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Zinc has been used in patients with acne vulgaris for its anti-inflammatory effects; however, it is unclear if zinc supplementation is also beneficial in other inflammatory skin conditions. The objective of this article was to determine the effect of zinc supplementation on inflammatory dermatologic conditions. We searched the Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, and Ovid with no time limit up to 29 May, 2019. Trials examining supplementation with zinc in the treatment of inflammatory dermatological conditions (acne vulgaris, atopic dermatitis, diaper dermatitis, hidradenitis suppurativa, psoriasis, and rosacea) in children and adults were selected. Of 229 articles, 22 met inclusion criteria. Supplementation with zinc was found to be beneficial in ten of 14 studies evaluating its effects on acne vulgaris, one of two studies on atopic dermatitis, one of one study on diaper dermatitis, and three of three studies evaluating its effects on hidradenitis suppurativa. However, the one article found on psoriasis and the one article found on rosacea showed no significant benefit of zinc treatment on disease outcome. Some preliminary evidence supports the use of zinc in the treatment of acne vulgaris and hidradenitis suppurativa; however, more research is needed with similar methodologies and larger sample sizes in these diseases. Further, zinc may be of some benefit in the treatment plan for atopic dermatitis and diaper dermatitis; however, additional studies should be conducted to further evaluate these potentially positive associations. To date, no evidence is available to suggest that zinc may be of benefit in rosacea and psoriasis; however, limited data are available evaluating the use of zinc in these conditions.

Background Both topical and oral probiotics are becoming widely used. There is increasing interest in the cosmetic potential in topical probiotics. Nitrosomonas eutropha is an ammonia-oxidizing bacteria. Aim The purpose of this study was to assess whether there is any improvement in facial wrinkles with the use of Nitrosomonas eutropha, a topical probiotic. Methods In this prospective study, high-resolution photographs were obtained in twenty-nine participants at baseline and after using topical Nitrosomonas eutropha for seven days. Results There was a significant difference in wrinkle depth and severity in the high concentration probiotic group. There was also a statistically significant improvement in pigmentation of the forehead and glabella in the higher concentration group. Conclusions Nitrosomonas eutropha may have aesthetic benefits in terms of reducing the appearance of wrinkles. Larger studies with longer treatment and follow-up periods are required.

Background Lichen sclerosus is a chronic inflammatory dermatological condition with a predilection for the anogenital area. Case We describe a case of iatrogenic Cushing syndrome from the administration of high-potency topical steroids for vulvar lichen sclerosus in a 6-year-old girl. Her symptoms resolved after the cessation of topical steroid treatment. Summary and Conclusion This case brings attention to iatrogenic Cushing syndrome as a potential complication when using high-potency topical corticosteroids in the anogenital region.

To compare the effects of turmeric tablets and turmeric-containing herbal combination tablets versus placebo on skin barrier function and sebum production by measuring facial sebum and transepidermal water loss (TEWL) in healthy subjects. This study was a prospective, double-blinded, rater-blinded, randomized pilot study. Thirty-three generally healthy participants were recruited from the UC Davis Department of Dermatology clinic and the surrounding community from 2016 to 2017, 30 participants were enrolled, and 28 participants completed the study. Thirty individuals were recruited and randomized to the placebo, turmeric, or herbal combination tablet groups. The participants were instructed to take the intervention tablets by mouth twice daily for 4 weeks. Facial sebum production and TEWL were assessed at baseline and 4 weeks. Twenty-eight participants completed the study and there were no adverse events. There were no significant changes in sebum excretion rate in any group after 4 weeks compared with baseline. In the herbal combination tablet group, there was a significant decrease in TEWL (P = .003). No significant changes in TEWL were detected in the turmeric or placebo groups. Turmeric-containing herbal combination tablets significantly decreased TEWL after 4 weeks of twice-daily supplementation. There were no adverse events in any of the three intervention arms. Overall, our findings spark future interest in determining how oral supplementation with herbal formulations may improve skin barrier function and skin appearance, and potentially offer alternative or complementary treatment options.

Background Bakuchiol is a phytochemical that has demonstrated cutaneous antiageing effects when applied topically. Early studies have suggested that bakuchiol is a functional analogue of topical retinoids, as both compounds have been shown to induce similar gene expression in the skin and lead to improvement of cutaneous photodamage. No in vivo studies have compared the two compounds for efficacy and side-effects. Objectives To compare the clinical efficacy and side-effect profiles of bakuchiol and retinol in improving common signs of cutaneous facial ageing. Methods This was a randomized, double-blind, 12-week study in which 44 patients were asked to apply either bakuchiol 0·5% cream twice daily or retinol 0·5% cream daily. A facial photograph and analytical system was used to obtain and analyse high-resolution photographs of patients at 0, 4, 8 and 12 weeks. Patients also completed tolerability assessment questions to review side-effects. During study visits, a board-certified dermatologist, blinded to study group assignments, graded pigmentation and redness. Results Bakuchiol and retinol both significantly decreased wrinkle surface area and hyperpigmentation, with no statistical difference between the compounds. The retinol users reported more facial skin scaling and stinging. Conclusions Our study demonstrates that bakuchiol is comparable with retinol in its ability to improve photoageing and is better tolerated than retinol. Bakuchiol is promising as a more tolerable alternative to retinol.

Probiotic, prebiotic, and synbiotic supplementation is becoming more prevalent nowadays. Clinical studies have demonstrated some of the medical benefits of probiotics, prebiotics, and synbiotics within dermatology but an evidence-based review of their effects in adults is needed. The aim of this study was to identify evidence for the use of supplementation with probiotics, prebiotics, or synbiotics for the prevention and treatment of dermatological diseases in adults. We conducted a search of the Ovid MEDLINE, Cochrane Central Register of Controlled trials and EMBASE electronic databases from 1 January 1946 to 11 January 2017. Trials examining supplementation in the treatment of dermatological diseases using oral or topical probiotics, synbiotics, and prebiotics in adults over the age of 18 years were selected. Of 315 articles, 12 met the inclusion criteria. Nutritional supplementation with probiotics and prebiotics was shown to improve atopic dermatitis (AD) symptomatology, quality of life, or clinical severity in six of nine studies. One study in psoriasis was shown to improve inflammatory markers, and one study suggested that probiotics could be used as adjunctive therapy in the treatment of acne. Preliminary studies are optimistic for the use of some strains of probiotics for symptomatic and clinical improvement in AD, and as adjunctive treatment with antibiotics for acne. Further research is necessary to better assess how probiotics and prebiotics may be used within dermatology.

We report a case of an increasing number of discrete patches of darkly pigmented terminal hair in a patient with nevoid basal cell carcinoma syndrome. This case adds to a small case series of three patients which have previously reported this observation. We report this case to highlight hairy patches as an important clinical feature associated with nevoid basal cell carcinoma syndrome.

Although transplantation is associated with an overall reduction in mortality compared with dialysis, it is not without risk. However, the risk of transmission of donor-derived infection or malignancy is low and needs to be balanced against the possibility of death associated with continued dialysis.

Background Thyroid carcinoma generally responds well to treatment and spinal metastasis is an uncommon feature. Many studies have looked at the management of spinal metastasis and proposed treatments, plans and algorithms. These range from well-established methods to potentially novel alternatives including bisphosphonates and vascular endothelial growth factor (VEGF) therapy, amongst others. The purposes of this systematic review of the literature are twofold. Firstly we sought to analyse the proposed management options in the literature. Then, secondly, we endeavoured to make recommendations that might improve the prognosis of patients with spinal metastasis from thyroid carcinomas. Methods We conducted an extensive electronic literature review regarding the management of spinal metastasis of thyroid cancer. Results We found that there is a tangible lack of studies specifically analysing the management of spinal metastasis in thyroid cancer. Our results show that there are palliative and curative options in the management of spinal metastasis, in the forms of radioiodine ablation, surgery, selective embolisation, bisphosphonates and more recently the VEGF receptor targets. Conclusions The management of spinal metastasis from thyroid cancer should be multi-disciplinary. There is an absence; it seems, of a definitive protocol for treatment. Research shows increased survival with 131I avidity and complete bone metastasis resection. Early detection and treatment therefore are crucial. Studies suggest in those patients below the age of 45 years that treatment should be aggressive, and aim for cure. In those patients in whom curative treatment is not an option, palliative treatments are available.