The June issue of the Journal of Drugs in Dermatology made several headlines with Healio recently. One article, “Rosacea More Common Than Expected Among Patients With Skin of Color,” was based on the study, “Improving Rosacea Outcomes in Skin of Color Patients: A Review on the Nuances in the Treatment and the Use of Cleansers and Moisturizers,” by a panel of experts including first authors Andrew F. Alexis, MD, MPH, and Heather Woolery-Lloyd, MD, FAAD. The panel reviewed literature on the subject and discussed potential statements related to rosacea and the over-the-counter treatment in patients with skin of color. The panel agreed that rosacea is more common in skin of color populations than previously reported and clinical features may be less conspicuous in individuals with higher skin phototypes. To avoid underdiagnosis, the panel recommended dermatologists should consider rosacea in the differential diagnosis of any patient presenting with a history of skin sensitivity, central facial erythema, papules, and pustules. The panel also pointed out that studies including Chinese rosacea patients showed that using a moisturizer and sunscreen negatively correlated with rosacea development.
The article, “Probiotics Improve Psoriasis Disease Activity, Quality of Life After 8 Weeks,” is based on, “Probiotics Supplementation Improves Quality of Life, Clinical Symptoms, and Inflammatory Status in Patients With Psoriasis,” by Jalal Moludi, PhD, and colleagues. In a double-blinded clinical trial, psoriasis patients were randomly assigned probiotic capsules that contained a multi-strain of at least 1.6× 109 CFU/g bacteria or a placebo for two months. Researchers found that probiotic supplementation for eight weeks positively impacted quality of life scores, disease severity, reduction of LDL, and total cholesterol levels, and attenuating inflammation cytokines/oxidative stress biomarkers. The authors stated that it seems probiotic supplementation would be a beneficial part of a psoriasis treatment approach, however, more studies are needed.
Healio also published, “Vitamin A May Be a Viable Substitute for Isotretinoin in Acne,” as a result of the study, “Oral Vitamin A for Acne Management: A Possible Substitute for Isotretinoin,” by Steven R. Feldman, MD, FAAD and researchers from the Wake Forest School of Medicine. The study sought to find a potential substitute for isotretinoin given recent changes to the iPLEDGE platform that impacted isotretinoin availability. Researchers conducted a literature review of vitamin A for acne and found eight out of the nine studies noted improvement in patients’ acne with vitamin A use. Ranges of doses used were 36,000 IU daily to 500,000 IU daily, with 100,000 IU daily being the most common. While oral vitamin A could potentially serve as an isotretinoin substitute, the authors noted that it would need to be monitored under the care of a medical provider given its teratogenicity, potential for toxicity and long half-life. Since vitamin A is available over-the-counter, the authors stated that careful patient selection and education would be essential.
