Journal Of Investigative Dermatology

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Updated: 43 min 5 sec ago

LB1114 Acupuncture improves Imiquimod-induced psoriasis-like skin lesions through reducing local inflammatory responses

Sun, 2019-09-01 00:00
Psoriasis is a common autoimmune disease. Acupuncture-related techniques have been widely used to treat psoriasis since its function of mediating nervous, immune and other systems. This study aims to investigate acupuncture treatment in psoriasis-like skin inflammatory responses, and explore the possible mechanisms. Imiquimod (IMQ)-induced psoriasis-like mice were treated with acupuncture, and methotrexate (MTX) was applied as a positive control. Psoriasis area and severity index (PASI) was scored to evaluate the skin lesions changes.

LB1113 TIRACLE™ and ACTIVITIS™: A novel anti-aging blend

Sun, 2019-09-01 00:00
TIRACLE™ is a unique bacteria fermentation extract from T. Thermophiles and S. Cerevisiae, previously shown to have skin-protecting properties. ACTIVITIS™, a novel botanical extract enriched for PP2A-activating flavonoids, inhibits demethylation of PP2A, which plays a crucial role in regulating oxidative stress in skin. To explore the potential benefits of TIRACLE™ and ACTIVITIS™ in combination, we employed a human Genome Array utilizing the EpiDerm™ FT model. We discovered 2,730 genes to be regulated by the combination of TIRACLE™ + ACTIVITIS™; 1,770 genes were significantly down-regulated, 960 genes were significantly up-regulated, and 671 were unique to the combination treatment including genes involved in skin aging, ECM remodeling, barrier repair, inflammation and PP2A signaling.

LB1112 Peripheral retinal vascular leakage in moderate to severe psoriasis: A pilot study

Sun, 2019-09-01 00:00
The impact of psoriatic inflammation on the eye is not fully understood. In this pilot study we investigated if peripheral vascular leakage (PVL), a feature of retinopathy, was evident in patients with psoriasis using Ultra-Wide-Field Fluorescein Angiography (UWFFA). We performed a pilot cross-sectional, IRB-approved, prospective study comparing UWFFA in patients with psoriasis to healthy age-matched controls. Subjects with active or history of moderate to severe plaque psoriasis underwent a complete ophthalmologic exam along with optical coherence tomography and UWFFA.

LB1111 High-dose intralesional triamcinolone as a novel adjunctive treatment for acute inflammatory lesions of hidradenitis suppurativa

Sun, 2019-09-01 00:00
Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition characterized by painful nodules, abscesses, and dermal tracts that severely impact patient quality of life (QOL). Intralesional triamcinolone (ILTAC) has been utilized for inflammatory lesions in HS, but the optimal dose has yet to be determined. Having observed the efficacy of high-dose ILTAC (20-40 mg/mL) for inflammatory nodules and draining fistulas in HS, we conducted a retrospective chart review and telephone interviews to assess this treatment modality.

LB1110 High-dose infliximab; A new treatment paradigm for hidradenitis suppurativa

Sun, 2019-09-01 00:00
Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition characterized by recurrent nodules and abscesses that may progress to purulent dermal tracts and scarring. Although prior studies have reported improvement of HS with infliximab (IFX) 5 mg/kg, no reports have examined the efficacy of high-dose IFX, ranging from 7.5 mg/kg to 10 mg/kg. A retrospective chart review of 60 patients with moderate-to-severe HS receiving high-dose IFX, 7.5–10 mg/kg, was conducted at the Albert Einstein/Montefiore Hidradenitis Suppurativa Treatment Center (HSTC).

LB1109 Diagnostic and therapeutic differences between immune checkpoint inhibitor-induced and idiopathic bullous pemphigoid: A retrospective case-control study

Sun, 2019-09-01 00:00
Bullous pemphigoid (BP) is a rare but often treatment-altering complication of immune checkpoint inhibitors (ICIs). This multicenter, retrospective case-control study aims to identify diagnostic and therapeutic differences between ICI-induced BP (ICI-BP) and idiopathic BP (iBP) using 15 ICI-BP cases and 30 age- and sex-matched iBP controls. ICI-BP cases were all from PD-1 blockade and occurred after a median of 11 cycles and 8.9 months of ICI treatment. Compared to controls, cases had a significantly longer delay from symptom onset to diagnosis (medians, 210 vs 91.5 days; p=0.04) and prolonged pruritus without rash (28 vs 7 days; p<0.001).

LB1108 Association of aplastic anemia with isotretinoin: Is it more common than we think?

Sun, 2019-09-01 00:00
The purpose of this study was to give dermatologists important information on the association of isotretinoin with aplastic anemia and therefore change their approach for monitoring patients taking isotretinoin. We reviewed FDA reports and most recent literature on the association of isotretinoin with bone marrow suppression. We then applied this information to the clinical course of a patient who had been on isotretinoin for a year and then presented six months later in septic shock with AA and ultimately died of multiorgan failure.

LB1107 Enhancing cosmesis while achieving stellar cure rates for early stage non-melanoma skin cancer in the outpatient dermatology clinic using a novel non-invasive modality

Sun, 2019-09-01 00:00
Introduction: Non-Melanoma Skin Cancer(NMSC) is generally treated in dermatology offices using invasive techniques. Objective: We evaluate the feasibility, tolerance, effectiveness and cosmesis using an office-based non-invasive modality for NMSC. Materials and Methods: Between April 2017 and August 2018, 87 patients with 123 pathologically confirmed early stage NMSC lesions treated with Image Guided Superficial Radiotherapy (IGSRT) were analysed. All lesions received twenty fractions of 50 or 70 kiloVoltage(kV) IGSRT given three or four times weekly.

LB1106 An exploratory open label phase 1b study of secukinumab in patients with moderate to severe papulopustular rosacea

Sun, 2019-09-01 00:00
Background: Recent analyses of rosacea skin biopsies implicated IL-17A in rosacea pathogenesis. Current rosacea treatment options are limited and no cure exists. Objective: Assess the potential benefit of secukinumab in patients with moderate-to-severe papulopustular rosacea. Methods: After IRB approval and written informed consent, a total of 23 participants received secukinumab at 300 mg weekly for five weeks then monthly for two months. Papule count, erythema, global severity, and adverse events at 0 and 16 weeks were assessed by three board certified dermatologists blinded to pre- or post-treatment.

LB1105 Hypergranulating wounds in hidradenitis suppurativa masquerading as pyogenic granuloma

Sun, 2019-09-01 00:00
Hidradenitis suppurativa is a chronic inflammatory skin disorder characterized by acute and chronic recurrent nodules, abscesses, and dermal tracts. We report a new morphologic variant of hidradenitis suppurativa manifest as hypergranulating wounds. Three female patients, ages 16, 18, and 44, with hidradenitis suppurativa symptoms spanning from 6 to 20 years, presented with red, fleshy, exophytic tissue, indistinguishable from pyogenic granuloma. These lesions were unresponsive to topical silver nitrate.

LB1104 Histologic features of GVHD-associated angiomatosis: Insights into pathogenesis and treatment

Sun, 2019-09-01 00:00
Graft-versus-host disease-associated angiomatosis (GVHD-AA) is characterized by benign vascular growths often observed on sclerotic skin from chronic GVHD. These lesions can ulcerate, bleed with minor trauma, and cause pain, leading to significant morbidity. Although many treatments have been tried, no standard of care exists. To obtain insights into disease biology and inform treatment, we conducted a retrospective study analyzing clinical data and histologic and immunohistochemical features of 16 biopsy specimens of 8 GVHD-AA patients.

LB1103 Interruptions and terminations of isotretinoin treatment in patients with acne and lab abnormalities

Sun, 2019-09-01 00:00
We assessed the rate of isotretinoin therapy interruptions and terminations due to lipid, liver function, and hematologic lab abnormalities in patients with acne who had hypercholesterolemia (HC), hypertriglyceridemia (TG), elevated alanine aminotransferase (ALT), leukopenia, or thrombocytopenia prior to initiating isotretinoin, a drug associated with these abnormalities. We reviewed records for patients with acne and baseline HC, TG, elevated ALT, leukopenia, or thrombocytopenia who started isotretinoin from January 1, 2008 to June 1, 2016 at Brigham & Women’s Hospital and Massachusetts General Hospital.

LB1102 Psychosocial impact of clinical severity on hidradenitis suppurativa

Sun, 2019-09-01 00:00
Background: Hidradenitis suppurativa (HS) negatively impacts quality of life. Objective: To find how HS Hurley and Severity Assessment of Hidradenitis Suppurativa (SAHS) relate to scores on Dermatology Quality of Life Index (DQLI) and Beck Depression Inventory (BDI). Methods: Cross-sectional study run Oct. 2018-Feb. 2019. Eligibility: age 12+ and a clinical visit for HS. Exclusions: declined involvement; English or French illiteracy; known depression or mental health disorder as defined by DSM-5 criteria.

LB1101 Itch and quality of life impact in atopic dermatitis vs bullous pemphigoid

Sun, 2019-09-01 00:00
Atopic dermatitis (AD) and bullous pemphigoid (BP) are inflammatory skin diseases in which patients often report intense pruritus and significant quality of life (QOL) impact. Although they have differences in classical presentation (eczematous eruption versus urticaria and blisters) and population characteristics (young-to middle aged persons vs. elderly), early stages of BP can appear similar to AD clinically and histologically. We wanted to explore whether there were significant similarities or differences in pruritus characteristics and QOL impact.

LB1100 Healthy Skin for Everyone: One-year data from a community-based skin cancer education program in an underserved population

Sun, 2019-09-01 00:00
“Healthy Skin for Everyone”, or “Piel Saludable Para Todos”, is a community-based initiative to address rising rates of skin cancer in minority populations accompanied by higher mortality and lack of evidence-based interventions. We previously enrolled 114 Spanish-speaking adults from a non-profit clinic to participate in a 45-minute workshop on skin cancer prevention led by trained community health workers followed by a 12-week text-messaging program. These are the results of a one-year follow up to assess the durability of behavioral changes.

LB1099 Placebo response in alopecia studies

Sun, 2019-09-01 00:00
Introduction: The purpose of this study was to assess the relationship between improvements in alopecia seen with placebo and the method of hair count analysis used to assess the response. Methods: A systematic literature review was performed using MEDLINE to find studies that reported the effect of placebo on alopecia. We then characterized these studies based on the method of hair count analysis. Hair counts in placebo arms of studies, quantified as mean change from baseline in total hair or nonvellus hair count, were gathered and compared.

LB1098 Placebo response in itch and atopic dermatitis studies

Sun, 2019-09-01 00:00
Introduction: The purpose of this study was to assess whether the improvements in itch seen with placebo are due to the use of minimum itch scores as an entry criterion. Methods: A systematic literature review was performed using MEDLINE to find studies that reported the effect of placebo on itch. We then characterized these studies based on whether or not itch was an entry criterion. Itch outcome in placebo arms of studies, quantified using visual analog scale (VAS), was gathered and compared to each other.

LB1097 The risk of appendicitis, cholecystitis, or diverticulitis in patients with psoriasis

Sun, 2019-09-01 00:00
The purpose of this study is to determine if patients with psoriasis are at an increased risk of developing appendicitis, cholecystitis, or diverticulitis compared to the general population. A retrospective, population-based, cohort study was performed utilizing data from the Kaiser Permanente Southern California (KPSC) health network during the study period January 1, 2004 through December 31, 2016. Of 1,690,214 KPSC patients eligible for our study, 10,307 met our diagnostic and inclusion criteria for psoriasis.

LB1096 Results of phase 2 study evaluating the efficacy and safety of SB206, topical berdazimer sodium gel, in subjects with Molluscum Contagiosum

Sun, 2019-09-01 00:00
Introduction: There is no approved topical prescription medicine to treat molluscum contagiosum (MC). SB206 is an investigational topical product that consists of 2 components; a gel containing berdazimer sodium that releases nitric oxide (NO) when co-administered with a hydrogel. NO, an endogenous small molecule, is known to be an immune modulator as well as an antimicrobial agent. Objective: A Phase 2, 12-week, randomized, vehicle-controlled ascending dose trial was conducted in patients with MC to evaluate the efficacy and safety of SB206 compared to vehicle (VH).

LB1095 Differences in cosmetic motivations based on demographic variables

Sun, 2019-09-01 00:00
Introduction: Demand for cosmetic procedures has increased among varying patient demographic groups in recent years, although motivations underlying this trend have not been well-defined. The purpose of this study is to assess whether cosmetic motives are correlated with demographic factors. Methods: Over 500 patients presenting for cosmetic consultation at 13 dermatology centers in the United States were surveyed. Similar motivations were organized into domains by qualitative analysis. Linear regression analyses were performed across 6 quality of life (QoL) domains to assess whether age, gender, level of education, race, and/or geographic region were associated with reasons for pursuing cosmetic procedures.

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