RESUMO
Hyperpigmentation, uneven skin tone, textural changes, and dull skin are common cosmetic concerns in skin of color. Other signs of aging, including fine lines, deeper wrinkles, and skin laxity, also occur but may present in later decades. In-office procedures such as laser treatments, energy devices, toxins, fillers, and chemical peels are useful options for addressing the most common cosmetic concerns in skin of color patients. Skincare can play an important role in improving cosmetic outcomes when used in conjunction with in-office procedures. With the availability of these approaches, clinicians can now integrate in-office procedures with skincare strategies to offer patients with skin of color a comprehensive treatment plan that meets their needs. J Drugs Dermatol. 2024;23:8(Suppl 1):s5-10.
Assuntos
Técnicas Cosméticas , Envelhecimento da Pele , Higiene da Pele , Pigmentação da Pele , Humanos , Higiene da Pele/métodos , Hiperpigmentação/diagnóstico , Hiperpigmentação/terapia , Terapia a Laser/métodos , Abrasão Química/métodos , Preenchedores Dérmicos/administração & dosagem , RejuvenescimentoRESUMO
Despite the widespread interest in dermatology on TikTok, studies have shown most related videos are not produced by board-certified dermatologists (BCDs) or other health professionals. To see if this trend extended to sun protection, we examined TikTok videos associated with sun safety to determine the proportion produced by BCDs. From August 25, 2023, to August 27, 2023, investigators input the following hashtags into the TikTok search bar: #sunscreen, #sunprotection, #spf, #skincancer, and #skinprotection. The top 100 videos in each category were analyzed and categorized based on the content creator. Additionally, we assessed whether videos explicitly addressed skin of color (SOC). Of the analyzed videos, only 16.6% originated from BCDs. Beauty bloggers/bloggers were the most prevalent creators in this category (38.7%), followed by patients/consumers (33.7%). Only 2.8% of the videos pertained to SOC patients. This highlights a gap in the type of educational content generated by dermatologists on TikTok, with sun safety being a potential subject to target within social media. Additionally, the small representation of videos addressing SOC patients underscores the need for more diverse and inclusive educational skincare content on TikTok.J Drugs Dermatol. 2024;23(7):571-574. doi:10.36849/JDD.8179.
Assuntos
Mídias Sociais , Protetores Solares , Humanos , Estudos Transversais , Protetores Solares/administração & dosagem , Mídias Sociais/estatística & dados numéricos , Queimadura Solar/prevenção & controle , Dermatologia , Gravação em Vídeo , Luz Solar/efeitos adversos , Pigmentação da Pele/efeitos da radiação , Dermatologistas/estatística & dados numéricos , Neoplasias Cutâneas/prevenção & controle , Educação de Pacientes como Assunto/métodosRESUMO
BACKGROUND: Biologics have shown promising outcomes in psoriasis clinical trials. However, there is a paucity of data exploring the potential differences in outcomes between self-identified racial groups. OBJECTIVE: To evaluate treatment response to ixekizumab in patients with psoriasis across different self-identified racial subgroups. METHODS: This study analyzed pooled data from 5 clinical studies (UNCOVER-1, UNCOVER-2, UNCOVER-3, IXORA-R, and IXORA-S) with patients of different self-identified racial subgroups, who were treated with an on-label dose of ixekizumab for psoriasis through 12 weeks. Treatment response to ixekizumab was assessed using the Psoriasis Area and Severity Index (PASI) and static Physician’s Global Assessment response rates. Patient Global Assessment of Disease Severity, Itch Numeric Rating Scale, Skin Pain Visual Analog Scale, and Dermatology Life Quality Index were used to evaluate the patient-reported outcomes (PROs) and impact on quality of life (QoL). RESULTS: A total of 1825 ixekizumab-treated patients from 5 pooled studies were included. Consistent with the clinical outcomes from the overall population, all self-identified racial groups showed rapid improvement in PASI through Week 12, although the response was somewhat slower in American Indian/Alaska Native patients. Differences in PROs and QoL assessments were observed among racial groups, especially in patients who identified as Black/African American and American Indian/Alaska Native. CONCLUSION: Ixekizumab is effective through 12 weeks of treatment for psoriasis across different self-identified racial groups. Sample sizes for some racial groups were small (N≤12), therefore, further research is required to understand potential differences in psoriasis treatment with ixekizumab between various racial groups.J Drugs Dermatol. 2024;23(2):17-22. doi:10.36849/JDD.7672.
Assuntos
Anticorpos Monoclonais Humanizados , Fármacos Dermatológicos , Psoríase , Humanos , Qualidade de Vida , Índice de Gravidade de Doença , Psoríase/tratamento farmacológico , Grupos Raciais , Resultado do Tratamento , Fármacos Dermatológicos/uso terapêuticoRESUMO
BACKGROUND: Acne vulgaris is a complex, multifactorial, inflammatory skin condition. Although frequently presented at dermatology clinics, the literature on adult acne is scarce, particularly concerning skin barrier function and management. We aimed to provide insights into the role of skin barrier integrity in adult acne patients and the role of cleansers and moisturizers as adjunctive to treating and maintaining adult acne. Methods: A panel of eight dermatologists who treat adult patients with acne developed a consensus paper on the role of skin barrier function and skin care in adult acne management. The modified Delphi method comprised a face-to-face meeting and online follow-up to discuss the results of a scoping literature review. Drawing from their experience and opinions, they agreed on seven consensus statements. Results: Epidermal barrier dysfunction plays a vital role in acne pathogenesis and asymmetrically impacts adult female acne. Erythema, pruritus, peeling, and xerosis are common adverse effects of first-line acne treatment options and, if not appropriately counseled and managed, can exacerbate, leading to regimen nonadherence and poor patient experience and outcomes. CONCLUSION: Improving patient knowledge of comprehensive acne treatments, including quality adjunctive cleansers and moisturizers, may maximize regimen efficacy and provide patients with personalized and successful acne treatment and maintenance tools. J Drugs Dermatol. 2024;23(8):674-679. doi:10.36849/JDD.8471.
Assuntos
Acne Vulgar , Higiene da Pele , Humanos , Acne Vulgar/terapia , Acne Vulgar/tratamento farmacológico , Higiene da Pele/métodos , Adulto , Fármacos Dermatológicos/administração & dosagem , Fármacos Dermatológicos/uso terapêutico , Feminino , Técnica Delphi , ConsensoRESUMO
BACKGROUND: TikTok gives its users a platform to share and view short videos on a wide range of topics, including dermatology related topics. This project sought to analyze the sources of TikTok videos associated with the treatment of four dermatologic conditions and to report the percentage of videos posted by board-certified dermatologists. METHODS: On July 16th, 2021, an investigator input the following hashtags into the TikTok application’s search bar: #AcneTreatment, #EczemaTreatment, #PsoriasisTreatment, and #RosaceaTreatment. After the total of 400 videos was obtained, the videos were then classified into the following categories based on the user posting the video: dermatologist, dermatology resident, non-dermatologist physician, physician assistant, nurse practitioner, registered nurse, esthetician, patient, beauty blogger, and other. Videos that were not in English, paid advertisements or by a business page, and/or unrelated to treatment or education of a dermatologic condition were excluded. RESULTS: The top posters of all the videos analyzed were patients (40.8%) followed by dermatologists (16.8%). Of all the videos analyzed, 37.3% were posted by licensed professionals and the remaining 62.7% were posted by non-licensed posters. The licensed professionals mostly posted about acne (52.4%) out of the four conditions. Non-professional posters mostly posted about psoriasis (86.7%) and eczema (66.7%) out of the four conditions. CONCLUSIONS: There is a need for more dermatologist-created, educational content on TikTok and other platforms to increase the likelihood that users will interact with dermatologic content posted by board-certified dermatologists. J Drugs Dermatol. 2023;22(3): doi:10.36849/JDD.6676.
Assuntos
Acne Vulgar , Dermatologia , Mídias Sociais , Humanos , Educação de Pacientes como Assunto , ComércioRESUMO
BACKGROUND: A study by Villa-Ruiz et al (2021) found that educational videos dominate the content of dermatologic videos on TikTok with 25.8% of the videos being posted by board-certified dermatologists. We sought to examine if these results would differ when the search is adjusted to hashtags specific to black skin. Methods: On October 12th, 2021, an investigator input #BlackSkinCare, #BlackSkinTreatment, #BlackSkinAdvice, and #BlackSkinCareTips in TikTok. #SkinOfColor was not searched as this term is used almost exclusively by dermatologists and could skew the results. After the total of 200 videos was obtained, the videos were then classified into categories regarding their content, and the skin concern and creator were recorded. RESULTS: Most of the videos were of educational content (57.1%), followed by personal experiences (23.2%). Clinical demonstrations/live procedures, business/advertisement, and entertainment/humor followed with 9.6%, 5.6%, and 4.5%, respectively. 54.5% of posts were about general skin care. 22.7% of posts addressed dark spots followed by acne (12.1%). Ingrown hair/razor bumps and skin texture/open pores followed, both with 3.5% each. 54% of videos were posted by vloggers or personal accounts. Board-certified dermatologists followed with 18.7% of the videos posted. Estheticians accounted for 16.2% and, lastly, business/industry comprised 8.6% of the videos analyzed. CONCLUSIONS: When searching black skin, TikTok posts are mostly educational and were less likely to have been created by a board-certified dermatologist. The top skin concern specified was dark spots. These findings suggest that there is an opportunity for dermatologists to increase educational content relating to black skin on TikTok. Campbell JR, Woolery-Lloyd H, Williams K. TikTok and black skin: is this a missed opportunity for dermatologists? J Drugs Dermatol. 2023;22(7):698-700. doi:10.36849/JDD.7061.
Assuntos
Acne Vulgar , Mídias Sociais , Humanos , Dermatologistas , Pele , Higiene da PeleRESUMO
BACKGROUND: Variations in the epidemiology, clinical presentation, and disease course in skin of color (SOC) atopic dermatitis (AD) patients have been reported that may impact treatment approach and skincare recommendations. METHODS: The project used a modified Delphi hybrid process comprising face-to-face discussions and an online review process. A panel of physicians (advisors) who treat SOC patients with AD used information from literature searches, expert opinions, and their experience to develop a practical algorithm to improve outcomes for SOC patients with AD. RESULTS: The algorithm for SOC patients with AD aims to inform dermatologists and other healthcare professionals caring for these patients. The first section of the algorithm addresses education and behavioral measures. Treatment adherence is a considerable challenge in chronic inflammatory conditions such as AD, making education essential. The second section discusses the assessment of the skin condition. The third section informs on treatment and maintenance measures for AD. Treatment and maintenance of AD in patients with SOC should be proactive, effectively control inflammation longitudinally, include effective skin barrier protective strategies, and consider cultural practices. CONCLUSION: Robust comparative studies are needed to better understand racial/ethnic variations in AD. The algorithm supports educating healthcare professionals and patients to foster individualized treatment, prevention, and adjunctive skincare approaches across diverse patient populations. J Drugs Dermatol. 2023;22:8(Suppl 2):s3-10.
Assuntos
Dermatite Atópica , Humanos , Dermatite Atópica/terapia , Dermatite Atópica/tratamento farmacológico , Pigmentação da Pele , Pele , Inflamação , AlgoritmosRESUMO
INTRODUCTION: Inflammatory skin disorders compromise skin barrier health. Early and daily skincare use aims to maintain a life-long healthy skin barrier. Racial/ethnic and age variations in skin barrier properties, cultural differences, and clinical presentation of the inflammatory skin disorder influence the choice of treatment and skin care. Ceramide-containing skin care may play a role in restoring and maintaining a healthy skin barrier. METHODS: A panel of 6 dermatologists met to develop consensus statements based on their 8 previous publications on promoting skin barrier health throughout life using ceramide-containing skin care. The publications covered skin barrier integrity in the newborn and infant, and the role of the skin barrier in mitigating atopic dermatitis (AD); racial/ethnic variations in the skin barrier and implications for skin care; the role of the skin barrier in inflammatory skin conditions including acne, AD and psoriasis in skin of color (SOC) populations; skin barrier integrity in patients with rosacea; and xerosis in patients with diabetes mellitus. The panel synthesized the 8 publications, selected information from a literature review, and their expert opinions and experiences to create the statements. The consensus was reached through a modified Delphi method where the panel met face-to-face and followed up virtually. RESULTS: The panel adopted 6 consensus statements highlighting the importance of skin care in restoring/maintaining a healthy skin barrier in the populations mentioned above. Skin care suited to this role is gentle, has near-physiologic pH, is pleasant to use, and contains ceramides. This type of skin care can promote a healthy skin barrier and attenuate or delay inflammatory skin conditions. CONCLUSIONS: Adjunctive daily skin care throughout life promotes a healthy skin barrier and is beneficial in managing various inflammatory skin disorders in all populations. However, when choosing optimal treatment and skin care, physicians should consider variations in age, skin properties, presentation of the condition, and cultural differences. J Drugs Dermatol. 2023;22:2(Suppl 1):s3-14.
Assuntos
Dermatite Atópica , Dermatopatias , Lactente , Recém-Nascido , Humanos , Ceramidas/uso terapêutico , Pele , Dermatite Atópica/diagnóstico , Dermatite Atópica/tratamento farmacológico , Dermatopatias/tratamento farmacológico , Higiene da PeleRESUMO
BACKGROUND: The skin of newborns and infants of all races/ethnicity is more susceptible to skin barrier disruption than adult skin. This consensus paper offers insights into potential skincare implications for using gentle cleansers and moisturizers for skin of color (SOC) newborns, infants, and children. METHODS: Six pediatric dermatologists and dermatologists used a Delphi communication technique to adopt 5 statements for SOC newborns, infants, and children on skin barrier integrity and the importance of skin care to promote a healthy skin barrier. Results: Regardless of ethnicity, newborn and infant skin is still developing and more susceptible to infections and chemical and thermal damage. A growing body of evidence supports skincare starting early in life, recognizing that the ongoing daily use of gentle cleansers and moisturizers containing barrier lipids, such as ceramides, promotes a healthy skin barrier. Understanding cultural differences in everyday skincare practices for SOC newborns, infants, and children is critical for developing an evidence base to substantiate skincare practices. Conclusions: Closing knowledge gaps in the clinical presentation, cultural differences, and approach to treating skin conditions using skincare for SOC newborns, infants, and children may improve patient outcomes. Schachner LA, Andriessen A, Benjamin L, et al. Racial/ethnic variations in skin barrier properties and cultural practices in skin of color newborns, infants and children. J Drugs Dermatol. 2023;22(7):657-663. doi:10.36849/JDD.7305.
Assuntos
Dermatopatias , Pigmentação da Pele , Lactente , Recém-Nascido , Humanos , Criança , Pele , Higiene da Pele/métodos , Banhos/métodosRESUMO
BACKGROUND: Racial/ethnic differences in the clinical presentation, sequelae, and desired treatment outcomes for acne have been reported. Post-inflammatory hyperpigmentation (PIH) frequently occurs in patients with richly pigmented skin complexions and can frequently be the most bothersome aspect of acne in this population. METHODS: The project used a modified Delphi hybrid process comprising face-to-face discussions followed by an online follow-up. A structured literature search was conducted to identify publications on racial/ethnic differences in the clinical presentation, sequelae, and desired treatment outcomes for skin of color (SOC) patients with acne . The advisors subsequently convened to review the results and draft an algorithm for the treatment and maintenance, including skincare recommendations, for SOC patients with acne. Online, the panel reviewed and adopted the algorithm using published evidence coupled with the panel's expert opinion and clinical experience. RESULTS: Studies suggest that strategies for improving outcomes in patients with acne who have SOC include: the early initiation and maintenance of treatment regimens; careful consideration of the tolerability of active ingredients, vehicle formulations, and dosing; and the use of skin care (eg, pH balanced, non-irritating cleansers, and non-comedogenic moisturizers) to minimize irritation or dryness. CONCLUSION: Acne treatment in patients with SOC involves unique therapeutic considerations, including management of PIH through efficacious longitudinal acne treatment, prevention of irritation, and potential active treatment of PIH. Skincare products are recommended as an adjunct to prescription therapy to maximize tolerability and may also play a role in maintenance therapy. J Drugs Dermatol. 2022;21:11(Suppl 2):s3-14.
Assuntos
Acne Vulgar , Hiperpigmentação , Humanos , Pigmentação da Pele , Índice de Gravidade de Doença , Acne Vulgar/tratamento farmacológico , Acne Vulgar/complicações , Higiene da Pele , Hiperpigmentação/complicações , AlgoritmosRESUMO
BACKGROUND: Despite considerable advances in our understanding of the pathogenesis and treatment of psoriasis, data pertaining to racial/ethnic variations, effects on barrier function, and the potential role of adjunctive skin care are relatively limited. Knowledge gaps in the clinical presentation, quality-of-life impact, and approach to treating psoriasis in patients with skin color contribute to disparities in care. In addition, small studies suggest that using skincare products can reduce psoriasis symptoms, improve barrier function, and result in higher patient satisfaction, yet patients with psoriasis may underuse skincare products. This manuscript seeks to offer insights into these knowledge gaps and their potential treatment implications. METHODS: A structured literature search followed by a panel discussion and an online review process explored best clinical practices in treating psoriasis patients with skin of color and providing expert guidance for skincare use, including gentle cleansers and moisturizers. RESULTS: Racial/ethnic differences in genetic factors, clinical presentation, and disease burden in psoriasis have been reported. Underrecognition of these differences contributes to racial/ethnic health disparities for psoriasis patients in the US. Several studies have shown a greater quality-of-life impact with psoriasis among patients with skin of color. Although the published data are limited, some studies have identified differences in skin barrier properties and suggest a role for adjunctive skin care in the management of psoriasis. CONCLUSION: Further study is needed to understand racial/ethnic population variations in psoriasis and develop strategies to reduce disparities in care. Addressing alterations in skin barrier function observed in psoriasis may help to improve treatment outcomes and patient satisfaction. J Drugs Dermatol. 2022;21(10):1054-1060. doi:10.36849/JDD.7090.
Assuntos
Psoríase , Pigmentação da Pele , Humanos , Psoríase/tratamento farmacológico , Psoríase/terapia , Grupos Raciais , Pele/patologia , Higiene da PeleRESUMO
BACKGROUND: While rosacea is a common inflammatory condition that affects diverse populations, published data in skin of color (SOC) are limited. This review explored nuances in clinical presentation and treatment considerations in SOC patients with rosacea and the role of cleansers and moisturizers in the management of rosacea in these populations. METHODS: A panel reviewed and discussed aspects of rosacea in SOC and possible implications for treatment and maintenance. The outcome of these discussions, coupled with the panel's expert opinion and experience was used to define draft statements. After group discussions and an online review process, the panel agreed on the inclusion and wording of five statements. RESULTS: Studies and anecdotal clinical experience suggest that rosacea is more common in SOC populations than previously reported. The clinical presentation of rosacea across diverse skin types includes the spectrum of clinical subtypes observed in other populations; however, clinical features may be less conspicuous in individuals with higher skin phototypes and the index of suspicion may be lower in SOC populations. To avoid underdiagnosis, dermatologists should consider rosacea in the differential diagnosis of any patient presenting with a history of skin sensitivity, central facial erythema, papules, and pustules. The compromised barrier in rosacea contributes to skin sensitivity. Studies including Chinese rosacea patients showed that using a moisturizer and sunscreen negatively correlated with rosacea development. CONCLUSIONS: The use of skincare could improve rosacea symptomatology. These products are recommended before and during prescription therapy and as part of a maintenance regimen as adjuncts. J Drugs Dermatol. 2022;21(6):574-580. doi:10.36849/JDD.6838.
Assuntos
Rosácea , Pigmentação da Pele , Eritema/diagnóstico , Humanos , Rosácea/diagnóstico , Rosácea/tratamento farmacológico , Pele , Higiene da PeleRESUMO
BACKGROUND: Research on the role of race and ethnicity in the pathophysiology of atopic dermatitis (AD) is limited. Variations in the epidemiology, clinical presentation, and disease course in skin of color SOC AD patients have been reported. This manuscript seeks to offer insights into distinct features of AD in populations with (SOC) and provide recommendations on the role of skincare in treating AD amongst diverse populations. METHODS: A literature review followed by panel discussions and an online review process explored best clinical practices in treating AD patients with SOC and providing expert guidance for skincare use, including gentle cleansers and moisturizers. RESULTS: Some studies have identified differences in skin barrier properties in racial/ethnic groups affected by AD that may have implications for barrier function. Variations in the clinical presentation – including morphology, severity, and distribution – of AD in populations with SOC have been reported. Epidemiologic studies suggest a higher prevalence among self-identified Blacks/African Americans and greater health care utilization for AD among both Blacks/African Americans and Asian/Pacific Islanders. Pigmentary sequelae, including hyper- hypo- and depigmentation is a distinct feature of AD in patients with SOC that may contribute to the quality of life impact of the disorder. Xerosis may be more stigmatizing in SOC due to greater visibility of scale and dryness in the context of melanin-rich skin. Racial/ethnic variations in the prevalence of pruritus have also been reported, which may in turn have implications for AD in SOC. Treatment and maintenance of AD in patients with SOC should be proactive, effectively control inflammation longitudinally, include effective skin barrier protective strategies, and consider cultural practices. CONCLUSION: Robust comparative studies are needed to better understand racial/ethnic variations in AD. Further research will help to tailor patient education and foster individualized approaches to treatment, prevention, and adjunctive skin care across the diverse spectrum of patient populations. J Drugs Dermatol. 2022;21(5):462-470. doi:10.36849/JDD.6609.
Assuntos
Dermatite Atópica , Dermatite Atópica/diagnóstico , Dermatite Atópica/epidemiologia , Dermatite Atópica/terapia , Humanos , Qualidade de Vida , Pele , Higiene da Pele , Pigmentação da PeleRESUMO
BACKGROUND: Cosmetic procedures with lasers, nonenergy devices, and injectables are increasing in popularity among patients with skin of color. Published algorithms address measures to reduce side effects related to aesthetic procedures; however, none focus on reducing adverse events in skin of color. METHODS: An expert panel of dermatologists and plastic surgeons conducted face-to-face and online meetings to develop an algorithm for measures before, during, and after using aesthetic devices (energy and nonenergy-based) and injectable treatments based on the best available evidence for skin of color. Published algorithms and literature searches for aesthetic procedures provided guidance for the current algorithm. A modified Delphi method was used to reach a consensus to apply outcomes of literature searches, along with expert opinion, resulting in the current algorithm. RESULTS: The four sections of the algorithm outline an approach to optimize outcomes with specific before, during, and after procedure considerations. Pre-procedural consultation includes the development of a specific treatment plan based on individual patient goals and risk profile (including history and signs that may predict a higher risk for pigmentary or scarring complications). Before the procedure, sun avoidance and sunscreen use are emphasized; herpes simplex virus 1 prophylaxis and bleaching agents are administered if indicated. During the procedure, skin cleansing products are addressed, along with judicious techniques to minimize unintended cutaneous injury or inflammation. Post-procedural sunscreen and gentle skincare that may include skin-lightening agents or formulations designed to prevent infection and promote optimum healing are advised. CONCLUSIONS: The algorithm strives to optimize treatment outcomes for patients with skin of color by providing their physicians with guidance on measures before, during, and after office-based medical aesthetic procedures. J Drugs Dermatol. 2022;21:9(Suppl 1):s3-10.
Assuntos
Clareadores , Técnicas Cosméticas , Envelhecimento da Pele , Algoritmos , Técnicas Cosméticas/efeitos adversos , Humanos , Lasers , Protetores SolaresRESUMO
As humans age, our ability to manage certain types of inflammation is reduced. As a result, we experience chronic, low-grade inflammation, which has been termed “inflammaging”. This type of low-level inflammation is driven by a progressive increase in pro- inflammatory systemic cytokines over time. Inflammaging is thought to contribute to many age-related chronic diseases including cardiovascular disease, diabetes, Alzheimer’s disease, and even certain cancers. Recent studies suggest that the human microbiome may play a critical role in inflammaging. As the largest organ of the body and home to a significant portion of the human microbiome, the skin may play a unique role in inflammaging. In this review article, we present common dermatological diseases through the lens of inflammaging, look at how our skin may play a role in reducing inflammaging, and highlight the need for further focused research in this area. J Drugs Dermatol. 2021;20(2):144-149. doi:10.36849/JDD.5481.
Assuntos
Envelhecimento/imunologia , Microbiota/imunologia , Dermatopatias/imunologia , Anti-Inflamatórios/farmacologia , Anti-Inflamatórios/uso terapêutico , Doença Crônica , Citocinas/imunologia , Citocinas/metabolismo , Fármacos Dermatológicos/farmacologia , Fármacos Dermatológicos/uso terapêutico , Dermatologia/métodos , Humanos , Inflamação/tratamento farmacológico , Inflamação/imunologia , Inflamação/microbiologia , Microbiota/efeitos dos fármacos , Pele/imunologia , Pele/microbiologia , Dermatopatias/tratamento farmacológico , Dermatopatias/microbiologiaRESUMO
BACKGROUND: Genetic and environmental factors influence stratum corneum (SC) barrier properties and function. Researchers increasingly focus on biophysical studies that may help clinicians provide their patients with an informed choice on tailormade skincare. This literature review on skin barrier properties comparing different ethnic populations aims to offer insights into the information's clinical relevance. METHODS: A literature review followed by panel discussions and an online review process aimed to answer the questions: Are there racial/ethnic differences in the SC barrier structure and healthy skin barrier function? Is there a need for specific cleansers and moisturizers? RESULTS: Ethnic categories based on race and ethnicity are often not well defined and inconsistent across different studies. Studies comparing ethnic groups' physical and biochemical skin barrier properties have reported differences in transepidermal water loss (TEWL), skin lipid levels, pH, and mast cell granule size. However, these studies frequently had methodological flaws, mainly were small, and demonstrated conflicting results. The literature suggests racial/ethnic variations in ceramide content, SC structure, and filaggrin mutations. Furthermore, studies have shown a greater burden of pruritus and atopic dermatitis among Black populations. Data on barrier properties in Hispanic/LatinX and South Asian populations are lacking. CONCLUSION: Robust comparative studies are needed to understand these basic concepts to help tailor skincare and skin of color patients' education. J Drugs Dermatol. 2021;20(9):932-938. doi:10.36849/JDD.6312.
Assuntos
Etnicidade , Pigmentação da Pele , Epiderme , Proteínas Filagrinas , Humanos , Pele , Higiene da Pele , Perda Insensível de ÁguaRESUMO
BACKGROUND: Acne vulgaris is among the most common dermatologic diagnoses observed, including skin color (SOC) populations. This project sought to help clarify the existing published data and provide consensus statements on acne presentation, prevention, treatment, and maintenance in SOC populations to help improve patient outcomes. METHODS: Six SOC dermatologists convened for a virtual meeting and used a modified Delphi process to address: 1) Are there racial/ethnic differences in the clinical presentation and sequela of acne? 2) Are there racial/ethnic differences in the therapeutic endpoint of acne treatment and patient expectations? 3) Is there a need for specialized approaches to therapeutic options and skincare in acne patients with SOC? The results of a literature review and the outcome of discussions, coupled with the panel's expert opinion and experience, are intended for health care providers caring for acne patients and clinician-researchers. RESULTS: Racial/ethnic differences in the clinical presentation, sequelae, and desired treatment outcomes for acne have been reported. Notwithstanding limitations in the number, size, and methodologies of studies to date, the available data suggest that strategies that improve outcomes in acne patients with SOC include: Early initiation and maintenance of treatment regimens and careful consideration of tolerability of active ingredients, vehicles, and dosing. Using pH-balanced, non-irritating cleansers and non-comedogenic ceramides containing moisturizers help minimize irritation or dryness. CONCLUSIONS: There a need for specialized approaches to therapeutic options and skincare in acne patients with SOC. OTC skincare products are recommended before and during prescription therapy and as part of a maintenance regimen. J Drugs Dermatol. 2021;20(7):716-725. doi:10.36849/JDD.6169 THIS ARTICLE HAD BEEN MADE AVAILABLE FREE OF CHARGE. PLEASE SCROLL DOWN TO ACCESS THE FULL TEXT OF THIS ARTICLE WITHOUT LOGGING IN. NO PURCHASE NECESSARY. PLEASE CONTACT THE PUBLISHER WITH ANY QUESTIONS.
Assuntos
Acne Vulgar , Pigmentação da Pele , Acne Vulgar/diagnóstico , Acne Vulgar/tratamento farmacológico , Cor , Humanos , Grupos Raciais , Pele , Higiene da PeleRESUMO
BACKGROUND: Atopic dermatitis (AD) is a common skin condition characterized by disturbed barrier function, skin inflammation, and cutaneous dysbiosis. Clinically, it manifests as chronic-recurrent xerosis, pruritus, and erythematous lesions. Its pathophysiology is complex, making the selection of appropriate treatment options a task. AIM: To share insights gained from a literature review and discussions with experts in dermatology on key factors related to the prevention, treatment, and management of AD in relation to the skin microbiome. METHODS: Results from an expert panel were summarized and discussed to provide updated recommendations for the treatment and maintenance of AD. RESULTS: Evidence supports a strategy for managing inflammatory skin diseases with a selenium-rich post-biotic thermal water and biomass containing moisturizer. The moisturizer helps to restore homeostasis of the skin, re-populate a diverse microbiome, encourage the growth of commensal bacteria, and improve barrier function and symptoms of AD. CONCLUSIONS: Normalization of skin microbiome diversity using a topical moisturizer containing post-biotic aqua and biomass may offer a valuable option for the treatment and maintenance of inflammatory skin diseases. Clinicians should discuss the benefits of this treatment in the context of a full AD management program that covers prevention, active treatment, and maintenance. J Drugs Dermatol. 2020;19(10):935-940. doi:10.36849/JDD.2020.5393.
Assuntos
Dermatite Atópica/terapia , Fármacos Dermatológicos/administração & dosagem , Hidroterapia/métodos , Microbiota/imunologia , Pele/microbiologia , Administração Cutânea , Adulto , Pré-Escolar , Terapia Combinada/métodos , Terapia Combinada/normas , Dermatite Atópica/complicações , Dermatite Atópica/imunologia , Dermatite Atópica/microbiologia , Dermatologia/métodos , Dermatologia/normas , Quimioterapia Combinada/métodos , Quimioterapia Combinada/normas , Humanos , Lactente , Guias de Prática Clínica como Assunto , Prebióticos/administração & dosagem , Probióticos/administração & dosagem , Índice de Gravidade de Doença , Pele/efeitos dos fármacos , Pele/imunologia , Simbiose/imunologia , Resultado do Tratamento , Perda Insensível de Água/efeitos dos fármacos , Perda Insensível de Água/imunologiaAssuntos
Negro ou Afro-Americano , Neoplasias da Mama , Fatores Etários , Feminino , Humanos , Óleos , População BrancaRESUMO
In this review, we examine published data reporting the efficacy of pharmaceutical agents to treat associated postinflammatory hyperpigmentation commonly seen in skin of color. Retinoids and azelaic acid have been widely used to treat acne. Now there are increasing data describing their use in skin of color for the treatment of both acne and the subsequent postinflammatory hyperpigmentation. Historically, some dermatologists have been hesitant to use retinoids in skin of color because of perceived hypersensitivity in this patient population. However, recent data support the use of retinoids and azelaic acid in skin of color as both safe and beneficial.