Increased Risk of Dementia in Patients with Atopic Dermatitis: A Nationwide Population-Based Cohort Study

Atopic dermatitis (AD) is a chronic inflammatory skin disorder with bimodal incidence peaks in early childhood and middle-aged and older adults. Few studies have focused on the risk of dementia in AD. The aims of this study were to analyse the incidence, and risk factors for dementia in patients with AD. This nationwide population-based retrospective cohort study enrolled 38,391 adults ≥ 40 years of age with AD and 2,643,602 controls without AD from the Korean National Health Insurance System (NHIS) database from 2009 to 2016. The cumulative incidence probability of all-cause dementia, Alzheimer\u27s disease, or vascular dementia at 8 years was 50, 39, and 7 per 1,000 person-years in patients with AD, respectively. The adjusted risks of all-cause dementia (hazard ratio (HR), 1.072; 95% confidence interval (95% CI) 1.026-1.120), and Alzheimer\u27s disease (HR 1.051; 95% CI 1.000-1.104) were increased in patients with AD. The effect of AD on the development of all-cause dementia and Alzheimer\u27s dementia varied according to age and diabetes mellitus (all p for interaction, \u3c 0.05). The risks of all-cause dementia and Alzheimer\u27s disease were increased in patients with AD. Management of modifiable risk factors is important for preventing dementia in patients with AD

Metformin: A Potential Treatment for Acne, Hidradenitis Suppurativa and Rosacea

Metformin is a widely used drug for treatment of diabetes mellitus, due to its safety and efficacy. In addition to its role as an antidiabetic drug, numerous beneficial effects of metformin have enabled its use in various diseases. Considering the anti-androgenic, anti-angiogenic, anti-fibrotic and antioxidant properties of metformin, it may have the potential to improve chronic inflammatory skin diseases. However, further evidence is needed to confirm the efficacy of metformin in dermatological conditions, This review focuses on exploring the therapeutic targets of metformin in acne vulgaris, hidradenitis suppurativa and rosacea, by studying their pathogeneses

Atopic Dermatitis and the Risk of Myocardial Infarction and All-Cause Mortality: A Nationwide Population-Based Cohort Study

PURPOSE: Atopic dermatitis (AD) is a chronic inflammatory skin disorder associated with various comorbidities. However, inconsistent results on the risk of myocardial infarction (MI) and mortality have been reported in patients with AD. This study was aimed to evaluate the risk of MI and all-cause mortality in patients with AD. METHODS: This nationwide population-based retrospective cohort study enrolled 56,205 adults ≥ 20 years of age with AD and 3,825,609 controls without AD from the Korean National Health Service (NHIS) database from 2009 to 2016. RESULTS: The risk of MI (adjusted hazard ratio [aHR], 1.111, 95% confidence interval [CI], 1.050-1.176) was increased in patients with AD. By AD severity, patients with moderate-to-severe AD had a higher risk of MI (aHR, 1.163, 95% CI, 1.080-1.251) than individuals without AD. The risk of all-cause mortality was only increased for patients with moderate-to-severe AD (aHR, 1.096, 95% CI, 1.040-1.155) compared to individuals without AD. In subgroup analysis, an increased risk of MI was observed in female, non-obese, non-smoking, non-diabetic, and non-dyslipidemic patients with moderate-to-severe AD compared to individuals without AD. An increased risk of all-cause mortality was observed in patients with moderate-to-severe AD compared to non-AD controls among individuals ≥60 years of age and non-smokers. CONCLUSIONS: The risk of MI and all-cause death was increased in patients with moderate-to-severe AD. Even without well-known risk factors for MI and mortality, patients with AD require the proper management and screening for comorbidities to prevent MI and decrease all-cause mortality

Itch and Janus Kinase Inhibitors

Itch is a common skin symptom, with complex aetiology and pathogenesis. It is mediated by 2 pathways, the histaminergic and non-histaminergic pathways. Chronic itch is understood to be processed by the latter and is difficult to treat with traditional pruritus therapies. The Janus kinase and signal transducer and activator of transcription pathway is a signalling mechanism that regulates gene expression through various cytokines. Janus kinase inhibitors, which have been tested and used for several autoimmune diseases, have also been shown to be effective for itch through clinical trials and case reports. Janus kinase inhibitors could be a good choice for pruritus in atopic dermatitis, psoriasis, and other diseases, such as prurigo nodularis and lichen planus, with rapid itch relief compared with conventional treatments. The most common adverse effects reported include nasopharyngitis, acne, and elevated blood creatine phosphokinase levels. Janus kinase inhibitors are currently prescribed with warnings about a potential increase in malignancies and cardiovascular diseases and usage in people of older ages. This review aims to provide knowledge about itch and the Janus kinase and signal transducer and activator of transcription pathway and to analyse the current evidence for itch relief by Janus kinase inhibitors

Clinical Efficacy of 5-Fluorouracil and Bleomycin in Dermatology

Bleomycin and 5-fluorouracil (5-FU) are widely used in various dermatological disorders. Both drugs are well-recognized as antineoplastic drugs and exert their effect by blocking the cell cycle. Topical and intralesional formulations are available and have been studied in both non-neoplastic and cancerous lesions. However, data comparing the effect of bleomycin and 5-FU in the dermatological disorders are limited. This review outlines the action mechanisms of both drugs and compares their clinical efficacies in a wide range of dermatologic diseases including hypertrophic scar, wart, skin cancer, vascular malformation, hemangioma, and vitiligo, and discusses the overall safety of the drugs. Intralesional bleomycin treatment is effective in hypertrophic scars and warts, but intralesional 5-FU may also be considered since it is cheaper and less painful. Moreover, intralesional 5-FU and bleomycin injection is a viable option for premalignant lesions (i.e., actinic keratosis) and inoperable skin cancers. Both bleomycin and 5-FU have been applied as treatment adjuncts for vitiligo, with 5-FU showing a slightly better outcome. Both agents have a good safety profile, and no serious side effects have been reported following their use in the field of dermatology

Allergic Sensitization Pattern in the Korean Dermatologic Patients

BACKGROUND: Avoiding causative allergens is important for controlling the clinical course of allergic diseases. Allergen sensitization is influenced by many factors including the environment and lifestyle. The socioeconomic development, climate, and lifestyle changes have increased the prevalence of allergic diseases worldwide. However, there is little information about changes in the trend of the common allergens over time. OBJECTIVE: This study was aimed at identifying the trends of the common allergens in Korea over a 10-year period based on the results of the multiple allergosorbent test chemiluminescent assay (MAST-CLA). METHODS: We retrospectively reviewed the medical records of 5,760 patients aged ≥18 years who visited the Dermatology Department at a tertiary hospital over a period of 10 years. The serum total immunoglobulin (Ig) E and specific IgE levels to 41 allergens were determined using MAST-CLA, along with the clinical diagnosis, duration of illness, white blood cell count and eosinophil percentage. RESULTS: CONCLUSION: The common allergens have changed over time. Based on the findings of this study, physicians and patients should consider changing their strategies for disease prevention and management

Nematic topological superconducting phase in Nb-doped Bi2Se3

A nematic topological superconductor has an order parameter symmetry, which spontaneously breaks the crystalline symmetry in its superconducting state. This state can be observed, for example, by thermodynamic or upper critical field experiments in which a magnetic field is rotated with respect to the crystalline axes. The corresponding physical quantity then directly reflects the symmetry of the order parameter. We present a study on the superconducting upper critical field of the Nb-doped topological insulator NbxBi2Se3 for various magnetic field orientations parallel and perpendicular to the basal plane of the Bi2Se3 layers. The data were obtained by two complementary experimental techniques, magnetoresistance and DC magnetization, on three different single crystalline samples of the same batch. Both methods and all samples show with perfect agreement that the in-plane upper critical fields clearly demonstrate a two-fold symmetry that breaks the three-fold crystal symmetry. The two-fold symmetry is also found in the absolute value of the magnetization of the initial zero-field-cooled branch of the hysteresis loop and in the value of the thermodynamic contribution above the irreversibility field, but also in the irreversible properties such as the value of the characteristic irreversibility field and in the width of the hysteresis loop. This provides strong experimental evidence that Nb-doped Bi2Se3 is a nematic topological superconductor similar to the Cu- and Sr-doped Bi2Se3

Observation of a thermoelectric Hall plateau in the extreme quantum limit

The thermoelectric Hall effect is the generation of a transverse heat current upon applying an electric field in the presence of a magnetic field. Here we demonstrate that the thermoelectric Hall conductivity $\alpha_{xy}$ in the three-dimensional Dirac semimetal ZrTe$_5$ acquires a robust plateau in the extreme quantum limit of magnetic field. The plateau value is independent of the field strength, disorder strength, carrier concentration, or carrier sign. We explain this plateau theoretically and show that it is a unique signature of three-dimensional Dirac or Weyl electrons in the extreme quantum limit. We further find that other thermoelectric coefficients, such as the thermopower and Nernst coefficient, are greatly enhanced over their zero-field values even at relatively low fields.Comment: 17+21 pages, 3+14 figures; published versio