OSHA and CMS released emergency rules on Nov. 4 that expand vaccination requirements to more health care workers as well as employees of any business with more than 100 employees. The CMS rule covers staff at any facility that accepts payment from Medicare or Medicaid, and requires eligible staff to receive the first shot of one of the three approved vaccines by Dec. 5. 2021, and complete their two-shot vaccination series by Jan. 4, 2022. Learn more about the requirements for each rule.
ASAP, the well-recognized acronym for “as soon as possible,” takes on special significance for dermatologists confirming the diagnosis of toxic epidermal necrolysis (TEN). In 2004, Ting et al introduced an alternative definition of the ASAP acronym — Acute Syndrome of Apoptotic Pan-epidermolysis, encompassing classical drug-induced TEN and the TEN-like entities: TEN-like graft-versus-host disease, TEN-like pseudoporphyria, and TEN-like acute cutaneous lupus erythematosus (ACLE). Drug-induced linear IgA dermatosis may also present clinically as TEN. The common denominator in ASAP is hyperacute apoptotic epidermal injury resulting in potentially life-threatening massive epidermal separation from the dermis. This commentary will focus on the expanding literature on TEN-like ACLE. Keep reading!
Prognostic value of lymphovascular invasion in early-stage Merkel cell carcinoma
In a retrospective chart review published in JAAD, 4,023 patients with early-stage Merkel cell carcinoma (MCC) were identified from the National Cancer Database. Of these, 1,139 (28.3%) had lymphovascular invasion (LVI). Factors associated with greater odds of LVI included treatment at an academic center, age 75 years or older, lesions in the upper/lower extremities, presence of tumor-infiltrating lymphocytes, and higher disease stage.
The five-year survival for LVI-positive patients was 50.6% compared with 61.7% survival for LVI-negative patients. LVI positivity was associated with decreased overall survival independent of stage. Adjuvant radiation was associated with improved overall survival. The authors recommend MCC patients who are LVI positive should be considered for adjuvant radiation therapy.
Life-changing advances and a multidisciplinary approach give new hope to patients with Merkel cell carcinoma. Learn more in this month’s DermWorld.
In a study published in JAAD, the authors used data from the National Health and Nutrition Examination Survey to examine the association between sunscreen and blood concentrations of benzene, a known human carcinogen. Data was available for nearly 11,000 adults.
Individuals who reported sunscreen use of any frequency were found to be significantly less likely to have elevated blood benzene levels and were more often below the lower limit of detection than patients who reported never using sunscreen, suggesting that the risk of systemic benzene exposure from sunscreen use may be low. Other factors that may influence systemic benzene concentrations include gasoline emissions, second-hand cigarette smoke, chemical products, and occupational exposures.
Dermatologists discuss the debate about the effects of sunscreen ingredients on the environment inDermWorld.
Does exercise influence skin aging, skin health, or androgenetic alopecia?
A recent letter published in JAADexplored the correlation between exercise and various dermatologic conditions, including skin aging, skin health, and androgenetic alopecia. The authors found that regular high-intensity aerobic exercise more than four hours per week reduced thinning of the stratum corneum and increased Pgc-1a expression, a mitochondrial regulator indicative of decreased aging of cells.
[What has research revealed about the pathogenesis of various hair disorders? Find out in DermWorld.]
Vigorous exercise was associated with a 25% to 30% reduced risk of psoriasis. Physical activity was also associated with improved healing of venous ulcers. There was insufficient evidence that exercise prevents skin cancer or worsens androgenetic alopecia.
Does a physician’s relationship to fitness affect patient care? Find out inDermWorld.
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