Efficacy of probiotics in the treatment of patients with acne
A review published in the Archives of Dermatological Researchsummarized data from clinical trials evaluating the efficacy of probiotics for the treatment of patients with acne vulgaris. There were significant changes in acne lesion counts following multi-strain topical treatment with Lacticaseibacillus rhamnosus GG, Lactiplantibacillus plantarum WCFS1, and Lactiplantibacillus pentosus KCA1 as well as treatment with topical Enterococcus faecalis, 5% L plantarum topical extract, and oral L plantarum. Two studies found decreased Cutibacterium acnes and Staphylococcus aureus counts after topical Lactobacilli application or supplementation with mixed oral probiotics. While the authors note that early studies show promising results, further investigation is warranted regarding the role of topical and oral probiotics for the treatment of acne.
What is the role of dietary fiber and probiotics on the microbiome and melanoma immunotherapy response? Read more.
DermWorld Insights and Inquiries: Vasculitis on the run
I was proud of completing the two-mile Cooper-Norcross “Run/Walk the Bridge” event last weekend on the Ben Franklin Bridge between Camden and Philadelphia, with a personal best power walk of 30 minutes. Two days after the walk, I read a case report titled, “Bilateral lower extremity inflammatory lymphedema” (BLEIL) by Robinson et al. After reviewing the literature, I suspect that exercise-induced vasculitis (EIV) and BLEIL are on a spectrum of benign cutaneous leukocytoclastic vasculitis. Vigorous exercise may induce a self-limited cutaneous leukocytoclastic vasculitis, including the recently described bilateral lower extremity inflammatory lymphedema. Keep reading!
Cosmetic tattoos, permanent makeup may cause allergic contact dermatitis
According to a study published in JAAD, both organic and inorganic pigments used in cosmetic tattoos, also known as permanent makeup, may cause allergic contact dermatitis. In this study, the authors investigated the listed contents of permanent makeup pigments in the U.S., whether they use organic pigments vs. heavy metals and their association with allergic contact dermatitis.
The researchers found a total of 974 permanent makeup inks containing 79 unique pigments that are sold and used in the U.S. Twenty of the 79 pigments were classified as inorganic metals, which included iron, chromium, manganese, and molybdenum. Contact dermatitis incidences were traced to 10 of the 79 pigments: Black 11, Blue 15, Green 7 blue 15, Orange 34, Red 101, Red 122, Red 181, Red 210, Yellow 42, Yellow 65, and Solvent Yellow 33. While most of the pigments used are organic, some of them are still metallic and are known to cause allergic contact dermatitis.
Dermatologists discuss cutaneous complications of tattoos — and their complex regulatory status in DermWorld.
Alaskapox infection: What dermatologists need to know
An article published in JAAD discussed how to recognize and manage Alaskapox infection (now boreal pox). Since boreal pox was first identified in Alaska in 2015, there have been six additional cases of infection. The most recent case involved hospitalization and death of an older immunocompromised patient. The reservoirs for borealpox virus are red-backed voles and shrews. Domestic pets may be intermediate hosts or passive vectors; to date, no human-to-human transmission has been reported. According to the authors, the skin lesions noted in this infection appear similar to those noted in other Orthopoxvirus infections. Because most cases are self-limited and no established treatments exist, supportive care and bandaging of lesions is recommended for mild disease.
Perioperative, intraoperative considerations for older patients undergoing dermatologic surgery
A continuing medical education article published in JAAD reviewed data regarding the perioperative considerations in older patients. Preoperative considerations include medication optimization (anxiolysis and anticoagulation), nonpharmacologic anxiolytic techniques, and fall risk assessment and prevention strategies. Intraoperative considerations include mobility-assistance devices and transfers, management of sundowning, and medication interactions. Postoperative considerations include the assessment of health literacy, wound care, home support, and re-introduction of medications and supplements.
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