J Am Acad Dermatol
December 2024
Hidradenitis suppurativa is a debilitating inflammatory disease with a profound impact on quality of life for affected patients and caregivers. The patient journey in hidradenitis begins with symptom onset and proceeds through diagnosis and treatment. It is fraught with misdiagnosis, lack of awareness, misinformation, and inappropriate treatments that lead to shame, blame, isolation, and medical mistrust.
View Article and Find Full Text PDFBackground: Hidradenitis suppurativa (HS) is an inflammatory chronic skin disorder of unknown etiology characterized by inflamed abscess-like nodules and boils resulting in sinus tract formation, tissue scarring, and massive infiltration of neutrophils. Multiple lines of evidence have highlighted the potential association between alterations in the Notch pathway and HS pathogenesis, but the mechanisms remain incompletely characterized.
Objective: We aimed to elucidate the role of neutrophil extracellular traps in Notch-γ-secretase signaling.
Background: Defining hidradenitis suppurativa (HS) subtypes was previously limited by small sample sizes and poor interrater reliability; no study has investigated subtype treatment responses. The objective of this analysis was to characterize HS clusters in adult patients with moderate to severe HS and evaluate secukinumab treatment responses between clusters.
Methods: Clusters were identified via an unsupervised machine learning clustering analysis using baseline data from the randomized, placebo-controlled SUNSHINE (NCT03713619) and SUNRISE (NCT03713632) phase 3 trials.
Background: Chemical hair relaxers are widely utilized by black women, yet little research exists on the allergens present in these products.
Objective: This study aims to investigate allergen prevalence in the most popular chemical hair relaxers.
Methods: We analysed 41 products from five major retailers, identifying allergens through ingredient lists and comparing them to the 2020 American Contact Dermatitis Group Core allergen series.
Background: Hidradenitis suppurativa (HS) is a debilitating chronic inflammatory skin condition that typically requires consistent care. Contributory factors to why patients with HS miss their clinic appointments have not been investigated.
Objectives: This article seeks to characterise reasons that HS patients do not keep their appointments and identify strategies to minimise no-show rates and improve delivery of care to HS patients.
Background: Direct-to-consumer advertisements (DTCAs) in medical marketing serve as a prominent modality to deliver information to an increasingly diverse audience of consumers and increase prescription sales. In dermatology, advertisements have the potential to shape the public's opinions, aid in the understanding of skin conditions, and raise awareness of available treatments.
Objective: To investigate and characterize the representation of skin tones in DTCAs.
Hidradenitis suppurativa (HS) is a chronic disease characterized by recurrent painful abscesses and chronic sinus tracts in intertriginous areas. In the United States, HS disproportionally affects adults of African-American heritage. Depending on the severity of disease, the consequences of HS can be far-reaching, significantly affecting mental health and quality of life.
View Article and Find Full Text PDFWe conducted a cross-sectional survey study of premedical undergraduate students at Howard University (Washington, DC), to evaluate the level of interest that underrepresented in medicine (UiM) premedical students have in the field of dermatology. The 19-question survey assessed student knowledge, opinions, and exposure to dermatology. Dermatology is an area of great interest for UiM premedical students that has few avenues available for exposure and learning.
View Article and Find Full Text PDFHidradenitis suppurativa (HS) is a debilitating inflammatory skin disorder characterized by abscess-like nodules and boils resulting in fistulas and tissue scarring. We previously reported evidence of an autoimmune signature in HS, characterized by enhanced neutrophil extracellular trap (NET) infiltration in HS skin lesions and dysregulation of the adaptive immune system characterized by the presence of autoantibodies. Timely removal of NETs is critical for tissue homeostasis to prevent a dysregulated generation of modified autoantigens and tissue damage.
View Article and Find Full Text PDFHidradenitis suppurativa (HS) is a chronic inflammatory scarring disease felt to be related to occlusion of the hair follicle unit in intertriginous areas. We perform a systematic review on HS histopathology to evaluate current knowledge and discuss future directions. PubMed and Scopus databases were searched for relevant articles published from January 1985 to January 2021 that discussed the pathology of HS.
View Article and Find Full Text PDFImportance: Topical formulations of tretinoin precursors (retinol and its ester derivatives) are widely available over the counter and may offer similar clinical benefits to those of tretinoin for treatment of photoaging. However, which of the many purported molecular effects of retinoids most strongly drives clinical improvements in tretinoin-treated skin remains unclear.
Objectives: To evaluate the clinical efficacy of topical tretinoin precursors (TTP) vs tretinoin (RA) in treating moderate to severe facial photodamage and to identify potential biomarkers that correlate with clinical efficacy.
Currently, there is a lack of racial/ethnic heterogeneity in research databases, exposing a systematic issue in studies exploring inflammation-mediated diseases, such as hidradenitis suppurativa (HS). HS is a chronic inflammatory skin condition that disrupts normal structure and functioning of terminal hair follicles, resulting in the formation of recurrent abscesses, nodules, and sinus tracts within intertriginous regions. Studies have described higher serum levels of inflammation-mediated C-reactive protein (CRP) in patients with HS, a disease that predominantly affects skin of color (SOC) populations.
View Article and Find Full Text PDFOf the four subtypes of cutaneous melanoma, acral lentiginous melanoma (ALM) is atypical in its presentation. ALM is a rare melanoma subtype that presents on the volar surfaces of the hand and foot. The difficulty of making an early diagnosis of ALM is highlighted by the case seen in our institution.
View Article and Find Full Text PDFObjectives: This study was undertaken to evaluate the diagnostic performance of the BinaxNOW COVID-19 Ag Card rapid antigen assay (Abbott; Chicago, IL, USA) in the detection of COVID-19 infection compared to the reference standard of PCR testing.
Methods: We evaluated the BinaxNOW COVID-19 Ag Card rapid antigen assay relative to a standard reference PCR test. We tested 3810 nasal swabs from symptomatic and asymptomatic adults undergoing surveillance COVID-19 testing at Howard University using one swab for each nostril.
Hidradenitis suppurativa (HS), also known as acne inversa, is a debilitating inflammatory skin disorder that is characterized by nodules that lead to the development of connected tunnels and scars as it progresses from Hurley stages I to III. HS has been associated with several autoimmune diseases, including inflammatory bowel disease and spondyloarthritis. We previously reported dysregulation of humoral immune responses in HS, characterized by elevated serum total IgG, B-cell activation, and antibodies recognizing citrullinated proteins.
View Article and Find Full Text PDFPurpose: Rural populations have higher poverty rates, lower educational attainment, higher smoking rates, lower rates of health insurance, higher proportions of elderly individuals, decreased access to health services including dermatology, higher all-cause mortality, and higher mortality from melanoma. Despite these disparities, rural patients have not been adequately studied within the dermatologic literature, particularly at geographic units smaller than the county level.
Methods: We used zip codes and Rural Urban Commuting Area (RUCA) codes to conduct a cross-sectional study on the prevalence and severity of melanoma among 31,750 rural versus urban patients treated by the Johns Hopkins Department of Dermatology from January, 2016 to June, 2017.
Several calls to action have been made in response to the lack of racial diversity in dermatology, but we have yet to explore how differences in social capital perpetuate homogeneity in dermatology training programs and the workforce. Herein, the concept of social capital is applied to this problem in dermatology and is used as a scaffold to suggest interventions that may ameliorate the systemic barriers faced by underrepresented-in-medicine (UIM) students.
View Article and Find Full Text PDFBackground: Hair products are a potential cause of allergic contact dermatitis. There are limited data on the allergen content of ethnic hair products.
Objective: To identify allergens unique to ethnic hair products (shampoos, conditioners, styling products) and provide a resource for low allergen hair care products for patients with ethnic hair types.
Background: Chronic pruritus dramatically disrupts quality of life, impairs sleep, and is difficult to treat. The pathogenesis and severity of chronic itch can vary significantly with race. Black skin has inherent structural and molecular characteristics that exacerbates pruritus, leading to unique presentations of pruritic conditions and added challenges in finding effective therapies.
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