Symptomatic relief observed in vulvar lichen sclerosus after platelet-rich plasma infiltration
Today’s report also covers research into the incidence of androgenetic alopecia in gender-diverse populations, the impact of hirsutism in female patients, and more (1,190 words, 5.5 minutes)
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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 an autoimmune dermatologic disease that can be extremely painful. Research suggests that topical corticosteroids are effective for treatment, but some patients deal with topical corticosteroid-resistant vulvar LS. According to a recent study published in the Archives of Dermatological Research (Jan. 19, 2023), platelet-rich plasma (PRP) infiltrations can have satisfactory effects in vulvar LS patients. The researchers assessed the evolution of symptoms in women with LS during and after PRP vulvar infiltrations.
For this pilot study, the researchers recruited 28 postmenopausal women diagnosed with LS who were intolerant or resistant to topical steroid treatments. The patients received three PRP infiltrations four to six weeks apart, 30 minutes after applying a lidocaine and prilocaine ointment to the areas affected by LS. The participants were not permitted any additional medications. Before the culmination of the study, five women withdrew, and 23 completed the study.
The researchers collected data at six different follow-up points—at baseline, one month after each infiltration, and six months after the final PRP treatment. A last follow-up was conducted one year after the final infiltration. The participants were also interviewed before and after each treatment to track symptom evolution.
The participants reported some symptom relief quickly after starting the PRP treatment. For example, patients experienced a significant decrease in severe vulvar itching after only two PRP infiltrations. Patients also experienced significant symptom relief regarding burning, pain, and soreness. At one-year follow-up, patients reported their symptoms had not returned.
Finally, the patients were also asked about their sex lives. However, 71% of the participants reported having no sexual intercourse, and the authors chose not to evaluate the improvement of pain or discomfort during sex.
Bottom line
The authors note that the study’s participants experienced a statistically significant improvement in vulvar LS symptoms. This improvement lasted for more than one year. They conclude that PRP infiltration may be an effective line of treatment for women with vulvar LS who do not respond to other therapies, such as topical corticosteroids.
Psychosocial and financial impact of hirsutism among female patients
An article published in the Journal of Cosmetic Medicine evaluated hirsutism’s psychosocial impact and financial burden on female patients. The authors found that hirsutism has a significant psychosocial impact and places a high financial burden on female patients.
The researchers interviewed 50 women with hirsutism using a questionnaire examining the condition’s psychosocial impact and financial burden. According to the findings, the financial burden impact of laser therapy was higher than other treatments.
Characteristics of skin physiological parameters and facial microbiome of “ideal skin” in Asian women
A study published in Clinical, Cosmetic and Investigational Dermatology examined the association between various skin physiological indicators and microbiomes to define the “ideal skin” of Asian women. The researchers found that, in Asian women, ideal skin had good water-oil balance and barrier function, high microbial diversity, and reasonable microbiome species distribution.
For this study, the authors collected pictures of 111 Chinese women aged between 18 and 25. They scored them by the severity of pores, acne, spots, and wrinkles. The images were then divided into three groups: ideal skin, normal skin and undesirable skin.
Incidence of androgenetic alopecia in transgender and gender-diverse populations
A study in the Journal of the American Academy of Dermatology examined the incidence of androgenetic alopecia (AGA) in transgender and gender diverse (TGD) patients undergoing gender-affirming hormone therapy (GAHT) in comparison to cisgender patients. The authors found that the rate of AGA among TGD patients taking masculinizing GAHT is 2.5 times higher than that of cisgender women. At the same time, TGD patients receiving feminizing GAHT didn’t have a significantly increased rate of AGA.
Sex differences in adverse drug reactions from adalimumab and etanercept in patients with inflammatory rheumatic diseases
A study published in Expert Opinion on Drug Safety evaluated the sex differences in the nature, frequency, and burden of patient-reported adverse drug reactions (ADRs) in patients with inflammatory rheumatic diseases. The authors found that women are significantly more likely to experience ADRs than men. They also determined the ADRs were different between men and women. For example, women experienced significantly more injection site reactions than men.
The study included 748 participants, and 59% of them were female. A total of 882 ADRs were reported, including 264 unique ADRs. Of the women, 55% reported at least one ADR. Of the men, only 38% reported at least one ADR. The burden of the ADRs was similar.
VIDEO: How eczema and other skin conditions can impact pregnancy success
The Society of Dermatology Physician Assistants and Bristol Myers Squibb assembled a panel of successful women in dermatology to exchange ideas and experiences on topics related to building careers, managing patients, work-life balance, and more.
A case of multiple squamous cell carcinoma in a patient using skin-bleaching products
A case study published in Case Reports in Dermatological Medicine described a 65-year-old Black woman who presented with multiple painful, bleeding and cauliflower-shaped tumours on both sides of her neck. The woman reported that the first lesion had appeared two years before the consultation. The patient received treatment with antibiotics, antiseptics, and traditional herbal ointments without symptom resolution. She also reported the use of skin-bleaching products.
On examination, the physicians found three tumours on the left side of the patient’s neck and one on the right side. Additionally, she presented with small angiomas around the tumours, discoloration of the neck and face, bruising patches, and stretch marks on her whole body. After a biopsy, the patient was diagnosed with invasive skin squamous cell carcinoma. She also had pulmonary metastases.
The patient underwent surgery to remove the tumour on the right side of her neck but died two months after the consultation. According to the authors, the patient’s multiple, large, and ulcerated lesions could have been attributed to the prolonged use of potent skin-bleaching products.
“Excellence and empathy guide my leadership approach as CEO at HMFP [Harvard Medical Faculty Physicians] and as a mentor. The key to mentoring is that the mentor should not try to make everyone be like them, but instead that the focus is on helping mentees articulate their own goals and vision, and then helping them get there. Excellence comes into play in leading by example, and empathy is essential in both mentoring and leading in that it encourages listening rather than talking, which allows you to learn about the mentee or team member to both gain important insight and ideas and to understand how you as the mentor or leader can help them reach their goals.”
— Dr. Alexa Kimball, a Boston-based dermatologist, in an interview with Becker’s Hospital Review.
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