Patients with vulvar lichen sclerosus may experience suicidal ideation, study finds
Today’s report also covers research into hair loss concerns in women who wear hijabs, association of maternal constipation and risk of atopic dermatitis in offspring, and more (1,464 words, 7 minutes)
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 dermatologists who treat 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
A recent study published in the International Journal of Women’s Dermatology (Oct. 2024; 10(3):p e164) explored the occurrence of suicidal ideation in individuals with vulvar lichen sclerosus (VLS). The research aimed to determine the extent to which VLS influences such ideation, particularly if the condition may directly instigate suicidal thoughts. The findings suggest that psychiatric support is crucial in the management of VLS, as it may be associated with suicidal ideation in some patients.
The study included 422 patients with VLS treated at a gynecologic dermatology clinic. The authors collected detailed demographic data, symptom profiles, and clinical findings, including baseline photographs scored according to the 2018 International Society for the Vulvovaginal Disease Delphi Consensus guidelines. Overall, nine patients reported experiencing suicidal ideation, and six were identified as active suicidal ideation due to VLS. The six patients who reported active suicidal ideation were non-Hispanic White women.
Common symptoms included vulvar itching, pain, pain during intercourse, and urinary incontinence. Physical examinations revealed hypopigmented white plaques, hardened skin, ulcerations, agglutination, and introital stenosis. Most of the patients who experienced suicidal ideation exhibited mild disease severity, suggesting suicidal ideation may not correlate with increased disease severity.
Psychiatric comorbidities were prevalent among patients who experienced suicidal ideation, with five having a history of depression and four of anxiety. The authors also found that one patient attributed her suicidal thoughts to chronic pain from VLS, another to VLS-related discomfort, and two patients worried about how the condition impacted their romantic relationships.
The authors highlight the importance of routine suicide risk screening during dermatologic assessments. They note that dermatologists and other healthcare professionals should be trained to identify at-risk patients and refer them to appropriate psychiatric resources. Additionally, support groups and tailored medical management may also be beneficial for patients experiencing isolation, suicidal ideation, and mental distress.
The Takeaway: Vulvar lichen sclerosus significantly affects patients’ quality of life and mental health. Some patients may experience suicidal ideation, so routine suicide risk screening and psychiatric support are essential. Suicidal ideation may not correlate with increased disease severity. The authors emphasize the need for comprehensive mental health support in dermatologic practice.
Bacterial vaginosis and biofilms: Therapeutic challenges and innovations
A review in the Indian Journal of Dermatology Venereology and Leprology examined the role of biofilms in bacterial vaginosis (BV) and the challenges they pose to treatment. The researchers found that BV biofilms can hinder the effectiveness of antibiotics and contribute to recurrent BV episodes.
For this review, the authors analyzed studies published between 2010 and 2023, focusing on clinical trials and research into biofilm-targeted therapies. The review highlighted the limitations of current treatments, such as antibiotics, which are often ineffective against biofilm-protected bacteria. Emerging treatments such as biofilm-disrupting agents and probiotics show promise in improving outcomes by targeting biofilms and restoring vaginal microbiota balance.
Medication use patterns in pregnant women with psoriasis
A study in Clinical and Experimental Dermatology investigated medication use patterns among pregnant women with psoriasis. The researchers found that psoriasis medications were mostly discontinued during pregnancy, with some reductions starting up to two years before conception and continuing postpartum.
For this study, the authors used Taiwan’s National Health Insurance database and Birth Certificate Application, including pregnant women diagnosed with psoriasis from 2005 to 2014. A total of 30,267 pregnant women with psoriasis were included in the final study, and medication use was tracked from three years before conception to three years after delivery. The results showed that 38.49% of participants received at least one prescription during the study. Topical corticosteroids were the most commonly prescribed treatments, with systemic drugs and biologics being less frequent. Medication usage reached its lowest levels in the third trimester but increased again after birth.
Association of maternal constipation and risk of atopic dermatitis in offspring
A study in the International Journal of Medical Sciences assessed the relationship between maternal constipation and the risk of atopic dermatitis (AD) in offspring. The researchers found that maternal constipation was associated with an elevated risk of AD in offspring.
For this study, the authors used the Longitudinal Health Insurance Database, a subset of Taiwan’s National Health Insurance Research Database, encompassing data from 2005 to 2016. The final sample included 138,553 mothers with constipation and the same number of matched controls. The results showed that maternal constipation was associated with a 1.26 higher risk of AD in offspring, and the risk of AD increases with the severity of constipation. The authors noted that maternal constipation might be a significant factor influencing the development of AD in children, emphasizing the need for attention to maternal gut health during pregnancy.
A research letter in the International Journal of Women’s Dermatology investigated alopecia concerns among Muslim women who wear the hijab. The researchers found that many hijabi women are concerned about alopecia, with contributing factors including tight hairstyles, the materials of the hijab, and the length of time the hijab is worn each day.
For this study, an online survey was distributed to 186 hijabi women through mosque group chats and social media. The results showed that 65% of respondents were concerned about alopecia, and only 37.4% reported noticing it. Over half of the women reported wearing an undercap most of the time. Some practices linked to alopecia included wearing the hijab for six to 10 hours daily and using hairstyles with tension. Common hijab materials include cotton, chiffon, and jersey. Additionally, most women said they received their information about haircare from social media, the internet, and friends.
VIDEO: Rethinking Dermatology: Understanding the Significance of Skin Diversity
U.K.-based dermatologists Drs. Sarah Walsh and Ophelia Dadzie discuss how Western dermatology developed and primarily focused on people with lightly pigmented skin.
A case of drug-induced hypersensitivity syndrome
A case report in the British Journal of Dermatology described a 34-year-old woman who presented with a red, maculopapular rash on her abdomen and chest after receiving three cycles of ipilimumab/nivolumab immunotherapy for anal canal melanoma. The rash rapidly progressed to cover 90% of her body surface area. She developed acute liver injury and thyrotoxicosis, and a skin biopsy revealed interface dermatitis and basal vacuolar degeneration. The patient was diagnosed with drug-induced hypersensitivity syndrome (DIHS) and was prescribed high-dose methylprednisolone and mycophenolate mofetil. Despite the treatment, her skin condition worsened, and her liver function continued to decline. After consultation with hepatology and a DIHS specialist, her treatment was switched to cyclosporin, significantly improving skin and liver function within days.
Nominations for the 2024 Women in Dermatology Honour Roll closing soon
The 2024 Women in Dermatology Honour Roll nomination deadline is July 26, 2024.
This Honour Roll acknowledges the leadership of a select group of Canadian physicians. It recognizes female dermatologists in Canada who have made significant contributions to the specialty, inspire others and serve as mentors and role models.
The 2024 honourees will be profiled in the upcoming Third Edition of Women in Dermatology, published by The Chronicle of Skin & Allergy.
Nominees should be female dermatologists who, throughout their careers, have made a lasting impact on others in the field of dermatology, served as a source of inspiration to residents, colleagues, and patients, and demonstrated extraordinary dedication, leadership, and commitment to the principles of dermatologic care.
To learn more or to obtain a nomination form, please go to the following link:
Registration is open for the 2024 Colloquium on the Black Patient
In recognition of persistent gaps in dermatologic training concerning skin of colour, the Colloquium on the Black Patient will discuss topics in dermatology specific to Black patients and recent progress in advancing the inclusion of diverse skin tones in research and medical education.
This live discussion will be held virtually on Saturday, Aug. 17, 2024, from 10 a.m. to 1:30 p.m. ET.
The Colloquium will cover the state of therapies, research, and education in dermatology for skin of colour, focusing on progress in Canada.
This non-accredited program will be available to attend at no charge, thanks to the support of our sponsors.
“Pigmentary disorders are very common in African Americans. Given the fact that we have more melanin, when the skin is injured, very often, some pigmentary disorders may be more common. I think you have to have a comfort zone in addressing this in darker skin types, and that’s one of my areas of expertise. Our specialty, our leadership now recognizes the importance of all dermatologists having expertise in treating skin of color. I've also worked with the American Academy of Dermatology in this area. Much work is being done, and there's much work to be done in the future.”
— Dr. Pearl Grimes, a Los Angeles-based dermatologist, in an interview with Pop Sugar.
You are receiving this newsletter because you subscribe to Women in Dermatology or another Chronicle journal, have attended a Skin Spectrum Summit live event or webinar, or have previously requested a subscription to one of our newsletters. If you no longer wish to subscribe to this newsletter, please email the subject line “Unsubscribe Women in Dermatology” to health@chronicle.org.
Women in Dermatology is published by Chronicle Companies: 1460 The Queensway, Suite 212, Etobicoke, Ont. M8Z 1S4
