The growing need for research in all areas of women’s health
Today’s report also covers research into photoprotection awareness among mothers of young children, the impact of pityriasis rosea on pregnancy, and more (1,510 words, 7 minutes, 30 seconds)
The Women in Dermatology e-newsletter is supported by an unrestricted grant from 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 bi-weekly 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.
Historically, women’s health research has focused significantly on reproductive health. While reproductive health is an important issue, this limited view excludes many of the primary causes of mortality and morbidity for women. Non-communicable and communicable diseases represent the highest proportion of disease burden among women and are now the leading cause of death and disability for women in most countries. A broader approach to women’s health research would benefit the treatment and understanding of these diseases.
A recent study published in the Journal of Women's Health (May 2022; 31(5): 611–619) analyzed articles on women's health to determine if the content covered a broad range of health issues impacting women or if the papers centred mostly around reproductive matters. For this study, the authors analyzed health articles published in six women's health journals (WHJ) and five general medical journals (GMJ) from 2010 to 2020 to categorize the main topics of the published articles. The findings were then compared with the leading causes of disease in women according to the Global Burden of Disease (GBD) study.
The researchers found 1,483 articles that were eligible for the analysis. In WHJ, 44% of topics were reproductive health, increasing to 49% in 2020 from 36% in 2010. The percentage was similar for GMJ. The second most frequently addressed topic was non-communicable disease, with cancer being the major disease area covered by medical journals.
Compared with the GBD study, major disease areas such as infectious disease, cardiovascular disease, and musculoskeletal disorders were significantly underrepresented in women's health publications. Additionally, most articles centred on a particular life stage focused on pregnancy and the female reproductive years, with few articles on menopause.
Bottom line
The authors conclude that women’s health publishing remains primarily focused on reproductive health, with few articles on many of the significant causes of disease and mortality in women. More than 40% of the research is centred around reproductive health, while the remaining 60% covers all of the other topics combined, including dermatology. According to the researchers, this is limiting and problematic. They urge journals, researchers and funders to embrace a broader view of women's health to effectively cover content that reflects the entire range of health issues that impact women. This way, scientific research will effectively serve women of all ages.
A gender perspective on biologic treatments in moderate-to-severe psoriasis
An article published in the journal Women’s Health Reports shared the results of a post-hoc gender analysis of the CANOVA study, which assessed the efficacy of biologics in patients with moderate-to-severe plaque psoriasis. The researchers found that while biologics are equally effective in treating psoriasis for both genders, women reported a more significant impact of the disease on quality of life (QoL) and lower treatment satisfaction.
For this post-hoc review, the authors analyzed the CANOVA study from a gender perspective. The CANOVA study was a real-world, multicenter, noninterventional, retro-prospective study conducted in 17 Italian hospital dermatology clinics that included 669 patients. According to the abstract, slightly more women had been treated with biologics, and the most frequently used biologics were secukinumab, ustekinumab, adalimumab, and ixekizumab in both sexes. Additionally, demographic and baseline characteristics and disease duration were homogeneous between the sexes. However, treatment satisfaction was significantly lower in women at enrolment and was still lower six months after treatment. The Dermatology Life Quality Index scores also revealed a significantly more significant effect of psoriasis on QoL in women at all stages.
Photoprotection among young children: Assessment of mothers’ awareness and health behaviours
A recent paper published in the journal Advances in Dermatology and Allergology assessed the health awareness and behaviours connected to sun protection in a group of mothers of children under six years of age. The researchers found that while there was a good level of photoprotection awareness among mothers of young children, further education is needed because most mothers applied sunscreen only during the summer months.
For this study, 107 women with children six years of age or younger answered an online survey containing 23 questions. Out of all the mothers, 105 declared using sunscreen. Among all the respondents, 36 women used sunscreen only during the summer, while 14 women said that they use it year-round, and 11 said they use it most of the year but not in winter. Mothers of younger children were more prone to use sunscreen all year than mothers of older children.
Restoration of appearance for women after aesthetic eyelash transplantation with a novel eyelash resection technique
A recent study published in the Journal of Cosmetic Dermatology presented a novel method to remove unsatisfactory eyelashes in patients with congenital sparse eyelashes who have undergone eyelash transplantation. The authors found that strip composite eyelash excision is a safe method that effectively removes unsatisfactory eyelashes. Effective removal of unsatisfactory eyelashes is indispensable for restoration of appearance.
For this study, the researchers used strip composite eyelash excision, a new technique involving resectioning eyelashes with a composite strip, on ten female patients between 2017 and 2020. The outcomes evaluated included patient satisfaction, hair regrowth, and long-term complications. All patients were satisfied with the results and did not experience unsatisfactory eyelash regrowth at the one-year follow-up. Additionally, no adverse effects or complications were observed.
An article published in the Journal of the German Dermatological Society (JDDG) reviewed existing literature and cases to determine the potential adverse effects that pityriasis rosea (PR) may have throughout pregnancy and the unborn child. The researchers found that, in most cases, PR does not have any influence over pregnancy or birth outcomes. However, if PR begins early in pregnancy, is long-lasting, spreads widely, and includes extracutaneous symptoms, the risk of an adverse outcome can increase.
For this retrospective study, data from 46 pregnant women diagnosed with PR treated in the Department of Dermatology of the Medical University of Graz between 2003 and 2018, was analyzed and compared with patient data from 53 previously published studies.
VIDEO: Women’s health in dermatology with Dr. Jenny Murase
Check out this episode of the Learn Skin Podcast. Dr. Jenny Murase discusses topics on pregnancy, patient comfort in the clinic, and integrative approaches specific to women’s health in dermatology.
Recalcitrant silicone granuloma treated with adalimumab
A case study published in SAGE Open Medical Case Reports reported the case of a 78-year-old woman with a past medical history of depression and breast cancer who presented with erythematous, tender plaques on her cheeks and forehead. The lesions appeared several weeks after a dental crown repair. Additionally, the patient had received silicone injections in her cheeks and glabella 18 years earlier. After several examinations, magnetic resonance imaging showed results consistent with the presence of plastic, resulting in inflammation in the injected areas.
The patient was successfully treated with a 10-day course of oral prednisone but developed a flare during the taper. A subsequent skin biopsy revealed a granulomatous inflammation consistent with a foreign body response, and a chest X-ray showed no abnormalities. She was then treated with intralesional and intramuscular triamcinolone acetonide before transitioning to oral doxycycline 100 mg twice daily for three months. Her doctors next prescribed oral cyclosporine, followed by mycophenolate mofetil (MMF), but she could not tolerate either treatment. Attempts to wean her off cyclosporine and MMF resulted in four flares that required the use of prednisone, cyclosporine, and MMF for a prolonged period. After four years, the patient was started on adalimumab 40 mg subcutaneously every two weeks. During her latest follow-up at 14 months after being prescribed adalimumab, she did not present any further recurrences of her symptoms. The patient was continued on adalimumab indefinitely.
“As a kid growing up, I had really severe eczema. I remember being five or six years old and having the kids on the playground point at my rashes with disgust and run away from me every time it flared up. I felt so isolated and embarrassed. My mom, seeing how much it affected me, took me to the dermatologist, and within a week I was accepted again on the playground. Without a scary surgery or even a shot, my whole world felt better within a few days. I remember thinking, “WOW. I really want to do that for other people.” I experienced first-hand the value of quality of life, and how impactful it truly is to feel comfortable and confident in your own skin. I now feel so grateful to provide that same comfort and confidence to my patients.”
— Dr. Neda Mehr, a Newport Beach, Calif.-based dermatologist in an interview with Authority Magazine.
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