396 Characterizing inpatient hospitalizations for hidradenitis suppurativa and assessing the impact of outpatient dermatology care on hospitalizations

Introduction: Hidradenitis suppurativa (HS) is associated with a significant disease burden. The use of high-cost settings care are common among HS patients. Objective: To explore factors that may influence hospital admissions and readmissions among HS patients. Methods: Using ICD-9/10 codes (705.83 and L73.2), we extracted the medical records of adult HS patients who visited the Henry Ford Health System (HFHS) ED between 2010 and 2020. Results: Of the 100 HS patients, 52 (52%) were admitted to an inpatient service. Hypertension (OR:2.55,95% CI:1.11-5.83, p value=0.027), diabetes mellitus (OR:2.42, 95%CI:1.05-5.61, p value =0.039), cellulitis (OR: 19.28, 95%CI:4.23-87.96 p\u3c0.001), sepsis (OR:10.25, 95%CI:1.34-89.24, p value=0.025), and depression (OR:3.32, 95%CI:1.10-10.04, p value =0.002) were significant predictors of admission. Chronic kidney disease (OR:3.05, 95% CI:1.00-9.23,p value=0.049), congestive heart failure (OR:4.06, 95%CI:1.19-13.80, p value =0.025), coronary artery disease (OR:15.20, 95%CI:2.80-82.65, p value=0.002), chronic obstructive pulmonary disease (OR:8.94, 95%: 1.51-52.86, p value =0.003), cellulitis (OR:4.62, 95%CI:1.66-12.88, p=0.003), sepsis (OR:3.75, 95%CI:1.02-13.82,p value =0.047), and depression (OR:4.50, 95%CI:1.54-13.18, p value=0.006) were positively associated with readmission. Those who received outpatient dermatology care had a lower risk of being admitted (n=87, 28.7% vs n=13,100%, p \u3c0.001) and readmitted (n=10, 11.5% vs n=5, 38.5%, p value =0.0108). Discussion: In this study, we demonstrate that certain comorbidities, that are common among HS patients, are significant determinants of admission to an inpatient service. Furthermore, the increase access to outpatient dermatology care significantly reduces the likelihood of HS patients being admitted and readmitted. Conclusion: The findings of this study illuminate the pivotal role of dermatologists in improving patients’ health outcomes while minimizing the avoidable use of high-cost settings care

Cannabinoids for the Treatment of Dermatologic Conditions

In recent years, cannabinoid (CB) products have gained popularity among the public. The anti-inflammatory properties of CBs have piqued the interest of researchers and clinicians because they represent promising avenues for the treatment of autoimmune and inflammatory skin disorders that may be refractory to conventional therapy. The objective of this study was to review the existing literature regarding CBs for dermatologic conditions. A primary literature search was conducted in October 2020, using the PubMed and Embase databases, for all articles published from 1965 to October 2020. Review articles, studies using animal models, and nondermatologic and pharmacologic studies were excluded. From 248 nonduplicated studies, 26 articles were included. There were 13 articles on systemic CBs and 14 reports on topical CBs. Selective CB receptor type 2 agonists were found to be effective in treating diffuse cutaneous systemic sclerosis and dermatomyositis. Dronabinol showed efficacy for trichotillomania. Sublingual cannabidiol and Δ-9-tetrahydrocannabinol were successful in treating the pain associated with epidermolysis bullosa. Available evidence suggests that CBs may be effective for the treatment of various inflammatory skin disorders. Although promising, additional research is necessary to evaluate efficacy and to determine dosing, safety, and long-term treatment guidelines

Tolerability profile of topical cannabidiol and palmitoylethanolamide: a compilation of single-centre randomized evaluator-blinded clinical and in vitro studies in normal skin.

BACKGROUND: An increasing number of studies have investigated the adverse effect profile of oral cannabinoids; however, few studies have provided sufficient data on the tolerability of topical cannabinoids in human participants. AIM: To assess the tolerability profile of several commercial topical formulations containing cannabidiol (CBD) and palmitoylethanolamide (PEA) on the skin of healthy human participants. METHODS: Three human clinical trials and one in vitro study were conducted. The potential for skin irritation, sensitization and phototoxicity of several products, were assessed via patch testing on healthy human skin. The products assessed included two formulations containing CBD and PEA, one containing hemp seed oil and four concentrations of CBD alone. Ocular toxicity was tested using a traditional hen\u27s egg chorioallantoic membrane model with three CBD, PEA and hemp seed oil formulations. RESULTS: There was no irritation or sensitization of the products evident via patch testing on healthy participants. Additionally, mild phototoxicity of a hemp seed oil product was found at the 48-h time point compared with the negative control. The in vitro experiment demonstrated comparable effects of cannabinoid products with historically nonirritating products. CONCLUSION: These specific formulations of CBD- and PEA-containing products are nonirritating and nonsensitizing in healthy adults, and further encourage similar research assessing their long-term safety and efficacy in human participants with dermatological diseases. There are some limitations to the study: (i) external validity may be limited as formulations from a single manufacturer were used for this study, while vast heterogeneity exists across unregulated, commercial CBD products on the market; and (ii) products were assessed only on normal, nondiseased human skin, and therefore extrapolation to those with dermatological diseases cannot be assumed

Identification of casein-derived phosphopeptides in bovine milk

Color poster with text and images.University of Wisconsin--Stout. Research Service

35186 Exploring the association between frontal fibrosing alopecia sunscreen and moisturizers

Frontal fibrosing alopecia (FFA) is an immune-mediated cicatricial alopecia. Skin care products including sunscreen were suggested to influence disease pathogenesis. Given the conflicting data, the aim of this study is to provide a quantitative summary on this topic. A systematic search surveying PubMed database was conducted in August 2021. The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed. The study was prospectively registered in Prospero (ID: 273840). The pooled effect size is presented as odds ratio (OR) with 95% confidence interval (CI). A total of 87 articles were identified; 9 articles were included. Using the Newcastle Ottawa scale (NOS), the quality of studies ranged from 5 to 7, suggestive of moderate quality. 1248 patients in the published literature had FFA (mean age: 58.9, 95.7% female) and were compared with 1459 control subjects (mean age: 56.9, 89.8% female). Six (66.67%) studies assessed the use of sunscreen and moisturizers 5 years before the onset of FFA. Nine studies evaluated the association between sunscreen and FFA (n = 9); the pooled OR was 1.45 95%CI [1.11-1.90], P =.0068. For the 8 studies exploring the relationship between facial moisturizers and FFA, the pooled OR was 1.26 (95% CI 1.10-1.43), P =.006. The results of this study suggest that both sunscreen and moisturizers likely increase the risk of FFA by 45% and 26% respectively. Due to lack of randomized controlled trials and small number of studies, the causality of this association could not be ascertained. As such, high-quality studies are needed

Visible Light and the Skin

Visible light (VL, 400-700 nm) was previously regarded as nonsignificant with minimal to no photobiologic effects on the skin. Recent studies have demonstrated that in dark-skinned individuals (skin phototypes IV-VI), VL can induce more intense and longer lasting pigmentation compared to ultraviolet A1 (UVA1, 340-400 nm). Additionally, long wavelength UVA1 (370-400 nm) has been shown to potentiate these effects of VL. The combination of VL and UVA1 (VL + UVA1, 370-700 nm) was also able to induce erythema in light-skinned individuals (skin phototypes I-III), which is a novel finding since the erythemogenic spectrum of sunlight has primarily been attributed to ultraviolet B (UVB, 290-320 nm) and short wavelength UVA2 (320-340 nm) only. Although biologic effects of VL + UVA1 have been established, there are no guidelines in any country to test for photoprotection against this waveband. This invited perspective aims to present the evolution of knowledge of photobiologic effects of VL, associated phototesting methodologies, and current position on VL photoprotection

Evaluating the United States Population\u27s Interest in Sunscreen: A Google Trend Analysis

Broad-spectrum sunscreen remains an important component of photoprotection against deleterious effects of ultraviolet (UV) radiation.(1) The advances made in the field of photoprotection has resulted in an expansion of various sunscreen formulations, providing numerous options to consumers. In the past several years, there has been a growing concern regarding the potential environmental and health impacts of certain UVR filters, which has resulted in public confusion on the use of sunscreen as a photoprotective measure.(1,2)