A previously uncharacterized pathway of vitamin D3 metabolism has been confirmed to operate in vivo, and this pathway begins with hydroxylation at C20 or C22. Resulting products, 20(OH)D3 and 22(OH)D3, have been detected in human serum and skin, and they undergo further hydroxylation to produce biologically active compounds that are noncalcemic at high pharmacologic doses. Many of these compounds have shown to inhibit growth of melanoma cells and stimulate keratinocytes differentiation. The purpose...
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While deregulated, cell-autonomous Hedgehog (Hh) signaling is associated with the development of human cancer, particularly basal cell carcinoma, relatively little attention has been focused on accompanying changes in surrounding tissues. We have previously shown that elevated Hh signaling in the epithelium of K5-tTA;tetO-Gli2 mice leads to development of basal cell carcinoma and odontogenic keratocysts. In addition, basaloid squamous cell carcinomas (BSCCs) arise in the jaws of these mice by 6 months...
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Melanocytic nevus count is a major risk factor for potentially fatal cutaneous melanoma, but its association with sunburns has not been well established in young children. We sought to review the literature on sunburn history and nevus development in young children. Of the total 197 publications that resulted from our PubMed search in February 2019, eight met inclusion criteria of case-control or cohort study design; included data on nevus count and lifetime history of sun burns; studied children,...
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We sought to determine factors related with sunscreen use by studying a high-risk population of 932 veterans in the Veterans Affairs Keratinocyte Carcinoma Chemoprevention (VAKCC) Trial. Patients had a history of 2 keratinocyte carcinomas (KCs) in the 5 years prior to the study. Questions about sunscreen use at baseline, participants’ ability to tan, during winter time, whether they have freckles or not, education higher than high school, state of residence according to ultraviolet index (UV) were...
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Langerhans cells (LC) represent a specialized subset of evolutionarily conserved dendritic cells (DC) in skin, which are essential for induction of skin immunity and tolerance. They self-renew in the skin at steady state, but could repopulate from peripheral blood Gr-1hi monocytes and bone marrow (BM) hematopoietic stem cells at inflammatory state. Transforming growth factor-beta1 (TGFβ1) is a crucial factor in the regulation of LC maintenance and function after birth, however the underlying TGFβ...
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Background: Dermatologic diseases account for over 650,000 hospital admissions annually, but in most, Dermatologists serve as consultants, as opposed to admitting physicians, even for severe dermatoses. Common dermatologic diseases are often misdiagnosed when admitted to general medicine services. We describe the demographics, diagnostic, and management trends of patients admitted to a dermatology inpatient service to analyze dermatology inpatient care of patients with dermatologic conditions. Methods:...
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Psoriasis is an immune-mediated disease thought to be driven by heightened Th17 and Th1 responses. Secukinumab is an IL17A inhibitor used for the treatment of psoriasis. We aimed to understand the impact of secukinumab on psoriatic whole skin tissue as well as specific skin immune cell populations. We treated 15 psoriasis patients with secukinumab and characterized the response of whole skin lesional tissue and cutaneous T cell subsets (CD4+ T regulatory cells (Tregs), CD4+ T and CD8+ T effector...
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The purpose of this study was to determine if the most common presenting location (MCPL) of melanoma varies by histologic subtype, age, sex, and race/ethnicity. Previous studies identified the MCPL of melanoma as the legs of women and back of men, however, these studies did not distinguish the MCPL by tumor subtype or other demographics. A total of 194,080 cases from the 2004-2015 National Cancer Database were analyzed in SPSS (Armonk, NY). The analysis was limited to nodular, lentigo maligna/lentigo...
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We report a case of squamous cell carcinoma secondary to plantar wart in a 72-year-old Chinese woman. 20 years previously the patient found a 1-cm round grayish yellow plaque on her right heel. The lesion was diagnosed as plantar wart by every dermatologist the patient consulted, and can be gradually subsided after treatment such as cryotherapy and photodynamic therapy, but recurred frequently. 2 years previously the plaque enlarged accompanying with aggravated pain, biopsy indicated verrucous hyperplasia.
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Clearance of atopic dermatitis (AD), defined as total absence of symptoms, may be achieved with or without treatment. Differences between those achieving clearance without treatment (remission) versus those achieving clearance with treatment (control) remain largely unstudied. We utilized a cross-sectional cohort design to identify factors associated with remission over control in children with AD. We used data from the Pediatric Eczema Elective Registry, an ongoing observational cohort of children...
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The human skin is colonized by a diverse population of microorganisms with most of them being harmless or even beneficial to their host. In the last decade, in vitro human skin model equivalents have been developed to assess the interplay between the skin and the microbiota. However, most studies have only looked at the impact of individual microbiota species. Therefore, there is still the need for a human skin model that would enable to maintain the diversity of skin microbiome found in vivo in...
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Background: While sun exposure is a well-established risk factor for non-melanoma skin cancer (NMSC), limited data is available on the association of factors such as patient sun protection behaviors and skin cancer knowledge. The objective of this study was to investigate factors that may predispose patients to NMSC and determine if they are associated with patient sun protection behaviors, skin cancer knowledge, and how these may influence quality-of-life following NMSC diagnosis. Methods: From...
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The Research Techniques Made Simple (RTMS) series of the Journal of Investigative Dermatology (JID) was created to be an educational tool for scientists and clinicians training for a lifelong career in Dermatology. Since its inception in the fall of 2012, 84 articles have been written and published monthly online, in seven volumes of annual reprints, and in each print issue of the JID since 2018. RTMS articles come as a packet that includes the article itself, a supplemental Powerpoint presentation...
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Keratinocyte carcinoma (KC) is the most common malignancy in white skin population and its incidence has been increasing. We sought to evaluate the trends in age adjusted KC mortality rates (MRs) in the United States as reported in death certificates for 2011-2017. Data was collected from CDC. Based on ICD10 codes we analyzed three KC categories: genital, perianal and the rest, which we present as “sun exposed”. We excluded the neoplasms of the scalp and neck due to reports of high number of misclassified...
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The clinical management of large and giant congenital melanocytic nevi (lgCMN) relies heavily upon iterative surgical procedures. In this issue Rouille et al. (2019) use lgCMN explants and a newly developed patient-derived xenograft model to show that the local administration of MEK and Akt inhibitors limits the lgCMN proliferative potential. These findings, along with emerging reports, support continued investigation of targeted therapies in lgCMN.
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The purpose of this study is to appraise Global Burden of Disease (GBD) and PatientsLikeMe.com (PLM) databases for the evaluation of dermatologic disease. Utilizing the GBD results tool [http://ghdx.healthdata.org/gbd-results-tool], incidence and prevalence data was extracted. In PLM, total number of subscribers for each disease and male/female distribution were assessed. Diseases analyzed were of the top fourteen diseases with the highest disability-adjusted life-year. As of September 2018, there...
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Checkpoint inhibitors are currently frontline therapy for stage IV melanoma patients, however many patients do not respond to them. Options for these patients are limited and there is a critical need for new therapies. The tumor microenvironment (TME) plays an important role in determining treatment efficacy. Tumors with poor T cell infiltration and a non-inflamed, myeloid rich TME typically do not respond to checkpoint therapy. Tumor associated macrophages (TAMS) are abundant in the TME and can...
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Skin cancer is a major public health concern worldwide due to its significant cost burden. Exposure to UV light is a major risk factor for all types of skin cancer. Regular sunscreen use provides protection from UV light and decreases the incidence of skin cancer. This study aims to evaluate the patterns and proportion of Mardi Gras attendants that use sunscreen. By assessing the population, the study can gauge the amount of knowledge the New Orleans population has about sun safety and skin cancer.
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Over the last two decades, the annual melanoma incidence has increased by 20% in the Latino population. Latinos/Hispanics often present with advance-staged melanoma (stage III and IV) and have an overall worse prognosis when compared to their Caucasian counterparts. Thus, new public health campaigns are warranted to target this specific population. We conducted semi-structured interviews with 10 Latino tattoo artists in Salt Lake City, UT. Although Latinos only constitute 13% of the population in...
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Psoriasis prevalence has long been considered to be 2-4% in the United States (US). Recently, prevalence rates of 0.5-0.6% were reported in Medicare patients and 0.128% in commercially insured children. We investigated psoriasis prevalence among commercially insured individuals younger than 65 years. The Truven Health Analytics MarketScan Commercial Claims and Encounters databases, which includes beneficiaries of employer-based commercial insurance in the US, was interrogated for continuously enrolled...
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Skin processes excellent regeneration properties allowing its rapid healing upon dermal injury. If wounds fail to heal in an orderly and timely manner, chronic ulcers develop. To test the potential of innovate therapies to promote wound repair, relevant wound infection models are needed. Current research is mainly conducted on animal models, which often limits direct transferability to human and poses ethic issues. These limitations can be overcome by using a proprietary ex vivo human skin model,...
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LB1073 Exploring the influence of rural/metropolitan health disparities on melanoma outcomes in Iowa
Melanoma remains one of the most preventable types of malignancy, yet we do not fully understand the contribution that rural health disparities have on diagnosis and survival outcomes. Currently, there is limited data regarding the link between geographic location of patients and socioeconomic variables with regards to melanoma diagnosis, staging, and survival. We performed data extraction and retrospective analysis of the SEER database of all patients receiving a diagnosis of melanoma from 1996...
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Editorial note: Welcome to the Journal of Investigative Dermatology (JID) Cells to Surgery Quiz. In this monthly online-only quiz, the first question (“What is your diagnosis?”) relates to the clinical image shown, while additional questions concern the findings reported in the JID article by Kuonen et al. (2019) (https://doi.org/10.1016/j.jid.2018.11.035).
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Over 5.4 million cases of non-melanoma skin cancer (NMSC) arise yearly, primarily in the elderly. In older patients with comorbidities, long-term benefits of treatment must be balanced with short-term risks. As limited life expectancy and Charlson comorbidity index have not been shown to affect treatment decisions, our study aimed to identify specific clinical characteristics differentiating untreated and treated patients among the elderly. We performed a retrospective cross-sectional review of biopsy-proven...
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Augustin and colleagues present a detailed investigation of the distribution of body sites affected by psoriasis in adult German patients with psoriasis under the care of dermatologists. Patients self-completed a grid indicating areas of involvement, with 96% providing complete grid data. Of the 2009 patients, 19% had psoriatic arthritis, 65% had scalp involvement, 36% had nail involvement and 41% reported an affected first-degree relative. In a linear regression analysis, the strongest predictors...
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Purpose: Many transgender people seek gender-affirming procedures to help alleviate gender dysphoria. As increasing evidence shows that transition-related care for transgender patients is medically necessary and cost-effective, gender confirmation surgeries are being increasingly covered by insurance. We seek to understand the scope of Medicaid coverage for transition-related dermatologic procedures in the United States. Methods: We performed a cross-sectional review of state-level policies regarding...
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Desmosomes are cell-cell junctions present in the epithelia and heart and provide mechanical resistance to these tissues in adults. Thus, it is of no surprise that people born with defects in desmosomal proteins can have numerous defects affecting the skin, hair, and heart. However, unlike other junctional complexes, the role of the desmosomes in epidermal development has largely been unexplored. Therefore, this work fills a major knowledge gap by probing the function and regulation of a critical...
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IQGAP proteins mediate many processes important for the development of hyperproliferative skin diseases, namely the EGF signaling, WNT and MAPK kinase cascades, they are required for cell adhesion and migration processes, tight junction and zonula occludens formation, cell cycle regulation. However, the possible contribution of the IQGAP3 in the development of hyperproliferative psoriatic plaques is unknown. We have shown earlier that IQGAP3 is overexpressed in the lesional skin of patients with...
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Iron is an essential nutrient for all living organisms and functions as a cofactor for cellular enzymatic processes. Multiple organ systems are affected by inappropriate levels of circulating iron levels, including the bone marrow, central nervous system, and skin. Cutaneous conditions associated with high and low iron include telogen effluvium, angular cheilitis, koilonychia, ichtyosis-like changes, atrophy, and changes in pigmentation. Iron homeostasis mechanisms exist to maintain total body iron...
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Mammalian epidermis positioned at the interface with the environment, protecting underlying tissues from external challenges such as pollutants. Diesel exhaust particles (DEPs) are a major contaminator of air pollution particles, and emerging evidences indicate that polycyclic aromatic hydrocarbons (PAHs), a main component of DEPs, cause skin irritation and inflammation through aryl hydrocarbon receptor (AhR)-dependent signaling pathways. In particular, prior studies revealed that an AhR activation...
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