p < 0.001), education (p < 0.001), and social media impact on cosmetic decisions (p = 0.001). They frequently sought dermatologists on social media before appointments (p = 0.001), whereas men emphasized dermatologists' fame (p = 0.024). Common cosmetic barriers included high costs (62.5%), complications (40.3%), and trust issues (40.2%). Women underwent various cosmetic procedures (p < 0.05), influenced by social media in their decisions and skincare routines. Our study reveals significant gender-based disparities in seeking skincare advice. Women rely on social media, clinics, friends, and beauty influencers, whereas men prefer pharmacists. Additionally, women depend on dermatologists' social media reputation and conduct thorough pre-appointment research. Their heightened social media engagement links to skincare practices and influences cosmetic procedure considerations based on age and usage frequency.

Scientific Rationale and Clinical Basis for Clindamycin Use in the Treatment of Dermatologic Disease.

Clindamycin is a highly effective antibiotic of the lincosamide class. It has been widely used for decades to treat a range of skin and soft tissue infections in dermatology and medicine. Clindamycin is commonly prescribed for acne vulgaris, with current practice standards utilizing fixed-combination topicals containing clindamycin that prevent Cutibacterium acnes growth and reduce inflammation associated with acne lesion formation. Certain clinical presentations of folliculitis, rosacea, staphylococcal infections, and hidradenitis suppurativa are also responsive to clindamycin, demonstrating its suitability and versatility as a treatment option. This review describes the use of clindamycin in dermatological practice, the mechanism of protein synthesis inhibition by clindamycin at the level of the bacterial ribosome, and clindamycin's anti-inflammatory properties with a focus on its ability to ameliorate inflammation in acne. A comparison of the dermatologic indications for similarly utilized antibiotics, like the tetracycline class antibiotics, is also presented. Finally, this review addresses both the trends and mechanisms for clindamycin and antibiotic resistance, as well as the current clinical evidence in support of the continued, targeted use of clindamycin in dermatology.

The Role of Cathelicidin in Dermatology Skin

Acne, Atopic Dermatitis, Psoriasis and Rosacea are examples of chronic inflammatory skin conditions. One characteristic of many skin disorders is the dysregulation of innate immunity in the skin. Acne, Atopic Dermatitis, Psoriasis, and Rosacea all have problems with the expression, function, or processing of the key innate immune effector molecule in the skin, cathelicidin LL-37. Cathelicidin induction can be altered to treat Acne and Atopic Dermatitis, which lessens the efficiency of the antimicrobial barrier. However, cathelicidin is overexpressed in Psoriasis and Rosacea. The most recent research on cathelicidin LL-37’s involvement in the etiology of inflammatory skin disorders will be included in this review. Since cathelicidin LL-37 may one day be employed as a therapeutic target, many cutting-edge therapy methods for the disease will be discussed. Keywords: Antimicrobial Peptide, Cathelicidin, Dermatology Skin

P339 Dermatological evaluation of candidates with IBD for biological therapy - should it become part of the scheme during qualification?

Abstract Background Oncological anxiety associated with biological therapy is a common challenge in inflammatory bowel disease (IBD) and it have raised questions about the need for dermatological assessment of the skin before starting a biological therapy to exclude cutaneous malignancies. Methods The aim of the study was to assess the frequency of skin cancers in IBD patients before starting biological therapy. We conducted a retrospective, single-centre evaluation on the frequency of skin cancers. Results A group of patients with IBD who were referred for qualification for biological treatment consisted of n = 805 patients, out of which 348 (43.2%) were female and 457 (56.8%) were male. Average age of patients was 36.84 ± 12.49 years. During qualification for biological treatment dermatological skin assessment was performed and dermal lesions were found in 15.5% (125) patients, of which 9 (1.1%) were cutaneous malignancies. Only steroid dependance and resistance differentiated in a significant way between patients with and without dermal lesions. Dermal lesions group included lower proportion of patients with steroid dependence (84.6% vs 92.9% in group without dermal lesions) and higher proportion of patients with steroid resistance (13.6% vs 7.1% in groups of patients with no dermal lesions) (V = 0.09, CI95 [0.01;0.17], p = 0.022). Surprisingly, there was no effect of thiopurines on development of dermal lesions between group with and without dermal lesions 90.4% vs. 84.6%, MD = 0.06, CI95 [0.01;0.12], p = 0.118. In a multivariate logistic regression model only higher BMI (OR = 1.08, CI95 [1.02;1.14], p = 0.007) was identify as a risk factor for development a dermal lesions. Additionally, as many as 9 patients were diagnosed with cutaneous malignancies, including 4 basal cell carcinomas (BCC), 4 squamous cell carcinomas (SCC) and one MSC. Only 11.4% patients complied with our strict policy of skin surveillance every 6-8 months. Conclusion In this study, we observed dermal lesions in 15.5% of patients, of which 1% were cutaneous malignancies. The only risk factor for dermal lesions was higher BMI. The lack of effect of thiopurines on oncological risk may indicate the need to monitor the skin condition in every patient with IBD. It is also crucial to disseminate knowledge about the need for regular skin assessments among IBD patients.

Implementation of a dermatology skin of color educational module for medical students.

Research in dermatology education highlights the lack of skin of color (SOC) instruction for medical students, leading to concerning healthcare outcomes. Because of the already limited opportunity for students to have dedicated teaching in pathophysiology, management, and treatment of dermatologic diseases in medical school, we developed an educational module that addresses these gaps. We created a one-hour virtual lecture for medical students focused on common skin diseases tested on the United States Medical Licensing Examination with visual images across all skin types. A questionnaire was administered before and after the educational module to assess outcomes comparing disease identification in lighter (Fitzpatrick scale I-III) versus darker (Fitzpatrick scale IV-VI) skin tones and to determine medical school student attitudes. An analysis of 43 examination scores before, and after attending the educational module determined rosacea, psoriasis, and basal cell carcinoma to be conditions in SOC patients that demonstrated the most significant improvement (47.3%, 54.9%, and 30.8%, respectively). Our results also highlighted worse performance outcomes for diseases in SOC in the pre-examination questionnaire. Thus, our study indicates that a concise education module focused on disease presentations inclusive of all skin types may efficiently increase students' ability to identify diseases commonly misdiagnosed in the clinical setting.

Anti-aging and rejuvenating effects and mechanism of Dead Sea water in skin.

External environmental stressors and internal factors have a significant impact on the skin, causing inflammation, aging, reduced immunity and other adverse responses. Dead Sea Water (DSW) is well known for its dermatological benefits and has been widely used in dermatological therapy and skin care for conditions such as psoriasis, atopic dermatitis and photoaging. However, the anti-aging and rejuvenating effects of DSW and the related biological pathways involved, which have attracted increasing attention, are not fully understood. The aim of this study is to investigate the anti-aging and rejuvenating effects of DSW and to explore the related potential biological mechanisms of DSW under different environmental conditions. The effects of DSW were investigated using invitro human dermal cells and reconstructed skin models. Extracellular matrix (ECM) components and the morphological changes at the dermal-epidermal junction (DEJ) in a 3D human skin model were evaluated after DSW treatment. RNA sequencing (RNA-seq) analysis of human dermal fibroblast models after DSW treatment was performed to explore the potential mechanisms of action of DSW under normal and UV stress conditions. The novel findings in this work present the biological functions of DSW, including procollagen-1 and elastin secretion, hemidesmosome increase and the epidermal basal cell regeneration. In addition, GO, KEGG and Reactome analyses reveal the activation of pathways related to ion transmembrane transporter activity, ECM component biosynthesis, senescence-associated secretory phenotype (SASP), DNA repair and autophagy, which are associated with the anti-aging activities of DSW. Our work provides new perspectives for understanding the anti-aging and rejuvenating effects and mechanisms of DSW. The new findings also provide a theoretical basis for the further development of age-related strategies.

Comparative efficacy of combined antihistamine and montelukast therapy in adult patients with atopic dermatitis.

Atopic dermatitis (AD) is one of the most common chronic skin conditions affecting about 20% of children and 5% of adults. However, the studies assessing novel therapies for AD have been focused mainly on paediatric patients and only few studies have involved adult participants. To compare the treatment outcomes between the antihistamine monotherapy and combined intervention with an antihistamine agent and a cysteinyl leukotriene receptor antagonist in adult patients with atopic dermatitis. Patients were randomized into two groups to receive 5 mg oral desloratadine or the combined therapy with 5 mg oral desloratadine and 10 mg montelukast. Both groups were also administered topical treatment using the same protocol (topical Elocon and moisturizer). To estimate the efficacy of the implemented therapy methods, different skin health scores (SCORAD, GISS, EASI, PPNRS and DLQI) and skin functional assessment outcomes (corneometry, pH and transepidermal water loss) were evaluated before and after the treatment. Significant differences were revealed in compared measurement results for scales of the Extent and Severity of Eczema assessment, Global Individual Signs Score, Eczema Area and Severity Index, Pruritus Numerical Rating Scale, Dermatology Life Quality Index and Skin Functional Properties (p > 0.05). Comparison of data presenting the therapy outcomes in two groups showed that administration of the combined therapy was significantly more effective compared to the antihistamine monotherapy. The results revealed considerable efficacy of the combined therapy reinforced by the use of cysteinyl leukotriene receptor antagonist, montelukast.