Novel PTCH1 and concurrent TP53 mutations in four patients with numerous non-syndromic basal cell carcinomas: The paradigm of oncogenic synergy.

There has been a significant increase in basal cell carcinoma (BCC) incidence, the most common cancer in humans and the age of presentation with the first diagnosis of BCC has decreased in past decades. In this study, we investigated the possibility of genetic markers that can lead to earlier and closer observation of patients at high risk for development of multiple BCCs. The overall goal is to decrease the morbidity and the economic burden of diagnosis and treatment of recurring and/or advanced BCCs. Four patients with numerous BCCs, some of them exceptionally large, were included in this study. A sample of representative BCCs, normal non-sun-exposed skin and blood samples were obtained from each patient. Whole-exome sequencing of DNA was conducted on all samples, and a series of bioinformatics filtering was performed to identify potentially pathogenic sequence variants. The analysis of the data resulted in detection of oncogenic mutations in PTCH1, two of which being novel, and concurrent mutations in TP53 in BCC tumours of all four patients. Such mutations may explain the numerous and postexcision recurring nature of the BCCs of exceptionally large size observed in all these patients, and they can be suggested to serve as a genetic marker for high-risk patients for early detection, prognostication and close follow-up.

Public social media consultations for dermatologic conditions: an online survey.

The use of social media in medicine has been increasingly studied in recent years, especially concerning its role in patient outreach, education, diagnosis, and management. Dermatology is a unique field in that patients can post photographs of their skin ailments when seeking online medical advice and information. This study examines the role of public social media consultations for dermatologic conditions. A large portion of patients utilize social media for dermatologic consultations and many do not seek care from a dermatologist afterward. Future studies should trend this phenomenon, especially as the use of social media continues to expand.

Lesions simulating retinoblastoma (pseudoretinoblastoma) in 604 cases: results based on age at presentation.

PURPOSE: To determine the types and frequency of ocular conditions that simulate retinoblastoma (pseudoretinoblastoma) based on age at presentation. DESIGN: Retrospective case series. PARTICIPANTS: Two thousand seven hundred seventy-five patients. METHODS: Chart review. MAIN OUTCOME MEASURES: Conditions simulating retinoblastoma. RESULTS: Of 2775 patients referred for management of retinoblastoma, 2171 patients (78%) had confirmed retinoblastoma and 604 patients (22%) had simulating lesions (pseudoretinoblastomas). In the pseudoretinoblastoma cohort, the mean patient age at presentation was 4 years (median, 2 years). There were 27 different pseudoretinoblastoma conditions, and the 10 most common included Coats' disease (n = 244; 40%), persistent fetal vasculature (PFV; n = 158; 28%), vitreous hemorrhage (n = 27; 5%), ocular toxocariasis (n = 22; 4%), familial exudative vitreoretinopathy (FEVR; n = 18; 3%), rhegmatogenous retinal detachment (n = 18; 3%), coloboma (n = 17; 3%), astrocytic hamartoma (n = 15; 2%), combined hamartoma of retina and retinal pigment epithelium (n = 15; 2%), and endogenous endophthalmitis (n = 10; 2%). Simulating lesions differed based on age at presentation, and children younger than 1 year were most likely to have PFV (49%), Coats' disease (20%), or vitreous hemorrhage (7%); those 2 to 5 years of age were most likely to have Coats' disease (61%), toxocariasis (8%), or PFV (7%); and those older than 5 years were most likely to have Coats' disease (57%), toxocariasis (8%), or FEVR (6%). CONCLUSIONS: The most common pseudoretinoblastomas include Coats' disease, PFV, and vitreous hemorrhage, but the spectrum varies depending on patient age.

Topical Moringa Formulations: An Emerging Skincare Ingredient.

Recently, the addition of moringa to skincare products has become a popular trend, especially in the natural beauty industry. It is being marketed for its intended moisturizing, antioxidant, and anti-aging properties; however, data are scarce demonstrating its clinical effects as well as standardized concentration, formula, source, and extraction methods. Skin specialists must be aware of this trendy ingredient, including its recent claims in marketing material and current evidence in the literature.

Classic bedside diagnostic techniques.

Correctly performing bedside diagnostic tests is an important fundamental skill for practicing dermatologists. Even with new technologies, bedside diagnostic tests have been useful in contemporary practice. When properly implemented, bedside diagnostic techniques can efficiently and economically aid in diagnosis and treatment. We have reviewed the most commonly used diagnostic procedures while considering them in their historical context, outlined the procedures for performing the tests, and discussed the relevance and regulatory requirements of the tests.

Impact of Psoriasis on Quality of Life: A Qualitative Study Focused on Patient Perspectives.

Psoriasis is a chronic skin condition that can affect any part of the body, is often present in visible areas, and may occasionally be difficult to treat. Psoriasis can lead to depression and decreased quality of life. We performed a qualitative survey to examine patient perspectives on how psoriasis impacts their lives. Patients with psoriasis are vulnerable to embarrassment and stigmatization in public spaces, as well as discrimination at work, school, or in society. Further studies are needed to determine the best interventions for improving the quality of life in this patient population.

Platelet-rich Plasma, Collagen Peptides, and Stem Cells for Cutaneous Rejuvenation.

In recent years, platelet-rich plasma (PRP), collagen peptides, and stem cells have become popular treatments for cutaneous rejuvenation. Mass marketing to consumers via the internet and social media has attracted the attention of the aesthetics industry to these treatments. However, the studies behind these treatment modalities have not supported the often exaggerated claims of effectiveness that have targeted consumers. It is important for clinicians to understand the evidence behind any new trends, especially in the fast-paced world of aesthetics, where treatments often outpace current medical understanding. Here, we summarize and evaluate the current prominent literature on these popular aesthetic treatments.

Platelet-rich plasma for facial rejuvenation: An early examination.

Platelet-rich plasma (PRP) has become a popular and trendy treatment in dermatology for various skin ailments, most notably for acne scars, traumatic scars, hair regrowth, and cutaneous rejuvenation. Although PRP has been utilized in the world of orthopedics for many years, its recent entry into dermatology has been wrought with controversy, especially as some have marketed it to consumers as a type of cure-all; however, the studies behind PRP treatment, especially for cutaneous rejuvenation, are currently limited, while we await additional larger studies. Clinicians should have an understanding of the evidence behind such new trends, especially in the fast-pace world of esthetics.

Microneedling and PRP for acne scars: A new tool in our arsenal.

A common complication of acne vulgaris is clinically significant scarring, which can greatly impact patient quality of life. While treatment options have included microneedling, the recent addition of platelet-rich plasma (PRP) to this regimen has led to an increased popularity of combination treatment. Here, we offer backgrounds on microneedling and PRP therapies and review the literature on combination treatment for acne scars.

Patient perception of beauty on social media: Professional and bioethical obligations in esthetics.

Recently, social media use has skyrocketed, especially with millennials. The use of filtered images and photo editing has led to a new trend of social media-induced dissatisfaction with appearance, termed "snapchat dysmorphia" and "selfie dysmorphia". It is important for practitioners to recognize and understand this trend in addition to knowing how to manage these patients. As clinicians, we have bioethical and professional obligations to educate ourselves on new and relevant trends, ensure adequate patient safety, and advocate for continued consumer education.

The rise of stem cells in skin rejuvenation: A new frontier.

Stem cells have recently garnered increased attention, especially pertaining to their use in cutaneous rejuvenation. Their popularity has continued to grow with patients and consumers alike, which has followed the substantial marketing bolstering them. Although limited, studies have begun to demonstrate promise in the field of esthetics. We review the prominent studies in the literature to shed more light on the use of stem cells for cosmetic practitioners.

Bakuchiol as a Trendy Ingredient in Skincare: Recent Evidence.

Recently, bakuchiol has become a popular ingredient in skincare products. It has widely been marketed to treat acne, melasma, photoaging, and hyperpigmentation. Studies have shown functional similarities to retinoids without the limiting side effects, such as erythema, burning, and stinging. Clinicians should be aware of this trendy ingredient, including its recent claims in marketing material and current evidence in the literature, especially as its use continues to expand in available skincare products.

Treatment of acne scars with PRP and laser therapy: an up-to-date appraisal.

Clinically significant scarring is a common complication of acne vulgaris. Recent treatments have included the use of platelet-rich plasma (PRP), especially in combination with laser therapy. Here, we offer backgrounds on PRP and laser therapy and review combination treatment for acne scars. It is important to note that current data are limited to small studies and that there is no standard protocol for PRP administration. Larger studies are needed to better evaluate combination treatment and determine the best modality.

The growing trend of cannabidiol in skincare products.

Recently, cannabidiol has garnered considerable attention in the public and media as a trendy and popular ingredient in skincare products. Cannabidiol is a cannabinoid that lacks psychoactive properties. It has been marketed to consumers as being antiinflammatory, analgesic, hydrating, moisturizing, and wrinkle-reducing. Others claim it to be a cure for skin aging, acne, eczema, psoriasis, and pruritus. However, current data is limited regarding its safety and efficacy. Clinicians should be aware of current regulatory concerns and the limited available evidence.

Uncovering Unconscious Bias and Health Disparities in the Practice of Dermatology.

The concept of unconscious bias has recently emerged as a possible contributor to current health disparities. A pilot study was performed to evaluate the presence of unconscious bias in dermatology, which has not yet been thoroughly examined. Our results show that some degree of unconscious bias may be present during clinical decision-making for patients of different skin tones and sex. Additional studies are needed to further characterize the role of unconscious bias in health disparities in dermatology.

Stem cells in aesthetic dermatology: bioethical and professional obligations.

Recently, stem cells in aesthetics have attracted increased attention, especially as they have become a popular trend that is being mass-marketed to consumers on the Internet and social media. Unfortunately, studies have shown this marketing to be misleading as it portrays many purported benefits of stem cells that have yet to be proven in the limited studies that are available. It is important for clinicians to understand the evidence and marketing behind any new trends, especially in the fast-paced world of aesthetics, where treatments often outpace current medical understanding. As clinicians, we have bioethical and professional obligations to educate ourselves on current trends, ensure adequate patient safety, and advocate for continued consumer education.