Acne vulgaris in black pediatric patients: clinical presentation, treatment patterns, and unique needs.

Acne vulgaris is a common dermatological diagnosis observed in pediatric patients with skin of color, often resulting in scarring, keloid formation, and post-inflammatory hyperpigmentation, significantly impacting their quality of life. This exploratory retrospective chart review included 77 black pediatric patients seen at a tertiary care center for acne vulgaris between 2018 and 2023. We analyzed demographics, acne descriptors, and treatment modalities. The most common acne morphology was comedonal acne (83.6%), with 71% of the patients being female. Significant age differences were observed particularly for acne at the chin and overall face. Treatment regimens commonly prescribed included combinations of adapalene and benzoyl peroxide (22%), topical antibiotics, tretinoin, and benzoyl peroxide (34%). Given the higher risk of sequelae for patients with darker skin, it is crucial to address their unique treatment needs. This study highlights the distinctive characteristics of acne in black pediatric patients and calls for further research to enhance our understanding and treatment of this population. Limitations include the lack of direct patient interactions and reliance on chart data. Further studies are needed to compare acne presentation in skin of color of other populations, refining our knowledge of acne clinical presentation, complications, and treatment modalities for diverse patient populations.

Laryngology Quality of Life Questionnaire Associations: Towards Reducing Survey Burden.

OBJECTIVES: Outcomes in laryngology focus primarily on patient reported outcome measures (PROMs). The increasing number of questionnaires may lead to survey fatigue. We sought to determine the relationship between the newest questionnaire, Laryngopharyngeal Universal Measure of Perceived Sensation (LUMP), and other laryngology PROMs. STUDY DESIGN: Cross-sectional study. METHODS: Patients undergoing laryngology multidisciplinary evaluation prospectively completed laryngology questionnaires. Average summed scores between standard laryngology PROMs (ie, VHI-10, RSI, DI, CSI, EAT-10) and LUMP were compared. Expert consensus panel identified the most clinically relevant statements which were then compared to LUMP summed scores, in increasingly additive fashion. RESULTS: Four hundred eighty patients (259 female) were assessed. Average age was 57.1 ± 17.7 years. Intraclass correlation coefficient (ICC) for each PROM in comparison to LUMP ranged from moderate to poor correlation: 0.64 (RSI), 0.55 (EAT-10), 0.50 (DI), 0.48 (CSI), and 0.34 (VHI-10). ICC for combinations of the five most clinically relevant individual items ranged from 0.29-0.53. CONCLUSIONS: Patients with self-reported globus had statistically significantly higher scores across all PROMs. RSI had moderate correlation with LUMP, and the five selected expert consensus items demonstrated weaker correlation. While RSI may serve as a moderately selective clinical proxy for the LUMP questionnaire, LUMP remains a validated tool with increased specificity for quantification of globus which may be especially important in the research setting. There is continued question about the need for multiple laryngologic PROMs to evaluate patient complaints, and survey reduction remains an area of interest to decrease respondent fatigue, optimize patient care, and quantify interventional success. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:1561-1565, 2021.

Septum submucosal glands exhibit aberrant morphology and reduced mucin production in chronic rhinosinusitis.

BACKGROUND: Chronic rhinosinusitis (CRS) is characterized by significant accumulation and thickening of mucus in the sinonasal cavities. One contributor of aberrant mucus production and impaired mucociliary clearance (MCC) is altered function of the sinonasal submucosal glands (SMGs), yet contributions of SMGs to upper airway disease initiation and progression remain unknown. The objective of this study was to characterize the morphology and secretory cell identities of the nasal septum SMGs in both healthy and CRS adults. METHODS: Biopsies from adult participants with CRS without nasal polyps (CRSsNP, n = 4), CRS with nasal polyps (CRSwNP, n = 8), and non-CRS controls (n = 14) were collected from the posterior septum. Glandular morphology and mucus markers were investigated using histological techniques and high-resolution confocal microscopy. RESULTS: Analysis revealed a significant decrease in gland density in the posterior septum of CRSsNP (28% ± 6.15%) and CRSwNP (23% ± 3.09%) compared to control participants (53% ± 1.59%, p < 0.0001). Further analysis of the CRS SMG secretory function revealed an overall decrease in Mucin 5B+ gland mucus being produced. Dilated and cystic ductal structures filled with inspissated mucus were also common to CRS glands. CONCLUSION: Here, we describe a significant alteration in SMG structure and function in the adult CRS posterior septum suggesting reduced gland contribution to MCC. The SMGs of both the nose and sinuses may represent targets for future therapeutic approaches.