Migraine, triptans, and the risk of developing rosacea: A population-based study within the United Kingdom

 DermatologistsBlog.com eInterview with: Julia Spoendlin MSc

Basel Pharmacoepidemiology Unit
Division of Clinical Pharmacy and Epidemiology,
Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
Hospital Pharmacy, University Hospital Basel, Basel, Switzerland

DermatologistsBlog.com: What are the main findings of the study?

This large primary care-based case-control study (including 53,927 rosacea patients) is based in a large and well-validated UK-based database (the General Practice Research Database – GPRD). Despite very scarce evidence, a notion of an association between rosacea and migraine sustained over decades. We assessed whether patients with prevalent migraine and / or previous triptan or ergot derivative exposure are at an increased risk of being diagnosed with rosacea.  Our study is by far the largest study so far to address the association of the two diseases, and the first study to include the aspect of migraine medication in the study question (ie triptans and ergot derivatives). From a pathologic / mechanistic point of view triptans as well as ergot derivatives could potentially exert beneficial effects on rosacea via vasocontriction and anti-inflammatory properties.

Our findings do not support the hypothesis of an overall association between rosacea and migraine, but women, especially at post-menopausal ages, might be at a somewhat increased rosacea risk, with the highest OR in female migraineurs between  50 and 59 years of age (OR 1.36, 95% CI 1.21-1.53) . Triptans did not seem to affect the rosacea risk, but probably represent a proxy for migraine severity, with slightly increased risk estimates in triptan users when compared to the overall migraine population (OR 1.66, 95% CI 1.30-2.10 for female triptan users ≥60 years).

However, the actual effect size was relatively small also in post-menopausal females, and we are therefore reluctant to suggest a clinically relevant risk increase to develop rosacea also in this subgroup.

Thus, the main finding of our study is that we did not observe an overall association between prevalent migraine and incident rosacea. A potentially slightly increased risk in postmenopausal females with severe migraine will have to be followed up.  
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by on May 9, 2013  •  Permalink
Posted in Author Interviews, Rosacea
Posted by admin on May 9, 2013

http://dermatologistsblog.com/rosacea/migraine-triptans-and-the-risk-of-developing-rosacea-a-population-based-study-within-the-united-kingdom/

Sex-Related Location of Head and Neck Melanoma Strongly Argues for a Major Role of Sun Exposure in Cars and Photoprotection by Hair

DermatologistsBlog.com eInterview with: Dr Candice Lesage
Service de Dermatologie
Hôpital Robert Debré, CHU de Reims
Avenue du Général Koenig
Reims Cedex 51092, France.

DermatologistsBlog.com:  What are the main findings of the study?

Dr. Lesage: This work allowed us to enlighten major findings.

First, we demonstrated a clear-cut sex-related distribution of HNM between a central and a peripheral area which had never been reported before. Then, we found a difference in the side distribution between men and women.

We also noticed that peripheral and central HNM differed by their clinical and histological characteristics.

These observations led us to formulate our hypotheses on the role of hair in photoprotection and sun-exposure in cars.
Read the full post »

by on May 7, 2013  •  Permalink
Posted in Author Interviews, Melanoma, Skin Cancer
Posted by admin on May 7, 2013

http://dermatologistsblog.com/skin-cancer/sex-related-location-of-head-and-neck-melanoma-strongly-argues-for-a-major-role-of-sun-exposure-in-cars-and-photoprotection-by-hair/

Gender differences in chronic pruritus

DermatologistsBlog.com eInterview with 

Dr. Astrid Stumpf
Wissenschaftliche Assistentin
Klinik für Psychosomatik und Psychotherapie
Universitätsklinikum Münster
Domagkstr. 22 48149 Münster

DermatologistsBlog.com: What are the main findings of the study?

Dr. Stumpf:  We examined a large sample of 1037 patients (54.8% women) with chronic pruritus (CP; > 6 weeks of duration) when they attended the Competence Center Chronic Pruritus of the Department of Dermatology, University Hospital of Muenster, Germany.

We found a lot of differences between men and women. Women reported higher pruritus intensities and a higher impact on quality of life.  Pruritus was more influenced by psychic factors in women. We also found a different coping in women than in men. Women had more visible scratch lesions, so they seem to scratch more than men. Furthermore women described the pruritus differently to men. They reported more often a pruritus occurring in attacks associated with pain, warmth and stinging.

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by on May 7, 2013  •  Permalink
Posted in Author Interviews, Itch
Posted by admin on May 7, 2013

http://dermatologistsblog.com/itch/gender-differences-in-chronic-pruritus/

Oral evening primrose oil and borage oil for eczema

DermatologistsBlog.com eInterview with: Joel T M Bamford, MD, FAAD
University of Minnesota Medical School
Department of Family Medicine and Community Health, Duluth, Minnesota, USA
Essentia Health System, Dematology Section (2S2W20), Duluth, Minnesota, USA

DermatologistsBlog.com: What are the main findings of the study?

Dr. Bamford:

  • This review closely followed the methods outlined in the 645 page, Cochrane Handbook for Systematic Reviews of Interventions.
    We found that taken orally neither natural plant oil supplement (Evening Primrose Oil or Borage Oil) were no better than placebo in treating signs and symptoms of eczema severity as globally rated by physicians.
  • More than 5% of those in both placebo and active treatment groups experienced temporary, mild gastrointestinal symptoms such as abdominal pain and diarrhea.
  • Almost 1600 people with moderately severe eczema, both adults and children, in 27 countries participated in randomized clinical trials in dermatology offices or academic centers.
    Read the full post »
by on May 7, 2013  •  Permalink
Posted in Atopic Dermatitis - Eczema, Author Interviews
Posted by admin on May 7, 2013

http://dermatologistsblog.com/atopic-dermatitis-eczema/oral-evening-primrose-oil-and-borage-oil-for-eczema/

Treatment of Nonfatal Conditions at the End of Life Nonmelanoma Skin Cancer

Dr. Eleni Linos MD DrPH Assistant Professor of Dermatology University of California San FranciscoDermatologistsBlog.com eInterview with
Dr. Eleni Linos MD DrPH
Assistant Professor of Dermatology
University of California San Francisco

DermatologistsBlog.com: What are the main findings of the study?

Dr. Linos: We found that currently, treatment decisions for non-melanoma skin cancer are not tailored to individual patients. Specifically, frail elderly patients near the end of life, have the same rates of surgery including Mohs surgery as younger healthier patients.
Read the full post »

by on April 29, 2013  •  Permalink
Posted in Author Interviews, Skin Cancer
Posted by admin on April 29, 2013

http://dermatologistsblog.com/skin-cancer/treatment-of-nonfatal-conditions-at-the-end-of-life-nonmelanoma-skin-cancer/

Cutaneous delayed-type hypersensitivity in patients with atopic dermatitis

DermatologistsBlog.com: Donald V. Belsito, MD
Department of Dermatology
Columbia University Medical Center
Herbert Irving Pavilion, Room 1231
161 Fort Washington, New York, NY 10032.

DermatologistsBlog.com: What are the main findings of the study?

Dr. Belsito: Patients with a history of atopic dermatitis are more likely to have allergic contact dermatitis than patients without an atopic diathesis. In addition, atopic patients were significantly more likely to have allergic reactions upon patch testing to all 3 metals routinely tested: nickel, cobalt and chromium.
Read the full post »

by on April 21, 2013  •  Permalink
Posted in Atopic Dermatitis - Eczema, Author Interviews, Contact Dermatitis
Posted by admin on April 21, 2013

http://dermatologistsblog.com/contact_dermatitis/cutaneous-delayed-type-hypersensitivity-in-patients-with-atopic-dermatitis/

Association of discoid lupus erythematosus with other clinical manifestations among patients with systemic lupus erythematosus

Joseph F. Merola M.D. Assistant Program Director, Combined Internal Medicine-Dermatology Residency Training Program Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Instructor, Harvard Medical School

Joseph F. Merola M.D.
Assistant Program Director,
Combined Internal Medicine-Dermatology Residency Training Program
Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts;
Instructor, Harvard Medical School

DermatologistsBlog.com eInterview with Dr. Joseph F. Merola, MD

Assistant Program Director,
Combined Internal Medicine-Dermatology Residency Training Program
Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts;
Instructor, Harvard Medical School

DermatologistsBlog.com: What are the main findings of the study?

Dr. Merola: Among patients with systemic lupus (SLE) , those with discoid lupus as part of their disease had an increased risk of photosensitivity , leucopenia and anti-Smith antibodies , but a decreased risk of pleuritis and inflammatory arthritis.  There was no association with any of the other SLE manifestations listed in the 1997 Revised American College of Rheumatology  SLE classification criteria.  In particular , there was no association with lupus nephritis , end-stage renal disease or anti-double-stranded DNA antibodies.

DermatologistsBlog.com: Were any of the findings unexpected?

Dr. Merola: Observational literature , as well as at least one retrospective cohort study , have led to the teaching among dermatologists , that patients with discoid lupus as part of their systemic disease might have a better prognosis , in particular with less nephritis (a much dreaded complication of SLE).  Our findings are contrary to that teaching and have implications for prognostic information provided to this subset of patients.

 

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by on April 17, 2013  •  Permalink
Posted in Author Interviews, Connective Tissue Disease, Lupus
Posted by admin on April 17, 2013

http://dermatologistsblog.com/connective-tissue-disease/association-of-discoid-lupus-erythematosus-with-other-clinical-manifestations-among-patients-with-systemic-lupus-erythematosus/

Surgeon error and slide quality during Mohs micrographic surgery: Is there a relationship with tumor recurrence?

DermatologistsBlog.com eInterview with Dr. Daniel B. Eisen
 Director of Aesthetic Dermatology
Co-director of Dermatologic Surgery and head of the Procedural Dermatology Fellowship program
University of California, Davis.

DermatologistsBlog.com: What are the main findings of the study?

Dr. Eisen: There was a significant association with surgeon error that resulted in residual unexcised tumor and tumor recurrence.
Also of import was the association of recurrence with tissue dropout.
Read the full post »

by on April 16, 2013  •  Permalink
Posted in Author Interviews, Surgery
Posted by admin on April 16, 2013

http://dermatologistsblog.com/author_interviews/surgeon-error-and-slide-quality-during-mohs-micrographic-surgery-is-there-a-relationship-with-tumor-recurrence/

Use of Sun Protection by Melanoma Patients

Anees B. Chagpar, MD, MSc, MPH, MA, FRCS(C), FACS Associate Professor, Department of Surgery Director, The Breast Center -- Smilow Cancer Hospital at Yale-New Haven Assistant Director for Diversity and Health Equity, Yale Comprehensive Cancer Center Program Director, Yale Interdisciplinary Breast Fellowship Yale University School of Medicine New Haven, CT 06510DermatologistsBlog.com eInterview with Anees B. Chagpar, MD, MSc, MPH, MA, FRCS(C), FACS

Associate Professor, Department of Surgery
Director, The Breast Center — Smilow Cancer Hospital at Yale-New Haven
Assistant Director for Diversity and Health Equity, Yale Comprehensive Cancer Center
Program Director, Yale Interdisciplinary Breast Fellowship
Yale University School of Medicine New Haven, CT 06510

Email:  anees.chagpar@yale.edu

DermatologistsBlog.com: What are the main findings of this research?

Dr. Chagpar: The main findings were that over a quarter of melanoma survivors report never wearing sunscreen, and 2.1% of them reported using a tanning bed within the past 12 months.  While this was better than the melanoma-free population, it was still concerning, as one would hope that melanoma survivors who are nine-fold more likely to get a second melanoma than the general population is to get a first would be particularly vigilant about protecting themselves from UV rays.  Furthermore, when controlling for age, race/ethnicity, and insurance, melanoma survivors were no less likely to use a tanning bed than those without melanoma.
Read the full post »

by on April 11, 2013  •  Permalink
Posted in Author Interviews, Melanoma, Sunscreens, Tanning Booths
Posted by admin on April 11, 2013

http://dermatologistsblog.com/tanning-booths/use-of-sun-protection-by-melanoma-patients/

Does it look like melanoma? A pilot study of the effect of sunless tanning on dermoscopy of pigmented skin lesions

DermatologistsBlog.com Interview with Johan Dahlén Gyllencreutz, MD
Dept of Dermatology
Skaraborg Hospital
541 85 Skövde Sweden

DermatologistsBlog.com: What are the main findings of the study?

Answer: That the use of a sunless tanning product containing dihydroxyacetone can cause pigmentation around the follicular openings to appear. This could possibly interfere with the dermoscopic evaluation of facial pigmented skin lesions as structures that are somewhat similar can be a sign of Lentigo Maligna. 
Read the full post »

by on March 28, 2013  •  Permalink
Posted in Author Interviews, Dermatoscopy
Posted by admin on March 28, 2013

http://dermatologistsblog.com/author_interviews/does-it-look-like-melanoma-a-pilot-study-of-the-effect-of-sunless-tanning-on-dermoscopy-of-pigmented-skin-lesions/

BRAF mutational epidemiology in dysplastic nevi: Does different solar UV radiation exposure matter?

DermatologistsBlog.com Interview with Ibrahim Khalifeh, M.D., A.B.D.

Assistant Professor
General, Cytopathology and Dermatopathology
American University of Beirut Medical Center
Beirut, Lebanon 1107 2020

Dr. Khalifeh:

The points I would like to highlight in our retrospective study:

-              This study is considered by far the largest series of BRAF analysis in dysplastic nevi. Our study is composed of 125 cases. The second largest study in the English literature BRAF status on 21 dysplastic nevi.

-              The large series offered us better vision of the accurate BRAF mutational rate in dysplastic nevi.

-              We tested 9 types of BRAF mutations on every case which allowed us to see the epidemiology of every type in our near eastern cohort.

-              This large series allowed us to obtain the epidemiological distribution of different histological grade in dysplastic nevi. Where we noticed that dysplastic nevi show statistically more significant atypia in the 2 population studied in comparison to reported western cohorts.

-              We collected the demographics, anatomic distribution, age, sex, size, etc. of dysplastic nevi and compared with other cohorts. All those clinical and microscopic parameters were correlated to BRAF status to determine the predictors of BRAF mutations.

-              Such correlations brought us to very important conclusions “there is no morphological difference between BRAF positive and negative dysplastic nevi, as suggested in melanomas, and BRAF status is not related to the degree of dysplasia”.
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by on March 27, 2013  •  Permalink
Posted in Author Interviews, BRAF, Skin Cancer
Posted by admin on March 27, 2013

http://dermatologistsblog.com/skin-cancer/braf-mutational-epidemiology-in-dysplastic-nevi-does-different-solar-uv-radiation-exposure-matter/

Omalizumab for the Treatment of Chronic Idiopathic or Spontaneous Urticaria

DermatologistsBlog.com Interview with Prof Dr. Ana GImenez-Arnau
Department of Dermatology.
Hospital del Mar. IMIM. Universitat Autònoma Barcelona

DermatologistsBlog.com: What are the main findings of the study?

Dr. Gimenez-Arnau: The main issue of this study was to demonstrate the efficacy of omalizumab obtaining relief of the urticaria symptoms (itch and hives) of moderate to severe chronic spontaneous urticaria in patients who are refractory to the actual approved treatments, non-sedative antihistamines at licensed doses. The term chronic just refers to the disease definition, this means long-lasting more than 6 weeks, but does not mean the urticaria is for all the life.

This study is designed to define the minimal effective dose. Because of this, three doses were compared with placebo, 75 mg, 150 mg and 300 mg. The primary efficacy outcome was the change from baseline in a weekly itch-severity score. Different secondary end points were also analyzed among others changes from baseline in the Urticaria Activity Score 7(assess wheals +itch), from the score for the weekly number of hives or the Dermatology Quality of Life Index.   

And what the results show, is that at minimum dose of 150 mg subcutaneously administered monthly, showed significant differences compared with placebo for all the endpoints analyzed except for angioedema control. 
Read the full post »

by on March 26, 2013  •  Permalink
Posted in Author Interviews, Biologics, Hives - Urticaria, Medications
Posted by admin on March 26, 2013

http://dermatologistsblog.com/medications/biologics-2/omalizumab-for-the-treatment-of-chronic-idiopathic-or-spontaneous-urticaria/

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