Prospective Randomized Double-Blind Vehicle-Controlled Study of Topical Coconut and Sunflower Seed Oil-Derived Isosorbide Diesters on Atopic Dermatitis.

Background: Preliminary studies support the use of topical coconut and sunflower seed oil for atopic dermatitis (AD). However, standardized topical formulations of fatty acids from these sources have not been studied. Objective: This study investigates whether coconut oil- and sunflower seed oil-derived isosorbide diesters can be used in conjunction with colloidal oatmeal to improve itch, AD severity, and the need for topical steroids in adults. Methods: This was a single-center, 4-week, randomized, double-blind, and vehicle-controlled study conducted between 2021 and 2022. Thirty-two male and female adults with mild-to-moderate AD were enrolled and completed the study. Participants were randomized to receive either 0.1% colloidal oatmeal (vehicle) or isosorbide diesters (IDEAS, 4% isosorbide dicaprylate and 4% isosorbide disunflowerseedate) along with 0.1% colloidal oatmeal. The main outcomes of the study were changes in the visual analogue rating of itch and 75% improvement in the Eczema Area and Severity Index score (EASI 75) at 4 weeks. Other measures included the use of topical steroids and the relative abundance of skin Staphylococcus aureus. Results: Participants in the IDEAS group had a 65.6% improvement in itch compared with 43.8% in the vehicle group (P = 0.013). In total, 56.5% and 25% of the those in the IDEAS and vehicle groups, respectively, achieved EASI 75 at 4 weeks (P = 0.07). There was no difference in skin hydration or transepidermal water loss. The relative abundance of S. aureus was decreased in the IDEAS group at week 4 compared with no change in the vehicle group (P = 0.044). Topical corticosteroid use increased in the vehicle group compared with a decrease in the IDEAS group at week 1 (292.5% vs 24.8%; P value = 0.039) and week 2 (220% vs 46%; P value = 0.08). Conclusions: Topical application of emollients containing coconut oil- and sunflower seed oil-derived fatty esters may improve itch, reduce topical steroid use, and reduce the relative abundance of S. aureus in mild-to-moderate AD. CTR number: NCT04831892.

Virtual Learning Decreases the Carbon Footprint of Medical Education.

INTRODUCTION: The environmental impact of holding in-person academic conferences and continuing medical education (CME) programs can be significant. In-person conferences provide a unique social and professional platform to engage in networking and foster professional development; however, there is an opportunity for hybrid and virtual platforms to provide CME for broader audiences looking to improve their clinical skills and strengthen their knowledge base. This study seeks to describe the reduction in carbon emissions associated with a webinar hosted by an online dermatology-focused medical education platform. METHODS: This cross-sectional study used the location of deidentified virtual attendees of a webinar to predict the carbon emissions produced if attendees had instead traveled to the location of the most recent Integrative Dermatology Symposium (Sacramento, CA). Following collection of each virtual attendee's location, the mode of transportation was predicted on the basis of each participant's distance to the conference. RESULTS: The estimated carbon emissions were calculated for 576 participants. The total estimated, unadjusted carbon emissions for both attendees predicted to fly or drive was 370,100 kg CO2. The emissions produced per participant from those expected to fly to an in-person CME after adjusting for all additional passengers on every flight were 4.5 kg CO2. The emissions produced per participant from those expected to drive were 42.7 kg CO2. CONCLUSION: The use of a virtual CME webinar led to a significant reduction in travel-related carbon dioxide emissions when compared to running the same program in-person event. When accounting for all passengers traveling via plane on any flight, driving to an event produced more emissions per participant than flying.