Seasonal variability in public searches of keratosis pilaris: How the internet can illuminate a pattern in public interest.

In this study, we examine keratosis pilaris search patterns using Google Trends to determine any seasonality. Monthly searches were collected from January 2004 to January 2020 using keratosis pilaris as the search term in the Google Trends database. The US search data were compared to monthly temperatures and tested for correlation. Worldwide search interest was also acquired and, along with the US data, a two-model analysis was performed to determine any seasonal patterns. Peaks in search interest closely overlapped with higher temperatures in the United States and showed correlation (.44; P \u3c .0001). The US and worldwide search interest also exhibited seasonality, which was confirmed with a sinusoidal regression being the best-fit model (

A cross‐sectional analysis of medications used by patients reporting alopecia areata on the FDA adverse events reporting system

Abstract Background Alopecia areata (AA) is an autoimmune condition that leads to patchy, nonscarring hair loss. Its etiology remains unknown; the condition can be debilitating for patients, impacting their psychosocial wellbeing. Various triggers have been reported, ranging from genetic predisposition and infections to environmental factors. Medications have also been thought to be an inciting factor in AA. Methods Using the Food and Drug Administration (FDA) Adverse Events Reporting System (FAERS), all cases reporting AA as an adverse event were used to capture associated medications and patient characteristics. Results There were 1,331 AA cases reported as an adverse event with medication use. Monoclonal antibodies accounted for 6 out of the top 10 drugs associated with the highest number of AA cases. Males were more likely to report AA when taking adalimumab (OR: 1.79, P = 0.04) and dupilumab (OR: 2.56, P = 0.03) compared to females. Individuals between 42 and 64 years old accounted for 46.7% of AA cases. Lastly, females in older age groups showed greater odds of developing AA compared to males (OR: 1.03, P < 0.01). Conclusions Based on the FAERS, there has been a steady rise in AA cases, and monoclonal antibodies were the most frequently cited medication class tied to AA. With a dearth of literature on triggers and patient demographics, we sought to describe features of AA cases that could increase awareness and be used to improve future clinical outcomes in patients

Beyond the Label: Real-World Side Effects Experienced With FDA-Approved Drugs for Non-Melanoma Skin Cancers

With immunotherapy historically focused on cutaneous melanoma, there has been a new wave of systemic medications available for treating non-melanoma skin cancers including basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and Merkel cell carcinoma (MCC). The immune checkpoint inhibitors approved by the FDA target programmed cell death protein 1 (PD-1) and the Hedgehog (Hh) signaling pathway. These medications have expanded treatment options; however, side effects are an important consideration. We used the FDA Adverse Events Reporting System (FAERS) to characterize the most prevalent, real-world side effects experienced by patients on these agents. Muscle spasms (23.45%), alopecia (16.06%), ageusia (12.02%), taste disorder (11.91%), and fatigue (11.67%) were the five most common side effects reported with medications used for BCC treatment. Logistic regression analysis showed males on vismodegib for BCC having greater odds of experiencing muscle spasms (aOR 1.33, P<0.001) and ageusia (aOR 1.34, P<0.001) versus females, who were more likely to exhibit alopecia (aOR 1.82, P<0.001) and nausea (aOR 1.96, P<0.001). With SCC treatment, the 5 most reported adverse events were fatigue (5.58%), rash (3.59%), asthenia (3.59%), pruritus (3.19%), and pyrexia (2.79%). Patients taking cemiplimab-rwlc for BCC compared to SCC were more likely to experience disease progression (aOR 10.98, P=0.02). With medication labels providing an excessively daunting list of side effects, we characterize practical side effects seen in patients receiving systemic treatments for non-melanoma skin cancers. J Drugs Dermatol. 2024;23(5):301-305. doi:10.36849/JDD.7968

The distribution of industry payments among pediatric dermatologists from 2015 to 2021

BACKGROUND/OBJECTIVESTo understand the landscape of industry payments to pediatric dermatologists to foster transparency and identify potential disparities in funding. METHODSUsing the Centers for Medicare and Medicaid Services (CMS) Open Payments database, a national cross-sectional study was performed examining payments to pediatric dermatologists from 2015 to 2021. RESULTSOf the 147 pediatric dermatologists who received industry funding, 35 were male and 112 were female. $9 million in payments was amassed, with 10$143,836 for males and $35,943 for females (p < .001). Eight female and seven male pediatric dermatologists received payments in the top 10th percentile, with different average payment in this subgroup (females$447,588 vs. males $698,746, p = .03). 11 states did not have a pediatric dermatologist receiving industry payments, while California (19) and Texas (12) had the most. CONCLUSIONSThere are approximately 400 board-certified pediatric dermatologists in the United States and fewer than 40% are receiving monetary compensation from private industry. A fraction of physicians accounted for a majority of total industry payments and industry payments to male pediatric dermatologists were higher despite nearly triple the number of female pediatric dermatologists. With the rise of valuable partnerships between healthcare and industry in modern medicine, the implications of geographic, gender, and financial disparity of industry payments in pediatric dermatology are worthy of further study

Use of Hydroxychloroquine in Hair Disorders

Hydroxychloroquine (HCQ) is an antimalarial that is utilized to treat a range of dermatologic and autoimmune disorders. With its ability to alter immunologic mechanisms, it has been used to slow or halt the progression of hair loss in conditions secondary to autoimmune dysfunction. Lichen planopilaris (LPP), frontal fibrosing alopecia (FFA), and alopecia areata (AA) are hair disorders with underlying autoimmune components and no standardized treatment guidelines. We summarized the available literature on the use of HCQ to treat LPP, FFA, and AA. For all three conditions, HCQ showed variable efficacy from halted hair loss to no improvement. While patients did show success with HCQ treatment, there were no clear treatment patterns. Regimens ranged from HCQ monotherapy to combination treatments with other agents like steroids. Overall, HCQ should certainly be considered by clinicians as a treatment option for patient suffering from these hair disorders. While there is no standardized treatment, incorporation of HCQ should take into consideration individual patient characteristics, clinical judgment, and risks of side effects

Eye injuries in the National Hockey League from 2010 to 2018: an analysis of injury rates, mechanisms, and the National Hockey League visor policy.

OBJECTIVE: We aim to assess the efficacy of widespread visor adoption by assessing eye injury rates during the 2010-2018 seasons. We also compare injury rates, missed games, and financial losses to previously reported data in order to track progress over time. Lastly, we characterize the mechanism and type of eye injuries sustained by National Hockey League (NHL) players to examine risk areas within NHL games. DESIGN: We performed a retrospective review of NHL player injuries using official NHL team reports, ProSportsTransactions, and TSN Sports. PARTICIPANTS: All NHL players who suffered an eye injury from 2010 to 2018 were included; 31 injuries matched this criterion. METHODS: Trends in injuries, missed games, and financial losses over time were analyzed using Pearson\u27s correlation coefficients. Wilcoxon-Mann-Whitney tests were performed to compare our data with eye injury data. Fisher\u27s exact test was performed to assess significance between mechanism and type of eye injury and outcome. RESULTS: There were 31 total eye injuries causing 233 missed games and a total of US$8 951 000 in financial losses across the 2010-2018 seasons. There was a strong decrease in the number of eye injuries (r = -0.83, p = 0.01) and a moderate decrease in number of missed games (r = -0.62, p = 0.09). Injuries due to direct puck strikes contributed to over US$6.5 million in financial losses and led to significantly more missed games compared with stick injuries (14.6 vs 4.3). CONCLUSION: We tangibly demonstrate the financial and physical effects of recent safety interventions and indicate areas for improved safety in the NHL