Topical Moisturizer Meaningfully Reduces Disease Severity in Atopic Patients With Xerosis.

BACKGROUND: Repairing the epidermal barrier is critically important in atopic dermatitis (AD), but the effect of moisturizer on quality of life (QOL) is not well characterized.  Objective: To assess whether the use of a moisturizer improves QOL in atopic patients with xerosis.  Methods: Thirty-five (35) adults with xerosis and AD received a moisturizer designed for AD to apply daily for three months. Adherence was assessed with electronic monitors. Quality of life (QOL) was assessed with the Dermatology Life Quality Index (DLQI) at baseline and follow-up.  Results: Mean adherence to the moisturizer was 46%. Dryness improved from 1.9 at baseline to 1.4 at follow-up (P=0.02). DLQI improved from 3.3 at baseline to 1.5 at 3 months (P=0.005). The "feeling self-conscious or embarrassed due to their skin condition" DLQI item improved from 0.79 at baseline to 0.14 at 3 months (P=0.0009).  Conclusion: Moisturizers are the foundation of AD treatment. Even non-medicated topical emollients can improve QOL in patients with AD.  J Drugs Dermatol. 2023;22(12):e51-e52.     doi:10.36849/JDD.7036e.

Topical Ivermectin Is Associated With Improved Erythematotelangiectatic, Papulopustular, and Phymatous Rosacea in a Secondary Analysis.

Rosacea has variable clinical presentation consisting of four overlapping phenotypes: erythematotelangiectatic, papulopustular, phymatous, and ocular.1 Rosacea's pathogenesis involves increased cutaneous density of Demodex folliculorum mites, which drive inflammation through activation of Toll-like receptor-2.1,2 Thus, topical ivermectin (IVM) 1.0% cream's anti-inflammatory and acaricidal activity provides an effective and targeted treatment for moderate-to-severe rosacea. However, literature assessing IVM is limited to efficacy in treating the papulopustular presentation, limiting generalizability.1,3,4 Although our primary endpoint was to assess patient adherence, the objective of this secondary analysis was to assess IVM efficacy in rosacea, regardless of clinical presentation.

A Comparison of Alternative Medicine Users and Non-Users in Patients With Hidradenitis Suppurativa.

BACKGROUND: Hidradenitis suppurativa patients often seek non-prescription therapies. OBJECTIVE: To determine the prevalence of alternative medicine use and characterize the differences between patients who report using alternative medications versus those who do not. METHODS: We surveyed 67 patients with hidradenitis suppurativa regarding demographics, alternative medicine use, disease severity, and quality of life. RESULTS: 25 (37.2%) of the HS subjects reported alternative medicine use. Alternative medicine users tended to be younger (36.7 vs 40.8 years), have a shorter time since diagnosis (12.6 vs14.6 years), and reported worse quality of life (14.1 vs 11.0) than non-users. These differences were not statistically significant. LIMITATIONS: Limitations included a small sample size. CONCLUSION: Alternative medicine use among patients with hidradenitis is common regardless of disease severity; even mild disease may drive patients to seek alternative treatment. J Drugs Dermatol. 2021;20(10):1072-1074. doi:10.36849/JDD.6046.

Adherence to topical treatment can improve treatment-resistant moderate psoriasis.

Most patients with psoriasis have limited disease that should be manageable with topical treatment. However, psoriasis often is resistant to topical treatment. The aim of our study was to determine if patients using psoriasis-resistant topical treatments can be effectively treated with topicals under conditions promoting adherence. During this open-label, randomized, single-center clinical study, 12 patients with moderate psoriasis that previously failed topical treatment were selected and treated with desoximetasone spray 0.25% for 2 weeks. Six patients were randomized to receive twice-daily telephone call reminders to further encourage good adherence. Disease severity was assessed by the visual analog scale for pruritus, psoriasis area and severity index (PASI), total lesion severity score (TLSS), and investigator global assessment (IGA). At the end of the study, most patients improved in most scores. Therefore, apparent resistance to topical treatment often is due to poor adherence and can be overcome, at least over the short term.

Emotional Well-Being Is Impaired in Hidradenitis Suppurativa Patients.

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory condition. OBJECTIVE: To measure emotional well-being in HS patients and compare to other populations, assess if there is an effect of disease severity on emotional well-being, and determine if emotional well-being is correlated with quality of life and depression. METHODS: A total of 153 HS subjects were recruited, and 66 Positive and Negative Affect Schedule (PANAS) surveys assessing emotional well-being were completed. Norms for comparison populations (disease-free undergraduates and adults) were used. A validated self-assessment tool was used to determine disease severity. Subjects completed the Patient Health Questionnaire-9 (PHQ-9) and Dermatology Life Quality Index (DLQI) to examine depression and quality of life, respectively. RESULTS: HS subjects had lower positive affect than undergraduates and higher negative affect than adults. There were no differences in PANAS scores by Hurley stage (p > 0.05). PANAS scores for HS subjects correlated with worse quality of life (r = 0.66, p < 0.00001) and depression (r = 0.74, p < 0.00001). CONCLUSION: HS patients have poor emotional well-being. PANAS scores correlated with worse quality of life and depression. Providing appropriate resources and treatments may be beneficial for HS patients.

Topical corticosteroids for treatment-resistant atopic dermatitis.

Although topical corticosteroids are the mainstay of treatment of atopic dermatitis (AD), these medications may lose efficacy over time, a phenomenon known as tachyphylaxis. However, the underlying mechanism for tachyphylaxis may be due to lack of treatment adherence rather than loss of efficacy of topical corticosteroids. In this study, we aimed to determine if AD patients who were previously unsuccessfully treated with topical corticosteroids would respond to desoximetasone spray 0.25% under conditions designed to promote good adherence over a 7-day period. At baseline, patients were randomized to receive either twice-daily telephone calls to discuss treatment adherence (intervention group) or no telephone calls (control group) during the study period. The patients improved rapidly. In most patients, treatment-resistant AD is most likely due to poor adherence to treatment rather than loss of drug responsiveness.

Screening for depression in rosacea patients.

Rosacea patients often are burdened with embarrassment, social anxiety, and psychiatric comorbidities. The Patient Health Questionnaire 9 (PHQ-9) is a validated and reliable self-administered tool for diagnosis of depression and designation of depression severity. This study aimed to examine the relationship between rosacea severity scores and level of depression using a validated rosacea self-assessment tool and the PHQ-9, respectively. Our results indicated that there is a direct relationship between rosacea severity and level of depression, and the PHQ-9 could prove useful in screening for depression in rosacea patients given the high incidence of psychiatric comorbidities in this patient population.

Recruitment and retention of Latino children in a lifestyle intervention.

OBJECTIVE: To describe promising recruitment and retention strategies for transient Latino populations, assisting investigators who work with this population in their research design and implementation. METHODS: Strategies in recruitment and retention from a year-long intervention in children and their families are described. RESULTS: Of the 159 families who agreed to participate in the program, 123 parent-child dyads were enrolled. Retention rates were 59% in the control group, 67% in the intervention group. CONCLUSION: Building and maintaining relationships between a consistent study team contact and participants promote strong recruitment and retention outcomes. Barriers such as child care and transportation must be minimized.