References

Liljedahl ER, Johanson G, Korres de Paula H. Filaggrin polymorphisms and the uptake of chemicals through the skin—a human experimental study. Environmental Health Perspectives. 2021; 129:(1) https://doi.org/10.1289/EHP7310

Germain N, Augustin M, François C. Stigma in visible skin diseases—a literature review and development of a conceptual model. J Eur Acad Dermatol Venereol. 2021; https://doi.org/10.1111/jdv.17110

Albeshri M, Alharithy R, Altalhab S, Alluhayyan OB, Farhat AM. The influence of modern social media on dermatologist selection by patients. Cureus. 2020; 12:(12) https://doi.org/10.7759/2Fcureus.11822

Hadeler EK, Maderal AD. Drug interactions of natural supplements in dermatology: a review. Int J Dermatol. 2020; https://doi.org/10.1111/ijd.15389

RESEARCH ROUNDUP

02 February 2021
Volume 10 · Issue 1

Abstract

In this regular feature, aesthetic nurse Claudia McGloin presents a brief synopsis of a range of recently published articles on medical aesthetics. Research roundup aims to provide an overview, rather than a detailed summary and critique, of the papers selected. Should you wish to look at any of the papers in more detail, a full reference is provided at the end of each study summary

One study explored the link between social media and dermatologist selection

Filaggrin polymorphisms and the uptake of chemicals through the skin—a human experimental study

An important protein for skin barrier structure and function is filaggrin. It is thought that mutations in the filaggrin gene FLG and loss of function may increase the dermal absorption of chemicals.

The main objective of this study was to confirm if dermal absorption of chemicals differs depending on FLG genotype. To conduct the study, the authors enlisted the help of 432 Swedish volunteers. The authors then carried out a quantitative polymerase chain reaction-based genetic screening for loss-of-function mutations and discovered 28 FLG null carriers.

Within this dermal exposure experiment, the authors exposed 23 FLG null and 31 wild-type carriers to three organic compounds common in the environment: the polycyclic aromatic hydrocarbon pyrene, the pesticide pyrimethanil and the ultraviolet-light absorber oxybenzone. To measure the concentrations of these chemicals in the volunteers' urine, the authors used liquid chromatography mass spectrometry over a 48-hour period after exposure.

The results of this study showed that there was a dose-dependent effect on the chemical absorption, with increasing lag times by increasing copy number variants for both pyrimethanil and pyrene, and decreasing area under the urinary excretion rate curve with increasing copy number variants for pyrimethanil.

The authors concluded that FLG genotype affects the dermal absorption of some common chemicals. Overall, FLG null carriers were the most susceptible, with the shortest lag time, highest rate constants for skin absorption and higher fractions of the applied dose excreted. Furthermore, the results indicated that low FLG copy number variants resulted in increased dermal absorption of chemicals.

Stigma in visible skin diseases—a literature review and development of a conceptual model

Patients who have visible skin diseases can have the burden of not only experiencing physical symptoms, but also psychosocial ones, such as depression, anxiety, impaired quality of life and low self-esteem. Stigmatisation can also play a major role in the lives of people with skin diseases.

This study's aim was to review the available evidence for the components, drivers and impacts of stigma, and to compile the data and produce conceptual models.

The authors carried out a specific literature search to identify any available studies on stigma in relation to visible skin diseases.

Following discussions with medical experts, patient advocacy groups, clinicians and researchers, the authors developed conceptual models of stigma in visible skin diseases.

The authors found a total of 580 references, from which, 56 were examined and summarised. They found two conceptual models of stigma, one with external stigma and self-stigma dimensions and the other for self-stigma in mental health. These models were altered to include a complete description of stigma in visible skin diseases.

The authors concluded that this is the first conceptual model of stigma in visible skin diseases, and suggested that this model will assist in standardising the evaluation of stigma and enhance empirical evaluation of anti-stigma interventions in visible skin diseases. They also suggested that further research should be conducted to develop a more complete model in stigma, due to significant gaps in existing evidence, particularly around the stigma in others and also to cover a broader range of visible skin diseases, as the impact and stigma may differ.

The influence of modern social media on dermatologist selection by patients

Social media has been identified as the main way that people seek immediate information, including medical advice and treatment, and also research healthcare providers and communicate with them about any issues.

This study focuses on how this affects people′s thinking when deciding which doctor or nurse to see for skin-related issues.

The authors carried out a cross-sectional study among 365 patients at the Derma Clinic in Riyadh, Saudi Arabia. They collected the data by using a validated self-administered questionnaire.

The results showed that, of the 365 participants, 44.9% visited the clinic for medical purposes, and 45.8% visited the clinic for cosmetic purposes. Some 66% of the participants visited a dermatologist whom they were familiar with, while only 21% of those participants knew their dermatologist from social media platforms such as Twitter, Instagram, Snapchat and Facebook. The study also showed that 44.54% of the participants wanted to know more about their dermatologists from Twitter, while the rest used other social media platforms to gain more information. Finally, the study found that a significant proportion of Instagram users visited the dermatology clinic for cosmetic reasons.

In conclusion to this study, the authors stated that recommendations for a doctor or nurse for medical or cosmetic purposes were primarily from a friend, closely followed by family members and social media. Among the social media users, patients who visit dermatology clinics for medical reasons preferred using Twitter. On the other hand, those who visited for cosmetic reasons preferred Instagram to follow their doctors, which emphasises the importance of aesthetic dermatology as a visual field.

Drug interactions of natural supplements in dermatology: a review

In dermatology, there is limited information available on the inter-drug interactions of natural supplements. Although many of these natural supplements are available over the counter, drug-drug interactions can still arise.

The aim of this study was to review the clinical use and drug interactions of six natural supplements that are commonly recommended for dermatological use: nicotinic acid (nicotinamide), polypodium leucotomos (heliocare), turmeric, horse chestnut seed extract, zinc and N-acetylcysteine.

The drug-drug interactions of each supplement were reviewed using the PubMed database and IBM Micromedex, and the authors were able to identify drug reactions.

The interactions found included an increased risk of myopathy and rhabdomyolysis when nicotinic acid is taken by patients using statins, and there was a heightened risk of bleeding associated with horse chestnut seed, especially if used in combination with warfarin. Additionally, the authors found that N-acetylcysteine may affect the concentrations of medications that are used in psychiatric settings, and polypodium leucotomos and turmeric may interfere with the cytochrome P450 metabolic pathway, thus affecting drugs that are metabolised by this pathway.

In conclusion, the authors recommended that, before recommending a treatment, dermatologists should be aware of these interactions. They also suggested that research should continue to assess the drug interactions of these natural supplements.