The Women in Dermatology e-newsletter is supported without restriction by Galderma Canada
Good morning and welcome to the Women in Dermatology e-newsletter from Chronicle Companies. We’re pleased to have you join us. This biweekly bulletin will update you on new findings regarding dermatologic issues that affect women and the female dermatologists who care for them. We welcome your feedback and opinions, so let us know if you have any comments, observations, or suggestions. You can email them to us at health@chronicle.org
Vulvar lichen sclerosus (LS) is a painful inflammatory condition involving the vulvar skin that affects many women worldwide. Although the connection between vulvar LS and vulvar cancer has been studied, the risk of extra-vulvar tumours has been under-investigated.
A recent study published in Maturitas (May. 2023) evaluated the risk of developing vulvar cancers in a cohort of women with vulvar LS. In the abstract, the authors state that while vulvar LS can occur at any age, it is more common during menopause. They also note that the cancerous potential of LS is still a matter of debate. Still, existing literature suggests that LS is associated with up to a 6.7% risk of developing vulvar squamous cell carcinoma.
For this study, the researchers reviewed the clinical data of 3,414 women living with vulvar LS treated in three Italian gynecologic and dermatologic clinics. Using the standardized incidence ratio, the authors estimated the risk of subsequent cancer by dividing the number of observed cases by the expected cases.
The researchers identified 229 cases of cancer among the study participants. They also found that the participants had an increased risk of vulvar cancer, vaginal cancer, and oropharyngeal cancer. However, the women showed a reduced risk of developing breast cancer and other types of gynecological cancers, such as cervical, endometrial, and ovarian cancer.
The authors note that the increased risk of oropharyngeal cancer suggests that there is a need for more research regarding oropharyngeal cavity symptoms and lesions in women with vulvar LS. They add that vulvar LS patients should undergo annual gynecological check-ups and cancer screenings.
Bottom line
The authors found a connection between vulvar LS and cancer, specifically vulvar, vaginal, and oropharyngeal cancer. On the other hand, they found no correlation between vulvar LS and cervical, endometrial, ovarian, or breast cancer. Women with vulvar LS should undergo yearly examinations with a careful evaluation of the vulva and vagina. Further research is needed to investigate the association between oropharyngeal cancer and vulvar LS.
Treatment of stretch marks using nano-fractional radiofrequency and magnetic nano-fractional radiofrequency
A study published in Dermatology and Therapy evaluated the efficacy and safety of a topical agent containing beta-glucan combined with nano-fractional radiofrequency for treating stretch marks. The researchers found that this novel treatment is safe and effective.
For this study, the authors selected 64 Chinese women between 20 and 45 years of age who had given birth at least six months before the study. The participants were randomly assigned to one of four groups: group A (control group), group B (topical agent only), group C (topical agent combined with nano-fractional radiofrequency), and Group D (vehicle combined with nano-fractional radiofrequency). The researchers then assessed the stretch marks' severity, depth, colour, density, and outline. Overall, the group that used the topical agent combined with nano-fractional radiofrequency showed the best results in terms of efficacy and safety.
Improvement of mild photoaged facial skin in middle-aged Chinese females with a combination of supramolecular retinol and acetyl hexapeptide-1
A study in Skin Health and Disease assessed the safety and efficacy of a cosmetic product containing supramolecular retinol and acetyl hexapeptide-1 in middle-aged Chinese women with mildly photoaged facial skin. Their main objective was to find the most appropriate concentration of retinol for Chinese patients. The researchers found that supramolecular retinol was better tolerated than non-encapsulated retinol, and the optimal retinol concentration for the general Chinese population was 0.1% retinol.
They also found that the cosmetic product improved skin texture, firmness, pore size, elasticity, and brightness. For this study, the authors recruited 32 healthy middle-aged Chinese women. The subjects underwent a patch test to compare the tolerance of supramolecular retinol to non-encapsulated retinol and find the optimal concentration.
Frontal fibrosing alopecia: A prospective observational study
A study published in the World Journal of Advanced Research and Reviews evaluated the demographics, clinical features, and trichoscopic characteristics of frontal fibrosing alopecia (FFA) in Moroccan women. The researchers found that FFA has a significant emotional impact on women and that they often use traditional cosmetic products on their hair. They also found that trichoscopy is an effective tool in diagnosing FFA and that red spots around hair follicles, bumps on the scalp, and decreased vellus hairs are clear signs of FFA.
The authors also found that itching was the most common symptom of FFA among the study’s participants, and all of them presented with frontotemporal hairline recession. Additionally, many patients experienced eyebrow loss and 45% experienced small facial bumps.
Skin cancer incidence in transgender individuals receiving gender-affirming hormone treatment
A study published in the International Journal of Dermatology evaluated the incidence of skin cancer in transgender patients receiving gender-affirming hormone treatment (GAHT). The researchers found that GAHT did not appear to affect skin cancer incidence in transgender patients. However, they noted that skin cancer incidence typically increases with age. As the number of elderly transgender individuals is still limited, it may be worthwhile to repeat the study in the future.
For this retrospective cohort study, the authors analyzed patients' clinical information who had visited the Center of Expertise on Gender Dysphoria of the VU University Medical Center Amsterdam between 1972 and 2018. Skin changes were observed in transgender patients undergoing GAHT, but skin cancer did not seem to have a connection with GAHT.
VIDEO: Lichen sclerosus - what causes a flare-up, and how is it treated?
Dr. Stephanie Jane Arnold, an Oxford, UK-based dermatologist, talks about lichen sclerosus (LS) and answers some of her patients’ most frequently asked questions, such as the causes, diagnosis, and treatment.
A case of recurrent cauliflower-like vulva edema in two consecutive pregnancies
A case study published in the Journal of the Egyptian Women’s Dermatologic Society described a 38-year-old pregnant woman who presented with a painless vulvar deformity. The patient reported experiencing similar symptoms during her previous pregnancy, which had resolved spontaneously after childbirth. Upon physical examination, swelling of the entire vulva was observed, which appeared firm, flesh-coloured, and cauliflower-like in shape.
The patient did not present with any vaginal discharge or lymph node enlargement, and her blood count was within normal ranges. One week after the examination, the patient delivered a healthy newborn, and the edema gradually regressed until it ultimately resolved approximately one week postpartum. There was no recurrence observed after three months of follow-up.
“We've been really lucky in atopic dermatitis with new therapies coming in the pipeline, and next year, it's no different. There's going to be probably four new approvals—we have two new topical agents that are likely to get approved, both nonsteroidal. One is topical tapinarof, which we know as VTAMA, which is a 1% cream that's already approved for psoriasis in adults. The studies are currently ongoing for atopic dermatitis in children and adults, and the results are very promising. We're still waiting for the final readout, but I'm also an investigator in that trial, so I've seen some great responses in patients and good tolerability.”
— Dr. Melinda Gooderham, a Peterborough, Ont.-based dermatologist in an interview with the American Journal of Managed Care.
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