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Wang Y, Li J, Guo C, Yang G, Lin H, Zhang Y. Bibliometric analysis and description of research trends in the treatment of psoriasis with biologic agents in the past two decades (2004-2023). J DERMATOL TREAT 2024; 35:2346282. [PMID: 38880492 DOI: 10.1080/09546634.2024.2346282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 04/01/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND Biologics are essential in treating psoriasis. In recent years, the pathogenesis exploration and development of new target drugs have provided a more complete evidence-based foundation for the biological treatment of psoriasis. This study aims to use bibliometrics to analyze the research status and development trends of biologics in psoriasis. METHODS The bibliometric analysis of publications related to biologics in psoriasis from 2004 to 2023 was conducted using the Web of Science Core Collection (WoSCC) database as the search data source. To perform the bibliometric analysis and create visual knowledge graphs, CiteSpace, the Bibliometrix R package, and VOSviewers were utilized. RESULTS The study included a total of 3800 articles. The United States had the highest number of publications. The leading authors and institutions were Steven R. Feldman and the University of Manchester, respectively, in the global partnership. The cluster plot divided all keywords into 11 categories. Currently, Secukinumab and Guselkumab are representative biological agents being studied due to their considerable efficacy and long-term safety. CONCLUSIONS Targeted therapy has emerged as a significant trend in the current treatment of psoriasis. Early and active use of biologics can effectively control disease progression, prevent or delay the occurrence of comorbidities, and may even alter the natural course of psoriasis. However, further investigation is required to fully understand the specific mechanisms of psoriasis and the use of biological agents.
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Affiliation(s)
- Yingdong Wang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Junchen Li
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Chenqi Guo
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Guojing Yang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Haiyue Lin
- Dermatology Department, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
| | - Yu Zhang
- Dermatology Department, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
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Drozdowski R, Jain N, Gronbeck C, Feng H. Disparities in Care for Psoriasis. Dermatol Clin 2024; 42:507-512. [PMID: 38796279 DOI: 10.1016/j.det.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2024]
Abstract
Race, ethnicity, language, sex, age, income, insurance status, location, and other socioeconomic and demographic factors influence access to and quality of care for patients with psoriasis, which can potentially lead to inequitable outcomes.
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Affiliation(s)
- Roman Drozdowski
- Department of Dermatology, University of Connecticut Health Center, 21 South Road, 2nd Floor, Farmington, CT 06032, USA
| | - Neelesh Jain
- Department of Dermatology, University of Connecticut Health Center, 21 South Road, 2nd Floor, Farmington, CT 06032, USA
| | - Christian Gronbeck
- Department of Dermatology, University of Connecticut Health Center, 21 South Road, 2nd Floor, Farmington, CT 06032, USA
| | - Hao Feng
- Department of Dermatology, University of Connecticut Health Center, 21 South Road, 2nd Floor, Farmington, CT 06032, USA.
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3
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Patil MK, Salazar CE, Venkatesh KP, Milosavljevic S, Rohan TZ, Charrow AP, Nambudiri VE. Prevalence of obstructive sleep apnea with hidradenitis suppurativa: a matched case-control study. Arch Dermatol Res 2024; 316:121. [PMID: 38630351 DOI: 10.1007/s00403-024-02869-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 02/12/2024] [Accepted: 04/07/2024] [Indexed: 04/19/2024]
Affiliation(s)
- Mihir K Patil
- Department of Dermatology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA
- Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Carlos E Salazar
- Department of Dermatology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA
- Harvard Medical School, Boston, MA, USA
| | - Kaushik P Venkatesh
- Department of Dermatology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA
- Harvard Medical School, Boston, MA, USA
| | - Sofia Milosavljevic
- Department of Dermatology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA
- Harvard Medical School, Boston, MA, USA
| | - Thomas Z Rohan
- Department of Dermatology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Alexandra P Charrow
- Department of Dermatology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA
- Harvard Medical School, Boston, MA, USA
| | - Vinod E Nambudiri
- Department of Dermatology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA.
- Harvard Medical School, Boston, MA, USA.
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4
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Vlachou E, Mamtani R, Hahn NM, Iii BJ, Hoffman-Censits J, Nimgaonkar V. Racial Differences in Cutaneous Events Among Patients Receiving Enfortumab Vedotin. Clin Genitourin Cancer 2024:102090. [PMID: 38688798 DOI: 10.1016/j.clgc.2024.102090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 04/03/2024] [Accepted: 04/06/2024] [Indexed: 05/02/2024]
Abstract
INTRODUCTION Enfortumab vedotin (EV) is an antibody-drug conjugate approved alone and in combination with pembrolizumab for advanced urothelial cancer (UC). EV-related-cutaneous-events (EVCEs) are common and rarely life-threatening. Black patients are frequently under-represented in oncology trials, and dermatologic conditions may vary with race. METHODS Therefore, this retrospective analysis investigated differences in EVCE frequency between Black and White patients in an urban cohort (Johns Hopkins [JH]) and a US-based, nationwide electronic health record (EHR)-derived deidentified database (Flatiron Health [FH]) with sub-group analysis of those who had received prior pembrolizumab. RESULTS The study included 12 Black patients in the JH Cohort (17.1%) and 24 Black patients in the FH Cohort (7.6%). In both cohorts, the frequency of EVCEs among Black patients was higher compared to White patients (JH: 66.7% vs. 33.3%; FH: 25.0% vs. 15.8%), though not statistically significant. In the larger FH Cohort EVCEs were significantly more common among Black compared to White patients treated with prior pembrolizumab (Odds Ratio [OR]: 4.76 [95%CI: 1.42, 15.95]) and recent pembrolizumab (within 90 days of EV initiation) (OR 9.00 [95%CI: 1.94, 41.66]). CONCLUSION This hypothesis-generating retrospective study, comprising the largest population of EV-treated Black patients reported to date, emphasizes the importance of attentiveness to EVCEs among Black patients, particularly with receipt of pembrolizumab.
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Affiliation(s)
| | - Ronac Mamtani
- Division of Hematology-Oncology, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Noah M Hahn
- The Johns Hopkins Greenberg Bladder Cancer Institute, Baltimore, MD; The James Buchanan Brady Urological Institute, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD
| | - Burles Johnson Iii
- The Johns Hopkins Greenberg Bladder Cancer Institute, Baltimore, MD; The James Buchanan Brady Urological Institute, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD
| | - Jean Hoffman-Censits
- The Johns Hopkins Greenberg Bladder Cancer Institute, Baltimore, MD; The James Buchanan Brady Urological Institute, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD
| | - Vivek Nimgaonkar
- Osler Medical Service, Department of Medicine, Johns Hopkins Hospital, Baltimore, MD.
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5
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Zhao H, Zhao H, Li M, Tang Y, Xiao X, Cai Y, He F, Huang H, Zhang Y, Li J. Twin defect-rich Pt ultrathin nanowire nanozymes alleviate inflammatory skin diseases by scavenging reactive oxygen species. Redox Biol 2024; 70:103055. [PMID: 38290385 PMCID: PMC10844124 DOI: 10.1016/j.redox.2024.103055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 12/28/2023] [Accepted: 01/22/2024] [Indexed: 02/01/2024] Open
Abstract
Nanozymes with superior antioxidant properties offer new hope for treating oxidative stress-related inflammatory skin diseases. However, lacking sufficient catalytic activity or having complex material designs limit the application of current metallic nanozymes in inflammatory skin diseases. Here, we report a simple and effective twin-defect platinum nanowires (Pt NWs) enzyme with multiple mimetic enzymes and broad-spectrum ROS scavenging capability for the treatment of inflammatory skin diseases in mice (including psoriasis and rosacea). Pt NWs with simultaneous superoxide dismutase, glutathione peroxidase and catalase mimetic enzyme properties exhibit cytoprotective effects against ROS-mediated damage at extremely low doses and significantly improve treatment outcomes in psoriasis- and rosacea-like mice. Meanwhile, these ultrasmall sizes of Pt NWs allow the nanomaterials to effectively penetrate the skin and do not produce significant biotoxicity. Therefore, Pt NWs have potential applications in treating diseases related to oxidative stress or inflammation.
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Affiliation(s)
- He Zhao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Han Zhao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Mengfan Li
- College of Materials Science and Engineering, Hunan University, Changsha, Hunan, 410082, China
| | - Yan Tang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Xin Xiao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Yisheng Cai
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Fanping He
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Hongwen Huang
- College of Materials Science and Engineering, Hunan University, Changsha, Hunan, 410082, China
| | - Yiya Zhang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China.
| | - Ji Li
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China.
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6
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Paul D, Todd A, Baum C. Squamous cell carcinoma incidence, demographics, and outcomes in skin of color patients. J Am Acad Dermatol 2024; 90:665-666. [PMID: 38008406 DOI: 10.1016/j.jaad.2023.11.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/19/2023] [Accepted: 11/20/2023] [Indexed: 11/28/2023]
Affiliation(s)
- Deborah Paul
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
| | - Austin Todd
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
| | - Christian Baum
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
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7
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Kirby JS, Okun MM, Alavi A, Bechara FG, Zouboulis CC, Brown K, Santos LL, Wang A, Bibeau KB, Kimball AB, Porter ML. Efficacy and safety of the oral Janus kinase 1 inhibitor povorcitinib (INCB054707) in patients with hidradenitis suppurativa in a phase 2, randomized, double-blind, dose-ranging, placebo-controlled study. J Am Acad Dermatol 2024; 90:521-529. [PMID: 37871805 DOI: 10.1016/j.jaad.2023.10.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 09/11/2023] [Accepted: 10/02/2023] [Indexed: 10/25/2023]
Abstract
BACKGROUND Janus kinase 1 inhibition may alleviate hidradenitis suppurativa (HS)-associated inflammation and improve symptoms. OBJECTIVE To assess efficacy and safety of povorcitinib (selective oral Janus kinase 1 inhibitor) in HS. METHODS This placebo-controlled phase 2 study randomized patients with HS 1:1:1:1 to receive povorcitinib 15, 45, or 75 mg or placebo for 16 weeks. Primary and key secondary end points were mean change from baseline in abscess and inflammatory nodule count and percentage of patients achieving HS Clinical Response at week 16. RESULTS Of 209 patients randomized (15 mg, n = 52; 45 mg, n = 52; 75 mg, n = 53; placebo, n = 52), 83.3% completed the 16-week treatment. At week 16, povorcitinib significantly reduced abscess and inflammatory nodule count from baseline (least squares mean [SE] change: 15 mg, -5.2 [0.9], P = .0277; 45 mg, -6.9 [0.9], P = .0006; 75 mg, -6.3 [0.9], P = .0021) versus placebo (-2.5 [0.9]). More povorcitinib-treated patients achieved HS Clinical Response at week 16 (15 mg, 48.1%, P = .0445; 45 mg, 44.2%, P = .0998; 75 mg, 45.3%, P = .0829) versus placebo (28.8%). A total of 60.0% and 65.4% of povorcitinib- and placebo-treated patients had adverse events. LIMITATIONS Baseline lesion counts were mildly imbalanced between groups. CONCLUSION Povorcitinib demonstrated efficacy in HS, with no evidence of increased incidence of adverse events among doses.
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Affiliation(s)
- Joslyn S Kirby
- Department of Dermatology, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania.
| | - Martin M Okun
- Department of Dermatology, Fort Memorial Hospital, Fort Atkinson, Wisconsin
| | - Afsaneh Alavi
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
| | - Falk G Bechara
- Department of Dermatology, Allergology and Venereology, Ruhr University Bochum, Bochum, Germany
| | - Christos C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Staedtisches Klinikum Dessau, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Dessau, Germany
| | - Kurt Brown
- Incyte Corporation, Wilmington, Delaware
| | | | - Annie Wang
- Incyte Corporation, Wilmington, Delaware
| | | | - Alexa B Kimball
- Department of Dermatology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Martina L Porter
- Department of Dermatology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, Massachusetts
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8
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Li J, Zhang J, Guo C, Lin P, Shen Q, Lin H, Zhang Y. Bibliometric analysis and description of research trends on T cells in psoriasis over the past two decades (2003-2022). Heliyon 2024; 10:e23542. [PMID: 38169994 PMCID: PMC10758876 DOI: 10.1016/j.heliyon.2023.e23542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 01/05/2024] Open
Abstract
Background It is now understood that T cells play a key role in the occurrence and development of psoriasis. Herein, a bibliometric analysis was conducted to summarize the content and trends of T cell-related research in psoriasis. Methods A bibliometric analysis was conducted on publications pertaining to T cells in psoriasis between 2003 and 2022 retrieved from the Web of Science Core Collection (WoSCC) database using tools such as CiteSpace, the Bibliometrix R package, and VOSviewer. Results The study included a total of 3595 articles authored by 14,188 individuals, including all coauthors in article bylines. The Laboratory for Investigative Dermatology at Rockefeller University, led by James G Krueger, has made significant contributions to this field through focusing on the pathogenesis of psoriasis and exploring the potential of using biological agents to treat psoriasis. Furthermore, targeted inhibitors have significantly impacted the treatment of psoriasis, with researchers focusing on small-molecule targeted drugs as a new area of research that could potentially replace biological agents. Conclusions Research has established the efficacy and long-term safety of targeted inhibition of T cell-related targets. Deucravacitinib, a psoriasis treatment drug targeting TYK2 as an allosteric inhibitor, has attracted significant attention and raised high expectations.
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Affiliation(s)
- Junchen Li
- Graduate school, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jianfeng Zhang
- Graduate school, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Chenqi Guo
- Graduate school, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Peng Lin
- Graduate school, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Qian Shen
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Haiyue Lin
- Dermatology department, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
| | - Yu Zhang
- Dermatology department, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
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Zhang S, Wu M, Xue W. Decoding the role of m 6A Regulators in identifying and characterizing molecular subtypes of rosacea. Heliyon 2023; 9:e23310. [PMID: 38144308 PMCID: PMC10746518 DOI: 10.1016/j.heliyon.2023.e23310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 11/23/2023] [Accepted: 11/30/2023] [Indexed: 12/26/2023] Open
Abstract
Rosacea is a common skin disease that predominantly affects individuals aged between 30 and 50 years. While the exact cause of the disease remains unclear, various factors have been shown to trigger or exacerbate its symptoms. N6-methyladenosine (m6A) modification is one of the most abundant epigenetic methylation modification in messenger RNA (mRNA) and non-coding RNA (ncRNA), plays a crucial role in RNA splicing, export, stability, and translation. In this study, we aimed to characterize m6A genes in rosacea, identify molecular subtypes based on m6A gene expression, characterize the immune features among subtypes, explore key molecules based on co-expression analysis, and identify potential targets and drugs. To achieve our objectives, we first compared the expression pattern and immune regulation of m6A genes between healthy and diseased groups. Then, we performed clustering to stratify disease samples into different subtypes and analyzed immune regulation and functional enrichment among the subtypes. Then, we conducted differential analysis between subtypes and applied weighted gene co-expression network analysis (WGCNA) in three subtypes. We found hub differential expression analysis (DEG) genes and their potential drug based on the WGCNA results and the drug-gene interaction database (DGIdb). Finally, in vivo and in vitro studies showed significant differences in m6A methyltransferase METTL3 levels in rosacea mice and control mice, as well as in the skin of rosacea patients and healthy people, while reducing METTL3 significantly inhibited the inflammatory response of human fibroblasts (HDFs) stimulated by LL37, suggesting that METTL3 may be associated with changes in overall m6A levels in rosacea. Taken together, our findings provide valuable insights into therapeutic targets and drug predictions for rosacea.
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Affiliation(s)
- Shuping Zhang
- Department of Dermatology, Postdoctoral Station of Clinical Medicine, The Third Xiangya Hospital of Central South University, Changsha 410013, Hunan, China
| | - Meng Wu
- Department of Dermatology, Postdoctoral Station of Clinical Medicine, The Third Xiangya Hospital of Central South University, Changsha 410013, Hunan, China
| | - Wenbo Xue
- Department of Surgery, The Third Xiangya Hospital of Central South University, Changsha 410013, Hunan, China
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Ticknor IL. A Call to Improve Medical Education on Skin of Color. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:1345. [PMID: 37683256 DOI: 10.1097/acm.0000000000005457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Affiliation(s)
- Iesha L Ticknor
- Fourth-year medical student, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California; ; ORCID: http://orcid.org/0000-0001-6938-7731
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11
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Okeke CAV, Tran J, Wright I, Okoye GA, Burgess CM, Byrd AS. Skin tone representation in dermatologic direct-to-consumer advertisements: a cross-sectional analysis and call to action. Int J Womens Dermatol 2023; 9:e101. [PMID: 37860124 PMCID: PMC10584291 DOI: 10.1097/jw9.0000000000000101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 07/06/2023] [Indexed: 10/21/2023] Open
Abstract
Background Direct-to-consumer advertisements (DTCAs) in medical marketing serve as a prominent modality to deliver information to an increasingly diverse audience of consumers and increase prescription sales. In dermatology, advertisements have the potential to shape the public's opinions, aid in the understanding of skin conditions, and raise awareness of available treatments. Objective To investigate and characterize the representation of skin tones in DTCAs. Methods Nielsen ratings were utilized to identify the networks most watched by Black viewers in 2022. Programming on NBCUniversal, ABC, CBS, and FOX that aired in the District of Columbia, suburban Maryland, and Northern Virginia from June 2022 to July 2022 was reviewed for DTCAs. DTCAs were then analyzed to determine the skin tones of models and skin conditions depicted on models with darkly pigmented skin. Results Of the 106 DTCAs related to dermatologic conditions, there were 13 unique advertisements featuring 32 unique models. Four advertisements depicted the skin condition on darkly pigmented skin tones. Using the Monk Skin Tone (MST) scale to assess the 32 unique individuals, only 25% (n = 8) were rated at an MST 7 or above, and 6.25% (n = 2) were rated at an MST 10. Limitations This study has the limitation of only sampling DTCAs from Washington, District of Columbia which does not fully represent all dermatology-related DTCAs in the United States. Conclusion Results of this content analysis demonstrate that the number of persons of color within dermatologic DTCAs is 23%, whereas there are 13.6% Black individuals in the 2021 US census. This suggests that DTCAs are becoming more diverse since 2018. However, findings also show that the vast majority of DTCAs do not include models with darkly pigmented skin, and there remains a lack of advertisements depicting skin disease among people of color. Given the role of DTCAs in informing and aiding patients' requests for prescription drugs, representation of all skin tones is essential for this communication to be effective, especially in the field of dermatology.
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Affiliation(s)
- Chidubem A. V. Okeke
- Department of Dermatology, Howard University College of Medicine, Washington, DC
| | - Joseph Tran
- Howard University College of Medicine, Washington, DC
| | | | - Ginette A. Okoye
- Department of Dermatology, Howard University College of Medicine, Washington, DC
| | | | - Angel S. Byrd
- Department of Dermatology, Howard University College of Medicine, Washington, DC
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12
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Hardy NJ, Gronbeck C, Feng H. Impact of race and ethnicity on length of stay, discharge location, and total charges for inpatients with skin ulcers in New York. Arch Dermatol Res 2023; 315:2187-2189. [PMID: 37061988 DOI: 10.1007/s00403-023-02624-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/25/2023] [Accepted: 04/06/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND Black patients receiving outpatient care for skin ulcers are less likely to see a physician and are at risk for higher stage pressure injuries. While racial/ethnic differences in outpatient treatment of skin ulcers have been described, this study aims to elucidate potential differences in the inpatient setting using publicly available data. METHODS We conducted a retrospective cohort study of the Statewide Planning and Research Cooperative System database, a de-identified, patient-level dataset for inpatient visits in New York between 2009 and 2021. Admissions were filtered by diagnosis-related group (APR-DRG) code 380 (skin ulcers). RESULTS Compared to non-Hispanic white patients, non-Hispanic black patients demonstrated longer mean LOS (8.15 vs. 7.48 days, p = 0.009), higher mean charges ($44,400 vs. $37,600, p < 0.001), and were more frequently discharged home without services (38.1% vs. 32.4%, p < 0.001). Black Hispanic patients had similar mean LOS (7.22 vs. 6.36 days, p = 0.133), similarly discharged home without services, and had higher mean charges ($45,800 vs. $36,700, p = 0.031). After adjusting for patient factors, non-Hispanic black patients had a longer LOS by 0.26 days (p = 0.028) with $2331 higher inpatient charges (p = 0.001) compared to non-Hispanic white patients. CONCLUSIONS The findings suggest racial and ethnic differences in hospitalizations for skin ulcers, with black patients experiencing greater LOS and charges. The reasons for these differences merit investigation, yet could be related to delays in outpatient care, more severe disease, presence of comorbid conditions, or complications requiring intensive inpatient services.
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Affiliation(s)
- Nicole J Hardy
- University of Connecticut School of Medicine, Farmington, CT, USA
| | - Christian Gronbeck
- Department of Dermatology, University of Connecticut Health Center, 21 South Rd, 2nd Floor, CT, 06032, Farmington, USA
| | - Hao Feng
- Department of Dermatology, University of Connecticut Health Center, 21 South Rd, 2nd Floor, CT, 06032, Farmington, USA.
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Abstract
Health disparities exist in marginalized patient populations throughout medical specialties, including in dermatology. It is important that the physician workforce reflect the diversity of the US population to address these disparities. At present, the dermatology workforce does not reflect the racial or ethnic diversity of the US population. The subspecialties of pediatric dermatology, dermatopathology, and dermatologic surgery are even less diverse than the dermatology workforce as a whole. Although women make up over half of the population of dermatologists, disparities still exists in areas such as compensation and presence in leadership positions.
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Affiliation(s)
| | - Victoria Barbosa
- University of Chicago Medicine Section of Dermatology, 5841 South Maryland Avenue, MC5067, L518B, Chicago, IL 60637, USA.
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Vitalpur G, Lahood R, Kussin M, Koenigsberg R, Huynh A, Kutala N, Qiu Y, Slaven J, Manaloor J. Impact of penicillin allergy labels among pneumonia admissions at an academic children's center. Allergy Asthma Proc 2023; 44:130-135. [PMID: 36872442 DOI: 10.2500/aap.2023.44.220104] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
Background: Pneumonia is the most common reason for pediatric hospitalizations. The impact of penicillin allergy labels among children with pneumonia has not been well studied. Objective: This study assessed the prevalence and impact of penicillin allergy labels among children admitted with pneumonia over a 3-year period at a large academic children's center. Methods: Inpatient charts of pneumonia admissions with a documented allergy to a type of penicillin from January to March in 2017, 2018, and 2019 were reviewed and compared with pneumonia admissions without the label over the same time with regard to days of antimicrobial treatment, route of antimicrobial therapy, and days of hospitalization. Results: There were 470 admissions for pneumonia during this time period, of which 48 patients (10.2%) carried a penicillin allergy label. Hives and/or swelling comprised 20.8% of the allergy labels. Other labels included nonpruritic rashes, gastrointestinal GI symptoms, unknown/undocumented reactions, or other reasons. There were no significant differences between those with a penicillin allergy label to those without regarding days of antimicrobial treatment (inpatient and outpatient), route of antimicrobial therapy, and days of hospitalization. Those with a penicillin allergy label were less likely to be prescribed a penicillin product (p < 0.002). Of the 48 patients who were allergy labeled, 23% (11/48) were given a penicillin medication without adverse reaction. Conclusion: Ten percent of pediatric admissions for pneumonia had a label of penicillin allergy, similar to the overall population. The hospital course and clinical outcome were not significantly affected by the penicillin allergy label. The majority of documented reactions were of low risk for immediate allergic reactions.
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Affiliation(s)
- Girish Vitalpur
- From the Division of Pediatric Pulmonology, Allergy-Immunology and Sleep Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Ryan Lahood
- Section of Allergy and Immunology, Children's Hospital of Colorado, University of Colorado School of Medicine, Aurora, Colorado
| | - Michelle Kussin
- Ryan White Center for Pediatric Infectious Diseases and Global Health, Indiana University School of Medicine, Indianapolis, Indiana
| | - Rebecca Koenigsberg
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
| | - An Huynh
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Nikita Kutala
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Yingjie Qiu
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine and Fairbanks School of Public Health, Indianapolis, Indiana, and
| | - James Slaven
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine and Fairbanks School of Public Health, Indianapolis, Indiana, and
| | - John Manaloor
- Pediatric Infectious Diseases, Children's Hospital of San Antonio, Baylor College of Medicine, San Antonio, Texas
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15
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Ludwig RJ, von Stebut E. [Inflammatory dermatoses in skin of color]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2023; 74:84-89. [PMID: 36592194 DOI: 10.1007/s00105-022-05096-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/05/2022] [Indexed: 01/03/2023]
Abstract
Acne, rosacea, atopic dermatitis, and psoriasis vulgaris are common inflammatory dermatoses. Of note, the epidemiology and clinical presentation of these common dermatologic diseases varies considerably between people with different colors of skin. Yet, most dermatology textbooks present and describe the clinical pictures of White people. To provide excellent dermatological care for all patients, it is of central importance to know the epidemiology and recognize key clinical characteristics of these diseases in patients with skin of color (SOC). In acne, cultural habits of Blacks (use of steroid-based lighteners, comedogenic hair care products) may lead to manifestation of specific forms of acne. In addition, postinflammatory hyperpigmentation and keloids pose particular therapeutic challenges in this patient group. Atopic dermatitis in Asians shows a clinical and histological picture that is similar to psoriasis in Whites. By contrast, atopic dermatitis manifests on the extensor side in Black people. Due to the difficulty of recognizing erythema in SOC, the severity of the respective inflammatory diseases in these individuals is often underestimated. The treatment of acne, rosacea, atopic dermatitis, and psoriasis does not differ between people of different skin colors. The exception is the necessary therapy for postinflammatory hyperpigmentation in all the inflammatory dermatoses mentioned, and for keloids in acne.
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Affiliation(s)
- Ralf J Ludwig
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Ratzeburger Allee 160, 23652, Lübeck, Deutschland.
- Departmentof Dermatology, University Hospital Schleswig-Holstein Lübeck, Lübeck, Deutschland.
| | - Esther von Stebut
- Department of Dermatology, Faculty of Medicine, University of Cologne, Köln, Deutschland
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16
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Diamond C, Albrecht M, Rundle CW, Stamey C. Quantitative and Qualitative Analysis of Skin of Color Images in Dermatologic Surgery Literature From 2019 - 2022. Dermatol Surg 2023; 49:110-112. [PMID: 36533806 DOI: 10.1097/dss.0000000000003654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Carrie Diamond
- School of Medicine, Duke University, Durham, North Carolina
| | - Mark Albrecht
- School of Medicine, University of Utah, Salt Lake City, Utah
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17
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Jones BL, Carter MC, Davis CM, Wang J. Diversity, Equity, and Inclusion: A Decade of Progress? THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:116-125. [PMID: 36272720 DOI: 10.1016/j.jaip.2022.10.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/05/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022]
Abstract
The concepts of diversity, equity, and inclusion are fundamental and more recently heavily discussed within medicine, research, and the larger society. There is increasing awareness that diversity of thoughts, perspectives, and backgrounds yields stronger teams and more effective results. There is also increasing awareness that stark inequities from systemic, institutional, and individual levels exist that limit the baseline opportunities for many populations. To close disparity gaps, broad aspects of diversity and promoting equity are required and efforts must be inclusive of those most marginalized. In this Clinical Commentary, we discuss, "How and If progress has been made in Diversity, Equity, Inclusion within the field of Allergy/Asthma/Immunology in the past decade?" We discuss the current state of clinical practice and what has been revealed over the past 10 years; describe our current workforce and what progress has or has not occurred there; and finally, review the state of scientific and medical research.
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Affiliation(s)
- Bridgette L Jones
- Department of Pediatrics, Section of Allergy, Asthma, Immunology and Division of Pediatric Clinical Pharmacology and Therapeutic Innovation, University of Missouri Kansas City School of Medicine, Children's Mercy Hospital Kansas City, Kansas City, Mo.
| | - Melody C Carter
- Mast Cell Biology Section, Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Carla M Davis
- Division of Immunology, Allergy and Retrovirology, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas
| | - Julie Wang
- Jaffe Food Allergy Institute, Department of Pediatrics, Division of Allergy & Immunology, Icahn School of Medicine at Mount Sinai, New York, NY
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18
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Strategies for augmenting the Spanish-speaking dermatology workforce of the United States. J Am Acad Dermatol 2022; 87:e159-e160. [PMID: 35697173 DOI: 10.1016/j.jaad.2022.05.061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/09/2022] [Accepted: 05/09/2022] [Indexed: 11/22/2022]
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19
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Loginovic P, Syed N, Parker AM, Williams NG, Mukundu Nagesh N. A student-led public education project on dermatology in skin of colour. SKIN HEALTH AND DISEASE 2022; 3:e166. [PMID: 36751310 PMCID: PMC9892426 DOI: 10.1002/ski2.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 08/24/2022] [Accepted: 08/31/2022] [Indexed: 11/10/2022]
Abstract
Despite the UK's population rapidly diversifying, the representation of dermatological conditions in skin of colour in education, medical resources, and clinical practice is lagging. Furthermore, resources and advancements created by recent initiatives appear not to be communicated to the general public and are not integrated into medical curricula. In this perspective article, we share our experience from a public-engagement campaign in South West England and propose that student-led initiatives hold the potential to close the existing gap in diversity and racial equity in dermatology by communicating recent efforts within the medical field to the general public. We describe how student-led initiatives allow medical students to advocate for diversity and equity within their institutions while delivering much-needed education to ethnically minoritised communities.
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Affiliation(s)
- Pavel Loginovic
- University of Exeter Medical SchoolCollege of Medicine and HealthExeterUK
| | - Natasha Syed
- University of Exeter Medical SchoolCollege of Medicine and HealthExeterUK
| | - Alex M. Parker
- University of Exeter Medical SchoolCollege of Medicine and HealthExeterUK
| | - Nel G. Williams
- University of Exeter Medical SchoolCollege of Medicine and HealthExeterUK
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20
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A novel inflammatory response-related signature predicts the prognosis of cutaneous melanoma and the effect of antitumor drugs. World J Surg Oncol 2022; 20:263. [PMID: 35982458 PMCID: PMC9389732 DOI: 10.1186/s12957-022-02726-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 08/06/2022] [Indexed: 11/10/2022] Open
Abstract
Cutaneous melanoma (CM) is a skin cancer that is highly metastatic and aggressive, with a dismal prognosis. This is the first study to use inflammatory response-related genes to build a model and evaluate their predictive significance in CM. This study used public databases to download CM patients' mRNA expression profiles and clinical data to create multigene prognostic markers in the UCSC cohort. We compared overall survival (OS) between high- and low-risk groups using the Kaplan-Meier curve and determined independent predictors using Cox analysis. We also used enrichment analysis to assess immune cell infiltration fraction and immune pathway-related activity using KEGG enrichment analysis. Furthermore, we detected prognostic genes' mRNA and protein expression in CM and normal skin tissues using qRT-PCR and immunohistochemistry. Finally, we developed a 5-gene predictive model that showed that patients in the high-risk group had a considerably shorter OS than those in the low-risk group. The analysis of the receiver operating characteristic (ROC) curve proved the model's predictive ability. We also conducted a drug sensitivity analysis and discovered that the expression levels of prognostic genes were substantially linked with cancer cell sensitivity to antitumor medicines. The findings show that the model we developed, which consists of five inflammatory response-related genes, can be used to forecast the prognosis and immunological state of CM, giving personalized and precision medicine a new goal and direction.
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21
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Walker AM, Lu G, Clifton SC, Ogunsanya ME, Chong BF. Influence of Socio-Demographic Factors in Patients With Cutaneous Lupus Erythematosus. Front Med (Lausanne) 2022; 9:916134. [PMID: 35899206 PMCID: PMC9311297 DOI: 10.3389/fmed.2022.916134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
Cutaneous lupus erythematosus (CLE) is a chronic autoimmune skin disease with potential for systemic involvement, disfigurement, and significant disease burden. The relationships of demographics and socioeconomic status with patients with CLE are emerging topics with important clinical implications. The primary objective of our study is to perform a literature review of studies that have investigated demographic and socioeconomic factors amongst patients with CLE and determine whether these factors influence diagnosis frequency, disease severity and outcomes or health related quality of life. We searched multiple databases to identify literature addressing CLE and concepts such as race, ethnicity, gender, income, education level and geographic location. Information regarding primary research objective was extracted from all full text articles, and a summary of findings was prepared. We found that race and ethnicity can influence CLE diagnosis frequency and disease outcomes. Chronic cutaneous lupus (CCLE) occurs more frequently in Black patients, often with higher overall disease damage. Differences between genders exist in CLE in terms of health-related quality of life, as female gender was a risk factor for worse quality of life in several studies. Lower income, low educational attainment, and lack of health insurance all contribute to poorer overall outcomes in CLE patients. This review will help inform physicians about populations at risk for potentially worse outcomes to guide treatment decisions for patients with CLE and provide important information to design interventions that address modifiable social determinants of health in this population.
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Affiliation(s)
- Amanda M. Walker
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Grace Lu
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Shari C. Clifton
- Health Sciences Library and Information Management, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Motolani E. Ogunsanya
- Department of Pharmacy, Clinical and Administrative Sciences, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Benjamin F. Chong
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, United States
- *Correspondence: Benjamin F. Chong
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