Risk of Vulvar Squamous Cell Carcinoma in Lichen Sclerosus and Lichen Planus: A Systematic Review.

OBJECTIVES: The objectives of this study were to determine: 1) the prevalence of lichen sclerosus (LS) and lichen planus (LP) present in association with vulvar squamous cell carcinoma (VSCC), and 2) the incidence and absolute risk of developing VSCC in LS and LP. METHODS: A search was performed of MEDLINE, EMBASE and CINAHL databases. Three independent reviewers screened articles published before September 1, 2020, first on title/abstract and then on the full text. Women with a history of VSCC, human papillomavirus, smoking, or autoimmune disease were excluded. Newcastle-Ottawa observational study scales were used to assess the risk of bias and methodological quality of the included studies. Of the 3132 studies assessed, 31 were selected for analysis. Due to study heterogeneity, a qualitative synthesis was conducted. RESULTS: The prevalence of LS and LP in association with VSCC ranged from 0% (95% CI 0-5) to 83% (95% CI 36-100) and 1% (95% CI 0-7) to 33% (95% CI 4-78), respectively. The incidence of VSCC ranged from 1.16 (95% CI 0.03-6.44) to 13.67 (95% CI 5.50-28.17) per 1000 person-years for LS. The absolute risk of developing VSCC in patients ranged from 0.0% (95% CI 0.0-5.52) to 21.88% (95% CI 9.28-39.97) with LS and was 1.16% (95% CI 0.1-4.1) with LP. Incidence was not calculable for LP owing to study characteristics. CONCLUSIONS: This review provides evidence that there is an increased risk of developing VSCC in women with LS, while associations with LP are less clear. Early identification, treatment, and long-term follow-up are essential to prevent potential malignant progression of these vulvar dermatoses.

A review of protection against exposome factors impacting facial skin barrier function with 89% mineralizing thermal water.

BACKGROUND: The skin exposome refers to the constellation of external exposures that contribute to cutaneous aging, including solar radiation, air pollution, tobacco smoke, unbalanced nutrition, and cosmetic products. This review explores the skin exposome and the role of a combination hyaluronic acid and mineralized thermal water product used to restore and maintain optimal skin barrier function. METHOD: An expert panel of 7 dermatologists who treat clinical signs of facial aging convened for a one-day meeting to discuss the results of a literature review on the skin exposome and the role of M89, a mineralized thermal water and hyaluronic acid-based gel, to improve the quality of facial skin. Evidence coupled with expert opinion and experience of the panel was used to address clinical challenges in the treatment of photo-aging, and the use of M89. RESULTS: Solar radiation (ultraviolet radiation, visible light, and infrared radiation), air pollution, tobacco smoke, nutrition, and miscellaneous factors, including stress, sleep deprivation, and temperature, may potentiate skin aging by triggering molecular processes that damage skin structure. M89 was developed to maintain and restore skin and contains ingredients to aid physical, hydric, antioxidant, and antimicrobial skin barrier function. CONCLUSIONS: Increasing knowledge of the exposome and microenvironment contributing to skin aging may support a better understanding of measures to support the skin. The initial results of in vitro and clinical studies of M89 show its potential to improve skin barrier function.

Allergic and photoallergic contact dermatitis: a 10-year experience.

BACKGROUND: Photoallergic contact dermatitis (PACD) is a hypersensitivity reaction that occurs when a previously photosensitized exogenous agent comes into contact with UV radiation. Currently, there are no studies profiling photoallergic reactions in Canada. Because the photoallergen profile changes over time, it is necessary to continually update our knowledge to ensure proper recognition of allergens and appropriate treatment of patients. OBJECTIVE: This study aimed to profile photoallergic reactions in Canada. METHODS: A retrospective chart review of all patients who underwent photopatch testing at Toronto Western Hospital between January 2001 and December 2010 was completed. Photoallergic, allergic, and irritant reactions were recorded for 26 common allergens. RESULTS: Ninety-nine patients (61.9%) had at least 1 positive reaction to the test allergens. Fifty-four patients (33.8%) had at least 1 photoallergic reaction. All 26 allergens produced at least 1 allergic or photoallergic reaction. The most common relevant photoallergens were benzophenone-3, octyl dimethyl para-aminobenzoic acid (PABA) in 5% alcohol, and butylmethoxy-dibenzoylmethane. CONCLUSIONS: This study is the first to profile photoallergic contact reactions in Canada. It is clear that the culprit photoallergen in PACD can often be identified in a properly selected population. Future surveillance is necessary to continue to characterize PACD trends in Canada and to help better treat and screen this patient population.