What’s the effect of probiotics on skin photoaging
?
In a systematic review and meta-analysis published in Photodermatology, Photoimmunology & Photomedicine, the authors aimed to assess the effects of probiotics on skin photoaging. This study included 13 articles examining the effects of probiotics on skin photoaging in humans and mice. The administration of probiotics in mice reduced the matrix metalloproteinase levels and reversed the UV-induced increase in epidermal thickness, UV-induced trans-epidermal water loss, and UV-induced skin dehydration. The authors propose that oral probiotics seem to have anti-inflammatory and skin barrier-restoring properties, although they discuss the limitations of murine experiments and the lack of standardized concentration, dosing, and timing for the probiotic.
Experts offer best practices on efficiently addressing patients’ questions about sunscreen in DermWorld.
DermWorld Insights and Inquiries: An appealing step closer to targeted topical therapies
Although advances in molecular genetics have revolutionized our understanding of the pathogenesis of disease, the road to developing topical therapies based on these discoveries is in its infancy. Under the umbrella of autosomal recessive congenital ichthyosis (ARCI) are the peeling skin syndromes (PSS) caused by defective cell-to-cell adhesion in the upper epidermis. To date, therapy for PSS primarily involves symptomatic control with topical emollients and avoidance of aggravating factors such as heat, humidity, and friction. Every dermatologist understands the potential appeal of effective, specific topical therapy for ARCI and PSS. A liposomal formulation of recombinant corneodesmosin has shown efficacy for peeling skin syndrome type 1 in vitro. It is scintillating to realize that we are on the cusp of having such creams developed. Keep reading!
Does nicotinamide prevent keratinocyte cancers in organ recipients?
Authors of a study published in The New England Journal of Medicine evaluated whether oral nicotinamide is useful for skin cancer chemoprevention in organ-transplant recipients. In this phase 3 trial, the authors assigned organ-transplant recipients who had at least two keratinocyte cancers in the past five years to receive 500 mg of nicotinamide or placebo twice daily for 12 months. Dermatologists examined the participants at three-month intervals for 12 months.
A total of 158 participants were enrolled with 79 assigned to the nicotinamide group and 79 in the placebo group. At 12 months, there were 207 new keratinocyte cancers in the nicotinamide group and 210 in the placebo group. Although the trial was stopped early due to poor recruitment, no significant between-group differences in squamous-cell and basal-cell carcinoma counts, actinic keratosis counts, or quality-of-life scores were observed.
What can dermatologists do to prevent squamous cell carcinoma in solid organ transplant recipients? Read more in DermWorld.
FDA advisory committees recommend vital changes to iPLEDGE
As a direct result of the AADA’s on-going advocacy to improve the iPLEDGE REMS Program, the FDA held a joint advisory committee meeting last week to discuss ways to minimize burdens in the iPLEDGE REMS Program while maintaining safe use of isotretinoin oral capsules for patients.
At the meeting, joint advisory committee members voted and discussed key changes to the program. Overall, their recommendations are aligned with the AADA’s recommendations for the program:
Over 75% of the committee voted to remove the 19-day lockout period.
Most advisory committee members discussed allowing patients to have access to home pregnancy testing for iPLEDGE after the public health emergency and nearly all support non-CLIA pregnancy tests for in-office testing.
73% of the committee members voted to remove the monthly attestation requirement to every four months or at the time of enrollment, for patients who cannot become pregnant.
Many members were in support of Isotretinoin Products Manufacturers Group (IPMG) having physician and stakeholder representation, including regular meetings with the manufacturers.
Prior to the meeting, the FDA approved several minor changes the Academy has advocated for since the transition to the new platform, such as reinstating the calendar feature. AADA also urged the IPMG to implement these changes immediately.
AADA iPLEDGE Workgroup leaders, Ilona Frieden, MD, FAAD, and John Barbieri, MD, FAAD, presented oral testimony outlining Academy members’ concerns and recommendations to the program, and the AADA submitted written comments. Additionally, 286 member dermatologists submitted comments to the FDA through AADA’s member action alert center. The AADA’s entire iPLEDGE Workgroup has been relentlessly advocating over the past several years to fix iPLEDGE, and their efforts only intensified following the disastrous rollout of the new iPLEDGE REMS platform in late 2021.
Although FDA is not legally required to follow advisory committee members’ recommendations, FDA generally accepts the committee’s proposed changes. In the coming weeks, the AADA will follow up with the FDA and urge them to accept these recommendations.
The role of dermatologists in detecting elder abuse
A JAAD review article highlights the clinical characteristics, screening tools, and practical developments associated with elder abuse. Risk factors for potential elder victims include increased age, female sex, low socioeconomic status, functional disabilities, cognitive impairment, and non-white race. Characteristics of potential abuse can be seen with bruises, lacerations, fractures, traumatic alopecia, and scabies. While there is a lack of universal agreement on screening recommendations, the authors recommend the Elder Abuse Suspicion Index as a rapid and effective screening method.
If elder abuse is suspected, a report to the Adult Protective Services or a Long-Term Care Ombudsman Program should be filed. Dermatologists can play a vital role in detecting and reporting elder abuse due to their patient population and the nature of full-body skin examinations. The authors also note that the signs, screening tools, and steps to reporting should be included in the dermatology residency curriculum.
Golden rules for the golden years. Read more about strategies for caring for elderly patients inDermWorld.
DEA issues letter on MATE Act training requirements
The U.S. Drug Enforcement Administration (DEA) recently issued a letter outlining the training that will meet the requirements of the Medication Access and Training Expansion (MATE) Act. On Dec. 29, 2022, the Consolidated Appropriations Act of 2023 enacted a new one-time, eight-hour training requirement for all DEA-registered practitioners on the treatment and management of patients with opioid or other substance use disorders.
Beginning on June 27, 2023, physicians will be required to check a box on their online DEA registration form affirming that they have completed the new training requirement. The deadline for completing this training requirement is the date of the physician’s next scheduled DEA registration submission — regardless of whether it is an initial registration or a renewal registration — on or after June 27, 2023. Learn more about how physicians can satisfy this new training requirement.
Stay tuned to DermWorld Weekly for additional guidance.
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