Free skin cancer screenings in the Triad on Wednesday
With the weather getting warmer, we're spending more time outdoors in the sun. That's why May is Skin Cancer Awareness Month. Atrium Health Wake Forest Baptist is offering two free screenings on May 7.
5:30 to 7:30 p.m., on May 7 at Dermatology – Country Club , located at 4618 Country Club Rd., Winston-Salem
5:30 to 7:30 p.m., on May 7 at Dermatology – Palladium, located at 5826 Samet Dr., Suite 103, High Point
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Medscape
13 hours ago
- Medscape
Pediatric HS Linked to Gut Microbiome Changes
Emerging evidence suggests the gut microbiome may play a contributing role in the development of inflammatory skin diseases — including hidradenitis suppurativa (HS). The evidence incudes a small prospective study recently published in JAMA Dermatology , which found significant differences in gut microbial composition in pediatric patients with HS compared with matched healthy control participants, offering new insights into possible disease mechanisms that may extend beyond the skin. This follow-up to prior microbiome studies included pediatric participants for the first time. 'Overall, we found significant differences in gut microbiome composition of pediatric patients with HS compared with pediatric control participants and adult patients with HS, suggesting that gut microbiome dysregulation may extend to pediatric patients with HS and should be investigated further,' wrote the authors, from the Department of Dermatology at Boston University School of Medicine, Boston. Gut Dysbiosis and Reduced Microbial Diversity in HS The study included 16 participants — eight participants with HS and eight matched control participants — half of whom were younger than 18 years. Although beta diversity (variation between individuals) was similar across groups, a decrease in alpha diversity (diversity within an individual's gut microbiome) was observed in participants with HS, as measured using Pielou evenness. 'This may indicate gut dysbiosis,' the authors noted. In pediatric patients with HS, there were notable shifts in microbial composition. Bifidobacterium adolescentis was present in all pediatric patients with HS but absent in all adults with HS. 'As B adolescentis abundance typically increases with age, its absence in adults with HS may indicate dysregulation in gut microbiome maturation,' the authors explained. Other notable findings in the pediatric patients with HS included increases in Ruminococcus , Clostridium , and Bilophila . An increase in the beneficial bacterium Faecalibacterium prausnitzii was also noted compared with pediatric control participants. Clinical Implications and Future Directions Asked to comment on this emerging research, Tamia Harris-Tryon, MD, PhD, associate professor of dermatology and immunology at UT Southwestern Medical Center in Dallas, said the results highlight a nutritional component to HS that warrants greater attention. 'HS patients often have diets that are deficient in fiber and other nutrients,' she explained. 'The gut microbiome is directly linked to diet. A diet low in fiber will be deficient in microbes that ferment fiber. Fiber fermentation influences the immune system.' Harris-Tryon added that the new findings, particularly in children, emphasize the need for diet-based interventions. 'HS patients, especially pediatric patients, need to be meeting with a nutritionist,' she said. 'The emphasis should be on increasing fiber and nutrient-dense foods in the diet, while dropping high-glycemic index foods such as candy, soda, fruit juice, sweet teas, and cutting packaged and ultraprocessed foods.' While microbiome-targeted treatments such as probiotics are often discussed in chronic inflammatory skin conditions, Harris-Tryon advised caution. 'There is no data for microbiome-directed therapies in HS yet,' she said. 'But there is significant data on the benefits of a nutrient-dense, fiber-rich diet in pediatric patients and the influence of diet on the gut microbiome. Diets from all over the world with components similar to the Mediterranean diet have been shown to be the most beneficial for human health, including skin health. Fermented foods are an excellent time-tested source of beneficial microbes — including low sugar yogurt, kimchi, and kefir.' In a recent episode of the Medscape InDiscussion podcast series on HS and the microbiome, Harris-Tryon emphasized that 'understanding how the gut, skin, and immune system talk to each other is going to be key to developing future treatments for HS' and noted that this area of research 'is really just beginning to open up.' The study authors also encouraged future studies to examine potential interactions between the gut and the brain. ' B adolescentis produces gamma-aminobutyric acid [GABA], a mediator of the gut-brain axis that has been associated with anxiety and depression disorders through direct modulation of neural signals from the gut,' they wrote. 'As HS can affect mental health, particularly in vulnerable pediatric populations, it may be worthwhile to incorporate mental health screenings in future studies and assess correlations with GABA-producing microbes.' Noting that the study had limitations, such as a small sample size and the lack of matching by BMI or disease duration, the authors concluded that there were significant differences in the gut microbiome of pediatric patients with HS compared with pediatric control participants and adults with HS. The authors also referred to their previous study, which observed an increase in Bilophila and a decrease in Pielou evenness alpha diversity in both pediatric and adult patients with HS compared to control participants, pointing to potential gut dysbiosis. Collectively, the authors noted these findings suggest that 'gut microbiome dysregulation may extend to pediatric patients with HS and should be investigated further.' The study was independently supported by institutional grants from Boston University. The authors reported having no conflicts of interest. Harris-Tryon disclosed serving or having served as a director, officer, partner, employee, advisor, consultant, or trustee for Mirofend and Johnson & Johnson; serving as a speaker or a member of a speaker bureau for Tamia; and receiving research grants from LEO Pharmaceuticals.
Medscape
3 days ago
- Medscape
WHO Resolution Aims to Bridge Global Gap in Skin Care
A medical resident in the South Pacific will soon make history. After he graduates in 2026, he's slated to become the first dermatologist to serve the Solomon Islands, a nation of 800,000 people. His training is both a breakthrough and the product of an international effort to improve access to skin care. As they gathered in Fiji in late May to support the resident's regional training program, visiting dermatologists got thrilling news: In Geneva, the World Health Organization (WHO) unanimously passed a landmark resolution to support global skin health. Dermatology trainee Joseph Sangatu, slated to become the first dermatologist in the Solomon Islands, and American dermatologist Esther Freeman, MD, PhD, in the patient ward at the Pacific Dermatology Trainin Cengter in Suva, Fiji. 'We're here 2 days after the resolution passed, already implementing it,' said Claire Fuller, a London-based consultant dermatologist and chair of the International League of Dermatological Societies (ILDS) in an interview. 'The timing is fantastic.' Addressing a Global Care Crisis The resolution aims to tackle stark disparities in global dermatological care. Africa and the Pacific islands have only zero to three dermatologists per million people, Esther Freeman, MD, PhD, associate professor of dermatology at Harvard Medical School and director of Global Health Dermatology at Massachusetts General Hospital, Boston, said in an interview from Fiji. 'Many countries have zero dermatologists. There are two dermatologists in Papua New Guinea for 10 million people,' she said. In May, at the annual meeting of the Society for Investigative Dermatology in San Diego, Freeman told colleagues about other gaps in care: In parts of Africa, people with albinism can't find sunscreen, and moisturizer for atopic dermatitis costs double the typical monthly salary. In Australia, only six dermatologists serve rural areas. At least a billion patients with skin disease have no access to dermatologic care, she said, and many more can't afford it. The WHO's 'Skin Diseases as a Global Public Health Priority' resolution, proposed by the Ivory Coast and backed by Nigeria, Togo, Micronesia, and China, aims to implement a coordinated global strategy through initiatives like Fiji's regional training program. The resolution, which passed without the support of the absent US delegation, doesn't come with funding. But José Ruiz Postigo, MD, PhD, a Neglected Tropical Diseases medical officer with WHO, told Medscape Medical News from Fiji that the vote is still transformative. A resolution comes with a high level of mandate, he said. 'When you approach someone at a ministry of health and they ask why you are doing this, to what extent is this a priority, you show them the resolution.' What Will the Resolution Do? One goal of the resolution is to boost the training of dermatologists around the world through programs such as the Fiji's Pacific Dermatology Training Center . It's the first dermatology training program ever established in the Pacific islands, and three Fijians are graduating as the region's inaugural dermatologists. The center, supported by a 5-year ILDS agreement, is similar to programs that have been implemented in other parts of the world. A regional center in Tanzania, for example, serves 16 countries across Africa. Fuller emphasized that training isn't just a matter of producing dermatologists: '80% of dermatology burden is caused by about 10 diseases. We've got an achievable curriculum, and we can train community frontline workers on these 10 diseases.' Freeman agreed, noting that a focus on 10 diseases is 'much more manageable . ' 'We definitely need dermatologists to train the trainers, but they're not the only key players. We'll never have enough dermatologists,' she said. 'Using Papua New Guinea as an example, we need to acknowledge who's on the ground. It could be nurses, medical officers, pharmacists. There's a lot of different cadres of health workers, and this gives us an opportunity to think about the big picture of how we treat people on the front line.' Funding Isn't Allocated — But It's Encouraged Even though it doesn't allocate funding, the resolution specifically recommends that member states increase investment and financing for skin health. 'We in the dermatology community can go to WHO members and say, 'You signed up for this resolution, how can we help you deliver it?'' Fuller said. 'We're not waiting for governments to just act on this; we're going to help them do it.' In addition, the resolution 'opens the door' toward nongovernmental funding, she said. 'Everyone can go to a donor, a university, and say 'Look, in view of this resolution, we want to do this, but we need money.' It's something concrete to point to.' The resolution also mandates WHO to develop internal dermatological resources. 'There's no dermatology department,' Fuller added. 'An obvious solution is to develop a dermatological resource within WHO.' As for the ultimate goal, she said, 'we'd like to be able to say that access to dermatological care is a standard: Any person with a common skin disease would be able to go to their frontline healthcare provider and get it addressed, and there would be specialist services available to refer to when needed.'
Medscape
3 days ago
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AI Rates Eczema Severity From Your Smartphone Snaps
Japanese researchers have developed an artificial intelligence (AI) tool that objectively assesses the severity of atopic dermatitis (AD) using user-uploaded photographs. The study published in the journal Allergy marks a significant advancement in the application of AI to chronic inflammatory dermatoses. To develop the AI model, three algorithms were trained and integrated: Body part detection, skin lesion detection, and severity assessment. The latter is based on the Three-Item Severity (TIS) score, a localized severity assessment ranging from 0-9, evaluating erythema, edema or papulation, and excoriation. Training relied on an extensive database from Atopiyo, the largest online AD platform, which allows 28,000+ users to share 57,000+ photos and comments about their symptoms, providing a rich dataset. The AI model was trained using 880 images, followed by testing using 220 images. A total of 9656 images with itch scores, excluding unclear images, were included to establish and validate AI-TIS in patients aged 2-71 years (median age, 33 years). The trained AI model correctly detected 98% of body parts and 100% of the eczema areas. Next, the investigators compared the AI outputs with established clinical scoring systems, including Scoring Atopic Dermatitis (SCORAD), which includes both objective measures, such as intensity parameters (oozing/crusts, lichenification, and dryness) and eczema extent, as well as subjective measures, such as pruritus and sleep loss. AI-TIS showed a lower correlation with the severity of itch on a scale of 0-5 (Itch-NRS-5) across 8556 images in 602 patients. A subgroup of 15 participants underwent an in-person evaluation by a dermatologist and received scores based on the TIS, SCORAD, and objective SCORAD scales. Pearson correlation between these clinical scores and the AI results was robust, with R = 0.73 for test images. This study demonstrated that the AI-TIS can successfully identify body parts, eczema-affected areas, and TIS scores from smartphone-uploaded images in a nonclinical setting. The strong correlation between the AI-TIS and objective measures, including the TIS and objective SCORAD scores, supports its clinical utility in assessing objective outcomes and patient perception. Because AD severity assessment still involves considerable subjectivity, the AI tool stood out for its ability to quantify objective disease signs from home photographs. This approach improved precision in clinical assessments and could enhance daily patient monitoring. In contrast, the weaker correlation between AI-TIS and Itch-NRS-5 suggests that pruritus in AD does not always correspond to eczema severity. The use of digital assessment, therefore, may be an alternative to complement subjective reporting and bring more objectivity to the management of AD. The AI model developed in this study has the potential to help patients with AD, objectively assess their skin condition, and facilitate timely and appropriate treatment. This study lays the groundwork for future advancements in AI-driven dermatological assessments, thereby enhancing patient care and clinical research. Despite these advances, the model has limitations; it needs to be expanded to cover a wider age range and diverse skin types and to incorporate elements from other well-established clinical scales, such as the Eczema Area and Severity Index. Nonetheless, this represents a meaningful step forward in dermatology and AD care.
