Rituximab in treating pemphigus 07-
STDs On Rise in
the USA January 2014
increases vitamin D, too 18-
Skin changes in postmenopausal women
unaffected by hormone therapy 02-
Breast cancer and moisturizers!
UV rays more damaging on ski slopes 19-
trigger bad habits which increase heart attack risk 19-
Asthma Drug May Help Those With Chronic Hives
Don't blow your nose when you have a cold!12-
Stress and Psoriasis
Psoriasis 18- September 2009
Gravity and Melanoma
04- February 2011
Shisha; more dangerous than cigarette 01- June 2008
Robotic Hair transplant
01- June 2008
Under eye dark-circles
Scar Repair Products Rarely Effective.29-April 2011
In a trial among 22 people
with severe pemphigus, a disorder marked by blisters on the skin and
in the mouth and genitals, 59 percent were symptom-free more than
six years after treatment with a single dose of Rituxan, researchers
at France’s National Institute of Health and Medical Research in
Rouen wrote in the journal Science Translational Medicine.
Pemphigus is usually treated
with steroids, though relapses are common, requiring long-term
treatment that can cause complications including diabetes,
osteoporosis and severe infections. While the study tested Rituxan
in patients already treated with steroids, the researchers expect
results in about a year from a larger trial that compares the drug
with steroids as a frontline therapy, said Philippe Musette, a
professor of dermatology who led the research.
“In an autoimmune disease it’s
really difficult to have complete remission,” Musette said in a
telephone interview. “With one shot of rituximab we have a long-term
result,” he said, using Rituxan’s generic name.
STDs On Rise in the USA
Washington Times (1/9, Wetzstein) reports that the Centers for
Disease Control and Prevention Sexually Transmitted Disease
report (pdf) released yesterday shows that gonorrhea rates
increased in 2012 and syphilis rose 11%, while chlamydia remained
relatively flat, although a record 1.4 million cases existed. The
report states, “This is the largest number of cases ever reported to
the CDC for any condition,” with the National Coalition of STD
Directors adding that “rising STD rates have a major negative impact
on our ability to address the HIV epidemic.” Public health officials
are encouraging sexually active individuals to undergo annual STD
screenings, with men who have sex with men (MSM) screened at shorter
intervals if partners are not monogamous or use illicit drugs.
Bloomberg News (1/9, Lopatto) reports that the CDC connected
this rise in STD infection rates to “inadequate testing among people
stymied by homophobia and limited access to health care.” According
to CDC STD Prevention Division Director Gail Bolan, “We know that
having access to high-quality health care is important to
controlling and reducing STDs. Some of our more-vulnerable
populations don’t have access. There are a number of men who come in
to our clinic for confidential services because they’re too
embarrassed to see their primary care doctors.”
Huffington Post (1/9) quotes the report as recommending “dual
therapy with ceftriaxone and either azithromycin or doxycycline” for
phototherapy increases vitamin D, too
In patients with psoriasis,
narrow-band ultraviolet-B light increased serum vitamin D levels
while clearing the condition, researchers said.
In a prospective cohort study in Ireland, after treating "30
consecutive patients...with narrow-band ultraviolet-B -- in
wavelengths of 311 to 313 nanometers -- three times a week until
their condition cleared," researchers found that the "median level
of serum 25-hydroxyvitamin D [25(OH)D] had more than doubled at the
end of successful phototherapy, compared with no change among
.....Because the lack of
association with response -- those who needed more exposures to
clear their condition had significantly higher serum 25(OH)D levels
at the end of treatment -- "we cannot conclude, therefore, that
narrowband UV-B mediates its therapeutic effects by increasing
vitamin D levels," the researchers wrote.
Nonetheless, the study "provides
further insight into the role of vitamin D specific to patients with
psoriasis," argued Pranita Vemulapalli, BS, and Henry Lim, MD, both
of the Henry Ford Medical Center in Detroit.
In an accompanying editorial,
they said that although the study could not establish a causal link,
"it did highlight the prevalence of hypovitaminosis D in the
population of patients with psoriasis in northern latitudes."
of Dermatology: 2010;146
changes in postmenopausal women unaffected by hormone therapy
05 September 2008
SOURCE: J Am Acad Dermatol 2008; 59:397-404
Age-related facial skin changes in
postmenopausal women are unaffected by long-term hormone therapy, according
to findings published in the Journal of the American Academy of
Declining estrogen levels are associated
with a variety of skin changes in postmenopausal women, such as decreased
skin thickness, collagen content and elasticity, increased fine wrinkling
and dryness, and impaired wound healing. Many of these changes are
reportedly reversed or improved by estrogen supplementation.
Phillips and team evaluated the effects
of continuous combined norethindrone acetate (NA) and ethinyl estradiol (EE)
in the control of mild-to-moderate age-related skin changes in 485 women who
were, on average, 5 years postmenopausal. The women were randomly assigned
to receive double-blind treatment with placebo, 1 mg NA/5 µg EE, or 1 mg
NA/10 µg EE, for 48 weeks.
At week 48, there were no significant
differences between placebo and the hormone therapy groups with regard to
the primary endpoints: investigator global assessment of coarse and fine
facial wrinkling, and patient self-assessment of changes in wrinkling.
Instead, slight decreases for both endpoints were observed in all three
There were also no significant
differences among the three treatment groups for the secondary endpoints.
Secondary endpoints included investigator global assessment and patient
self-assessment of skin laxity/sagging and texture/dryness, as well as
wrinkle depth and skin elasticity.
"It is possible that longer treatment
duration, or different formulations or doses of estrogen, might have more
positive effects," comment Phillips and team. "Differing progestogen
combinations and examination of nonphotodamaged skin might also demonstrate
Phillips and colleagues note that a
marginally significant overall treatment effect was observed in the subgroup
of women who were less than 24 months postmenopausal (n=57).
Despite the result being unreliable due
to the small sample size, and the fact that the current study was not
designed to look at women who were in the early postmenopausal period, the
researchers say that "future studies in this group would be of interest,
particularly as hormone therapy given close to menopause appears to be
Breast cancer and
Bankhead) reported that "breast cancer patients may
unknowingly expose themselves to estrogen by using
certain skin moisturizers," according to a
researcher at the San Antonio Breast Cancer
Symposium. Adrienne C. Olson, Pharm.D., of
Breastlink in Rancho Palos Verdes, "collected
containers of 16 nonprescription skin moisturizers,
spanning a wide cost range." Dr. Olson "sent the
samples to a research laboratory, which tested the
products for the presence of estradiol, estrone, and
estriol." According to Dr. Olson, "laboratory
analyses identified a half-dozen different products
containing measurable levels of estriol and estrone,"
even though "none of the products listed the
estrogenic hormones among its ingredients."
rays more damaging on ski slopes
The combination of higher altitude and
ultraviolet (UV) rays reflected by the snow puts skiers
and snowboarders at an increased risk of sun damage and
ultimately, skin cancer.
While it "is easy to associate
winter with frostbite and windburn... most people are
unaware that UV rays can be even more damaging on the
slopes than on the beach." That's because "UV exposure
increases eight to10 percent with every 1,000 feet above
sea level." In addition, "snow reflects about 80 percent
of the UV light from the sun, meaning that you are often
hit by the same rays twice." Winter sports enthusiasts
should "use a broad-spectrum sunscreen with an SPF of 15
or higher," and "apply it 30 minutes before hitting the
slopes," even on cloudy days, and wear a "lip balm with
an SPF 15 or higher."
may trigger bad habits which increase heart attack risk
(12/15, Edelson) reported, "Stress increases the risk of heart attack and
other cardiovascular problems by pushing people toward bad habits,"
according to a study published in the Dec. 16/23 issue of the Journal of
the American College of Cardiology. Mark Hamer, Ph.D., of University
College London, and colleagues, "followed 6,576 participants in the Scottish
Health Study, which started with them filling out a 12-item questionnaire
designed to measure their general happiness by listing such things as
symptoms of depression or anxiety and recent sleep disturbances. About 15
percent of the people in the study were classified as suffering from
psychosocial stress on the basis of their answers." The investigators "also
collected physical data, starting with basic information on weight, height,
physical activity, alcohol intake, smoking, and blood levels of cholesterol
and C-reactive protein (CRP)."
Participants "were followed for an average of seven
years, and during this time there were 223 incident cardiovascular disease
events, including 63 fatal events,"
Medscape (12/15, O'Riordan) added.
"In an age- and sex-adjusted model, individuals identified as
psychologically distressed on the GHQ-12 [General Health Questionnaire] had
a 54 percent increased risk of cardiovascular events during the follow-up
period, confirming existing data." Overall, the authors demonstrated that
"behavioral factors, including smoking, physical activity, and alcohol
consumption, accounted for 65 percent of the relationship between
psychological distress and cardiovascular disease risk." Notably, another
"19 percent of the association was explained by pathophysiological risk
factors, such as hypertension" and CRP.
Asthma Drug May
Help Those With Chronic Hives
drug already used to treat moderate-to-severe allergic asthma (Omalizumab=Xolair)
appears to offer relief to people with chronic hives who haven't
been helped by standard medications, new research suggests.
The current study confirms that when Xolair is taken at a high dose
for a six-month period it seems to be both safe and effective at
controlling the severe and often debilitating itching that
characterizes long-term hives.
....While not lethal, chronic hives can last for months, and tend to
come and go without a clear idea of what brings it on...
To explore Xolair's potential, the team tested its effectiveness
among more than 260 chronic hives patients for whom prior treatment
Patients were randomly divided into four groups, in which they were
respectively treated with a once-a-month injection of Xolair at
either a 75 milligram (mg) dose, a 150 mg dose, a 300 mg dose, or a
Tracking was conducted for both a three-month period and a six-month
The team found that by the 12th week, people given Xolair showed a
marked reduction in their overall number of hives, hive intensity
and itching severity, compared with patients who got the dummy
treatment. Symptom relief was maintained through the six-month mark,
and the authors determined that those treated with the highest (300
mg) dosage of Xolair saw the biggest improvement.
Side effects were described as being mild to moderate, and included
headaches, joint pain, sinus infection and reactions at the point of
The study authors acknowledged that more research will be needed to
see how the drug performs over longer periods of time.
Dr. Robert Kirsner, chair of the department of dermatology and
cutaneous surgery and chief of dermatology at the University of
Miami Miller School of Medicine, suggested that the new intervention
could prove to be a boon for a condition that "can significantly
affect patients' quality of life."
SOURCE: The Journal of Investigative Dermatology
Don't blow your
nose when you have a cold!
Blowing your nose to alleviate
stuffiness may be second nature, but some people argue it does no
good, reversing the flow of mucus into the sinuses and slowing the
Counterintuitive, perhaps, but
research shows it to be true.
To test the notion, Dr. J. Owen
Hendley and other pediatric infectious disease researchers at the
University of Virginia conducted CT scans and other measurements as
subjects coughed, sneezed and blew their noses. In some cases, the
subjects had an opaque dye dripped into their rear nasal cavities.
Coughing and sneezing generated
little if any pressure in the nasal cavities. But nose blowing
generated enormous pressure — “equivalent to a person’s diastolic
blood pressure reading,” Dr. Hendley said — and propelled mucus into
the sinuses every time. Dr. Hendley said it was unclear whether this
was harmful, but added that during sickness it could shoot viruses
or bacteria into the sinuses, and possibly cause further infection.
The proper method is to blow one
nostril at a time and to take decongestants, said Dr. Anil Kumar
Lalwani, chairman of the department of otolaryngology at the New
York University Langone Medical Center. This prevents a buildup of
Source: New York Times
Stress and Psoriasis
Patients with psoriasis who have
persistently high levels of daily stressors have decreased cortisol
levels, making them particularly vulnerable to peak stress times that
are related to subsequent worsening of the disease, report researchers.
"Clinicians should be aware of the
possible effect of daily stressors on disease outcome and endocrine
function, particularly when patients are going through stressful periods
and for those subgroups of patients who are most vulnerable to the
enduring influence of daily stressors," say Andrea Evers and colleagues
from the Radboud University Nijmegen Medical Centre in The Netherlands.
Experimentally induced stress has
been shown to blunt hypothalamic-pituitary-adrenal (HPA) axis activity
in psoriasis patients, the researchers explain in the British Journal
of Dermatology, which may result in increased inflammatory responses
due to the diminished suppressive effect of cortisol.
Evers and colleagues have previously
shown that increased peak levels of daily real-life stressors are
associated with decreased cortisol levels, and increased psoriasis
disease severity a month later.
In this study, the team studied
serum cortisol levels, clinical indicators of psoriasis disease
severity, and self-report measures of daily stressors (such as running
late for an appointment or losing keys) over 6 months in 62 patients
with psoriasis, aged an average of 52 years.
They found that patients who
consistently experienced high enduring levels of daily stressors, as
indicated by above-median total daily stressors levels, had lower
average levels of cortisol than those with below-median total daily
stressors levels, at 0.29 vs 0.37 µmol/l.
There was no difference in current
disease severity between patients with high total daily stressors levels
and those with lower levels, at a Psoriasis Area and Severity Index of
7.34 versus 5.84, respectively. And, while levels of daily stressors
correlated negatively with cortisol levels, no correlation was seen
between daily stressors and disease severity.
But based on their previous
findings, the researchers say the decreased cortisol levels associated
with high daily stressors levels "might reflect a general vulnerability
to exacerbation of inflammation in these patients, such that relatively
stressful periods may aggravate the course of psoriasis in these
individuals in particular."
Abstract of the study
Obesity and Psoriasis
(9/18, Piper) reported that, according to a
study published in the Sept.
issue of the journal Acta Dermato-Venereologica, "excessive body weight
increases both the risk for psoriasis onset and the severity of the
condition." Researchers from Sweden's Karolinska Institute "performed a
population based case-control study involving 373 patients aged between
17 and 84 years who had developed plaque psoriasis for the first time
within the past 12 months," matching "these patients...to 373
individuals without psoriasis." The team found that "obese individuals
were twice as likely as normal weight individuals to develop psoriasis."
Furthermore, "each one-unit increment in" body mass index (BMI) "was
associated with a seven percent higher relative risk for increased
psoriasis activity, while a five-BMI-unit increase increased the risk by
Cancer cells grow weaker under
simulated spaceflight conditions, suggests German researchers.
In the journal Acta Astronautica,
a team led by Krassimira Ivanova of the German Aerospace Center in Cologne,
looks at melanoma cells -- the most dangerous form of skin cancer.
In comparison to cancer cells grown
under normal gravity, batches of them rotated to simulate weightlessness for
six hours and 24 hours, show they release significantly lower levels of
cancer gene chemicals tied to the "metastatic" spread of skin, lung and
ovarian cancer throughout the body.
"This is an interesting rapid
publication that suggests that the growth of some cancer types might be
different in space," says the Rupert Gerzer, the journal's editor-in-chief,
in a commentary. "The data within the paper is of high scientific interest
and is also operationally important, as cancers like the malignant melanoma
described in this paper may lie dormant for decades but may be activated
when the immune system is compromised, e.g., during a spaceflight."
The authors caution the results need to
be tested in more than just test tubes, however, concluding, "whether
simulated weightlessness and/or real microgravity may alter the metastatic
potential of melanoma cells remains to be investigated."
Source: USA today
more dangerous than cigarette
June 01, 2008
A new study finds that the use of
water pipes may be on the rise among college students. Some believe that
smoking tobacco this way is less dangerous than smoking cigarettes
—which is not the case, the researchers say.
The study, which appears in the
May issue of The Journal of Adolescent Health, looked at water-pipe use
among students at Virginia Commonwealth University. It found that of
more than 700 students surveyed, more than 40 percent reported having
used a water pipe in the previous year.
The pipes, often called hookahs
or shishas, are perhaps best known in the Middle East and are used to
smoke flavored and sweetened tobacco. The tobacco is heated over
charcoal, and then is cooled as it passes through a bowl of water and is
inhaled from a hose.
Despite the belief of some
students, water pipes may expose users to more toxic materials than
cigarettes. Each puff has as much as 100 times the smoke as a puff from
a cigarette, the study said. And smokers are also inhaling fumes from
A robot that
can pluck and move individual hair follicles on a person's head makes
hair transplants look more natural than those performed by humans, a US
The robot can
also perform the procedure twice as fast as human clinicians, with less
pain and scarring for the patient, says Restoration Robotics of Mountain
transplants typically take 8 to 10 hours. A strip of healthy, hairy
scalp 1 centimetre wide and 15 cm long is removed from the back of the
head under local anaesthetic.
After the gap
is sewn up, medical staff then manually separate the strip into 2000
individual hair follicle "bulbs". These are painstakingly implanted in
1-millimetre wide incisions across bald parts of the head.
"It's a lot
like gardening," says Rogers. "Removing the strip is like pulling turf
and implantation is like planting bulbs."
Moll of Restoration Robotics says the expensive (from around £3000, or
$5800), time consuming and repetitive task needs automating.
removing a strip of scalp, which is painful and carries the risk of
infection, his robot plucks healthy follicles individually, at a rate up
to 1000 an hour...
has another advantage over manual transplants – the ability to design
somebody's hairline on a computer. This can help give the transplanted
hair a more natural look...
recent years, the drumbeat against under-eye circles
has grown louder.
around the eyes can be unsightly,” declares one
advertisement for an eye cream. An advertisement for
Hylexin cream features a pale model with black
stripes under her eyes, like a football player, for
dramatic effect. And just in case you think you are
overreacting, the ad reinforces the notion that dark
circles are indeed a flagrant shortcoming.
percent of the 13,000 Clinique users surveyed by the
company in 2006 cited under-eye circles and
puffiness as their No. 1 beauty concern.
“We were really
shocked,” said Dr. Mammone, who has a Ph.D in
molecular and cellular biology. “We knew many of our
people in distribution and sales suggested that it
was a concern, but we didn’t really know until the
survey that it is a major issue.”
anti-aging skin care treatments, which include
products designed to get rid of dark circles,
increased to $1.08 billion in 2006, up from $588
million annually in 2001, according to Mintel, a
market research firm. No one specifically tracks the
market for dark-circle remedies.
circles is tricky.
There are a lot
of factors that contribute to quote-unquote dark
think dark circles are a telltale sign of tiredness,
or the unsightly evidence of a binge involving one
too many margaritas. That is true to a certain
extent, as fatigue makes skin dull, and drinking
alcohol dehydrates and thins the skin.
But the most
likely culprit causing chronic dark circles,
dermatologists say, is excess pigmentation in the
skin. Dark circles are prevalent on all skin colors
and types, but they especially trouble
African-Americans, Southeast Asians and Southern
Italians. Beach bunnies should note: sun exposure
exacerbates dark circles.
vessels that sit close to the thin under-eye skin
are another cause, doctors said.
causes skin to thin, can darken the eye area, as can
certain medications such as birth control pills,
which can dilate blood vessels.
The problem is
that few, if any, of the creams on the market are
formulated for people with excess pigmentation or
are available, however it is unclear how effective
Many consumers turn to over-the-counter
treatments — the gels, creams, oils and sheets available at the local
drugstore — to try to prevent or erase their scars. But a recent data on
these treatments by the Los Angeles Times found that most,
unfortunately, don't work. "There are a thousand wives' tales and a
whole bunch of things you can buy, but none have scientific validity to
speak of," Dr. Terence Davidson, a professor of surgery at University of
California, San Diego, School of Medicine, told the L.A. Times.
Indeed, many of the elixirs on the
market sounds a bit like folk medicine, promising to reduce the
appearance of scars with onion extracts or vitamin oils. They're not
cheap either, the L.A. Times reports, especially since you have
to use them long-term; scars take six months to two years to heal.
The only thing really shown to
help the healing process and minimize scarring, [Dr. Joseph Sobanko,
a dermatological surgeon at the University of Pennsylvania Health
System] says, is keeping a wound moist and covered. Most scar
products do that. But there's little evidence that they work any
better than inexpensive petroleum jelly.
Studies of products like Mederma,
which uses onion extract, and vitamin E oils found that they worked no
better than cheaper Vaseline (presumably, other cheap oils like coconut
or olive would work similarly too), while data on antibiotic ointments
found that they didn't help healing or reduce infection. Plus,
antibacterial products contribute to the rise of antibiotic resistance.
The only product that appeared to
have any clinical benefit was silicone gel sheets, the kind that have
been used on burn victims since the 1980s. Studies suggest that the
sheets help prevent new scars and soften old ones.
Silicone gel sheeting seems to
be the exception. Several articles reviewing 30 years of research
suggest that it can speed healing and lead to thinner, softer, less
red and less painful scars, depending on the study. It's not clear
what silicone itself does. But the sheets do a better job of keeping
the scar covered, and that prevents water from evaporating from the
Moisture is key because it lets
the skin grow back evenly, says Dr. [Jessica] Wu, a Los Angeles
dermatologist. "If you slice a finger open as you're cutting your
bagel in the morning, you have two edges of the wound. The new skin
grows across that gap," she explains. "If the wound dries, a scab
forms between the two edges. Now the skin has to grow down and
across, like it encountered a boulder. It's likely to lead to a
depressed, pitted scar."
SOURCE: LA Times