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Chronic inflammatory skin disorders, such as atopic dermatitis, have significant disease burden worldwide. Although efficacious, the adverse effect profile of topical corticosteroids limits long-term use. As an alternative, cannabinoids have been shown to have anti-inflammatory therapeutic effects.The aim of this study was to assess the effects of a topical cannabinoid product using dermatitis mouse model.Thirty-five mice were randomized into treatment groups. 12- O -tetradecanoylphorbol-13-acetate was used as an irritant on 1 ear with the contralateral ear serving as a control. Ear edema was calipered. The test product containing 0.9% cannabidiol and palmitoylethanolamide was compared with a potent topical corticosteroid.Treatment with topical cannabinoid formulation reduced ear edema by 51.27% at 24 hours' and 65.69% at 48 hours' postapplication. Alternatively, mometasone reduced ear edema by 89.82% at 24 hours and 98.25% at 48 hours. Natural reduction (control) in ear edema was 26.32% at 24 hours and 44.21% at 48 hours. Both test groups resulted in significantly decreased edema when compared with baseline ( P0.05), as well as compared with the negative control group ( P0.05).Significant reduction in ear edema, a marker for localized cutaneous inflammation, could be attributed to anti-inflammatory properties of cannabinoids. Although effects were less robust than topical corticosteroid use, cannabinoid formulations have therapeutic promise for dermatitis.

We explore the utility of social media platforms as educational tools in dermatology, providing a summary of how these sites are used by the public and dermatologists alike, and demonstrating ways these findings may be applied for educational purposes.Over half of the world's population utilizes social media platforms. More recently, these platforms have increasingly been used for educational purposes. In the field of dermatology, a large portion of the educational content is coming from users with no formal medical or dermatologic training.Each of the top five social media platforms in the world (Twitter, Instagram, TikTok, YouTube, and Facebook) has unique qualities which people may utilize to educate fellow users. As more of the population seeks online health information and education, it is important that dermatologists, while taking ethical considerations into account, become more comfortable facilitating educational content on social media.

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Dermatology and medicine are producing data at an increasing rate that are progressively difficult to sort and manage. Artificial intelligence (AI) and machine learning are examples of tools that may have the capability to produce significant and meaningful results from these data. Currently, AI and machine learning have a variety of applications in medicine including, but not limited to, diagnostics, patient management, preventive medicine, and genomic analysis. Although the role of AI in dermatology is greater than ever, its use is still extremely limited. As AI is continually developed and implemented, it is essential that stakeholders understand AI terminology, applications, limitations, and projected uses in dermatology. With the continued development of AI technology, however, its implementation may afford greater dermatologist efficiency, greater increased patient access to dermatologic care, and improved patient outcomes.

Androgenic alopecia (AGA) is the most common form of non-scarring alopecia, affecting millions of men and women in the United States (U.S.). This review highlights alternative and complementary treatment options for AGA. The treatment regimens for AGA have increased in pharmacotherapeutics, surgical, and complementary (CAM) categories. Each of the different treatment approaches can now be utilized by dermatologists to combat patient hair loss. The U.S. Food and Drug Administration (FDA) has approved only two agents to treat AGA: prescription-only, oral finasteride and over-the-counter (OTC), topical minoxidil. Increased availability of therapies claiming hair regrowth properties, coupled with limited pharmacotherapeutic options for AGA, lead patients to seek alternative treatments. Increased awareness of the current evidence supporting complementary and alternative therapies among dermatologists will facilitate appropriate and timely education of AGA patients.

Atopic dermatitis (AD) is a chronic skin disorder characterized by pruritus, erythema and excoriation. While AD has a multifactorial etiology, neuro-signaling pathways are now recognized to play an essential role in the pathogenesis of AD, particularly pruritus. Neuromodulators, such as topical naltrexone, are being utilized in AD treatment. Another class of neuromodulator, Palmitoylethanolamide (PEA), has demonstrated effectiveness in the treatment of itch, excoriation and erythema in AD patients. Phytocannabinoids including cannabidiol (CBD) are becoming increasingly accessible to the public and continue to be advertised for their efficacy to treat inflammatory skin disorders such as eczema. However, no human studies have been conducted to support the claim. Therefore, this study aimed to explore the effects of CBD in individuals with self-reported eczema. Twenty individuals consented to participate and 16 completed a 28-item online questionnaire assessing subjectsrsquo; disease severity using Patient Oriented Eczema Measure (POEM) and psychosocial burden of their disease through the emotional domain of Quality of Life Hand Eczema Questionnaire (QOLHEQ). Findings demonstrated a significant reduction in the mean score of POEM from baseline (meanplusmn;SE: 16plusmn;1.35) and at a two weeks interval (8.25plusmn;1.80), Plt;0.0007. Similar reduction was seen in emotional domain of QOLHEQ from a mean score of 20.9plusmn;2.06 to 8.375plusmn;1.609 at 2 week-interval, Plt;0.004. 67% of subjects reported a decrease in itch and 50% perceived an improvement in their eczema by more than 60%. This observational study shed light on the potential clinical utility of topical CBD in the treatment of atopic dermatitis. J Drugs Dermatol. 2020;19(12): doi:10.36849/JDD.2020.5464.

Skin cancer is one of the leading causes of skin disease burden worldwide. This systematic review provides an overview of the United States (US) and global melanoma and non-melanoma skin cancer (NMSC) epidemiologic studies published in the last 5 years. The incidence of melanoma and NMSC continues to rise both in the US and worldwide. The highest global age-standardized incidence rates (ASIRs) for melanoma were Australasia, North America, Eastern Europe, Western Europe, and Central Europe. Various results were reported for the mortality of skin cancer; however, overall, the mortality was higher in men than women and remained relatively stable. Notably, NMSC caused more deaths globally than melanoma, albeit at a slower rate. Epidemiologic studies on skin cancer provide the vital information needed to implement effective preventive efforts. Increased global skin cancer burden necessitates continued surveillance and production of accurate, high-quality NMSC and melanoma epidemiologic studies.

Dermatologists serve a vast array of patients with unique backgrounds. The National Institutes of Health (NIH) designated members of sexual and gender minorities as underrepresented in scholarly literature. Our study examines the past 10 years of studies published in highly-cited dermatologic journals, surveying each study for common data collection of sexual orientation and gender identity (SOGI) in dermatological studies. We found representation of sexual and gender minorities to be increasing in dermatological studies but recommend that SOGI data be collected regularly just as any other common variable in dermatological patient studies.

Social media provides a readily accessible means to promote user-generated content, broaden interpersonal connections, and encourage social collaboration. In this paper, we will review the use of popular social media platforms within dermatology along with the potential benefits and harms of these platforms when used by dermatology providers and their patients. Social media has also found a place in medicine and presents new opportunities and challenges for health care professionals. In dermatology specifically, social media has become a platform for patient education, public outreach, and professional development and networking. Although there are many risks associated with social media use in dermatology, there is also opportunity to promote public health, patient education, and professional interactions.

Surfactants, many of which are used as detergents, can be found in many common household items, such as shampoos, conditioners, soaps, and cosmetics. One should recognize the multitude of surfactants that are used in today's products to identify any potential allergic contact dermatitis (ACD) or irritant contact dermatitis (ICD). Given their abundance in everyday products, it is understandable that many cases of occupational contact dermatitis that arise can be attributed to surfactants. The products most connected with ACD are cocamidopropyl betaine, oleamidopropyl dimethylamine, decyl glucoside, 3-dimethylaminopropylamine, amidoamine, and cocamide diethanolamine. Similarly, the most common surfactant-related causes of ICD are sodium lauryl sulfate and benzalkonium chloride. It is important for dermatologists to identify the causes and differentiate between the two, to adjust treatments and products accordingly. Here, the most frequently used surfactants, as well as their correlation between ACD and ICD, will be reviewed.

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BACKGROUND There is limited measurement and reporting of quality of life (QoL) outcomes for patients with contact dermatitis (CD). OBJECTIVE The purpose of this study is to develop a standardized Contact Dermatitis Quality of Life index (CDQL) for adult patients. METHODS A list of 81 topics was compiled from a review of QoL measures used previously in CD research. A total of 2 rounds of web-based Delphi surveys were sent to physicians who registered to attend the 2018 American Contact Dermatitis Society meeting, asking that they rank the relevance of topics for measuring QoL in CD using a 4-point scale. Items met consensus for inclusion if at least 78% of respondents ranked them as relevant or very relevant, and their median score was ≥3.25. RESULTS Of the 210 physicians contacted, 34 physicians completed the initial survey and 17 completed the follow-up survey. A total of 22 topics met consensus for inclusion in the CDQL, addressing symptoms, emotions, functions of daily living, social and physical functions, work/school functions, and treatment. CONCLUSIONS This study was limited by the following factors: few open-ended questions in the initial survey, a lack of direct patient feedback, and long survey length, which likely contributed to lower survey participation. The CDQL is a comprehensive, CD-specific QoL measure developed on the basis of expert consensus via a modified Delphi process to be used by physicians and other health care professionals who care for adult patients with contact dermatitis.

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's 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.

Social media has become an important tool to facilitate global communication. Platforms such as Facebook, LinkedIn, Instagram, Snapchat, and Twitter have fundamentally altered the landscape by which individuals and organizations interact with one another. Social media affords individuals access to online medical information, facilitates communication amongst patients and clinicians, and allows photos and videos to be shared among patients and healthcare professionals. However, ethical dilemmas, ranging from maintaining patient privacy to disclosing conflicts of interest, arise from the expanded influence afforded to providers via social media and the lack of guidelines for its use in the professional context. This chapter explores ethical uses of social media for engaging patients, educating the public, and marketing dermatology practices.

Owing to the COVID-19 outbreak, the use of telemedicine applications has increased throughout the United States. Using an algorithm to analyze mobile application rankings, we were able to examine how applications with telemedicine services have increased in prevalence and rank pre- and post- COVID-19. Telemedicine apps saw an increase of 210.92 ranked positions on average. Within US telehealth, skin conditions have become the fifth most common diagnosis. Widespread use of teledermatology has been well-accepted. Dermatologists and patients report high satisfaction using teledermatology during COVID-19 and intend to continue using these services in the future. COVID-19 has assisted in reducing physician concerns previously preventing some dermatologists from utilizing teledermatology in their services. Additionally, the geographical and socioeconomic barriers preventing some patients from receiving dermatologic care have been minimized through the use of teledermatology. Addressing these obstacles for dermatologic care improves healthcare equity.

Importance: Social media is making information about skin of color more readily available to those unfamiliar with ethnic skin and hair. Objectives: To answer: 1) what skin of color-related dermatology content is being posted on Instagram? And 2) who is producing this content? Design: Cross-sectional epidemiologic study analyzing the content of posts associated with 31 Instagram skin of color dermatology-related topics (hashtags). Setting: Population-based Participants: The Instagram accounts linked with the top 9 posts as generated by the Instagram algorithm associated with each search term. Exposures: Instagram account holders. Main Outcomes and Measures: [1] The number of posts associated with each skin of color dermatology hashtag search term. [2] Classification of posts as either educational or promotional. [3] Classification of posts as a photo or video. [4] Classification of Instagram accounts that produced the posts (American board-certified dermatologists, dermatology residents, foreign dermatologists, patients, medical interest groups, or other). [5] Quantification of the number of post likes and comments. [6] Comparison of number of educational and promotional posts between board-certified dermatologists and other Instagram users. Results: The 31 sampled hashtags were associated with a total of 9,087,589 posts as of January 16, 2020. 219 of the 288 top posts generated from these queries met inclusion criteria. Board-certified dermatologists (26 posts) only generated 12% of top posts, whereas individuals not certified in dermatology produced 88% of top content. Of this group, social media influencers were the largest subcategory (37 posts). A majority of the top posts were promotional (135 posts, 61.6%) and formatted as photos (181 posts, 82.6%). While there was a significant difference in the number of likes for content posted by board-certified dermatologists vs non-dermatologists (P=0.027), these differences became non-significant after stratifying by the intention of the post (promotional P=0.13, educational P=0.17). Conclusions and Relevance: Board-certified dermatologists are underrepresented among people generating top skin of color dermatology-related content on Instagram. Board-certified dermatologists should establish a more prominent presence on social media platforms so that patients have greater access to accurate, evidenced-based educational resources regarding dermatologic conditions, treatment options, and treatment risks from reliable sources. J Drugs Dermatol. 2020;19(7): doi:10.36849/JDD.2020.5142.

Parkinson’s disease (PD) is a neurodegenerative disorder associated with multiple comorbidities, including seborrheic dermatitis (SD), which develops in more than half of PD patients. SD in patients with PD can be severe and frequently intractable by traditional topical therapy. Cannabinoids possess anti-inflammatory and neuromodulatory properties working within the intrinsic endocannabinoid system, the activation of which may alleviate the motor symptoms of PD. The effect of cannabinoids on SD is unknown. Here we explore the pathophysiological mechanisms and possible therapeutic role of oral cannabinoids in PD patients with SD, and review speculative mechanisms underlying the association of PD and SD. Current data supporting the use of cannabinoids in both PD and SD, as well as oral cannabinoid safety and tolerability, are presented. Cannabinoids may provide the possibility of simultaneous treatment of both SD and PD. Specific SD studies and additional safety data on oral cannabinoids are needed.