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 are pleased to have you join us. Every two weeks, this publication will provide you with updates 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
While men are no strangers to ageism, the media disproportionately targets women with anti-ageing skincare advertisements, leading some to approach dermatologists with requests for treatments to help them look younger. What is the role of dermatologists in reframing and promoting healthy ageing?
A recent article published in the International Journal of Women’s Dermatology (Dec. 2021; 7(5):529-532), reviewed some of the core principles of healthy ageing and explored the common misconceptions, both from patients and physicians, that exist regarding ageing. According to the authors, one example of these misconceptions is the media’s portrayal of dermatology as a specialty centred around skincare and antiaging. The researchers also state that this portrayal has led many to believe that the sole role of a dermatologist is to protect patients from displaying outward signs of ageing.
Patients often have unreasonable expectations for what can be accomplished by skin rejuvenation procedures. The authors note that while dermatologists can ameliorate some cutaneous changes due to age, it is not possible to reverse the process of ageing itself. Therefore, they suggest that dermatologists should advocate for evidence-based practices in patient interactions and avoid making assumptions about where patients are in the ageing process or their treatment goals.
Bottom line
The authors conclude that ageing is not a disease to be cured but a process that can be optimized. Healthy ageing is about much more than appearance. They also state that dermatologists are in a unique position to provide temporary cosmetic fixes for signs of skin ageing and address other factors that affect the process of healthy ageing. Dermatologists can also guide and motivate patients to make changes that will help them increase their healthy lifespan and quality of life as they age.
Impact of psoriatic disease on women aged 18 to 45
A recent study published in the International Journal of Women’s Dermatology found that psoriasis poses a considerable burden on women of childbearing age. Many of the surveyed women stated that they had not achieved their desired career due to their condition. Career dissatisfaction and increased sick leave were linked to poor mental health.
For this study, women between the ages of 18 and 45 years from across Europe with moderate to severe psoriasis, psoriatic arthritis or a combination of both were recruited from market research panels and patient association groups of the International Federation of Psoriasis Associations, European Federation of Psoriasis Patient Associations, and Arthritis Ireland and asked to complete a survey. Survey questions covered overall wellbeing, employment, mental health and family planning. The authors concluded that it is necessary to tailor information about psoriasis to women to better support women living with this condition.
Adverse events of approved targeted therapies for cancer in females
An article published in the International Journal of Women’s Dermatology noted that new therapeutic classes, including monoclonal antibodies and oral enzymes inhibitors, have been approved to treat female patients with breast cancer and gynecologic cancers. The authors analyzed the adverse effects of some of these targeted therapies on patients.
The authors found that cooperation across multi-disciplines, including dermatology to manage cutaneous adverse effects, is key for optimal patient care. That is especially true for oral treatments that raise new issues, such as drug interaction, adverse effects, compliance, or patient education. They also stated that thorough descriptions are vital regarding new treatments to understand better adverse effects and the potential toxicity of the treatments.
Doctor Mahira El Sayed discusses the challenges in managing psoriasis in women.
Incidence and mortality rates of skin cancer: a population-based study of sex differences in Ontario
A study published in the Canadian Medical Association Journal aimed to determine differences by sex in the incidence and mortality rates of keratinocyte carcinoma in Ontario. The researchers found that the incidence rate of keratinocyte carcinoma was higher in females younger than 55 years but higher in males aged 55 years or older. They also concluded that between 2008 and 2017, the incidence rate rose faster in females than males aged 45 to 64 years. However, the mortality rate was higher in males than females.
This was a population-based retrospective study of adults residing in Ontario between Jan. 1, 1998, and Dec. 31, 2017. The authors used health administrative databases to identify keratinocyte carcinoma using a validated algorithm of health insurance claims, and deaths related to keratinocyte carcinoma from death certificates.
In a study published in the International Journal of Women’s Dermatology, researchers from El Bosque University in Bogota, Colombia, aimed to estimate the prevalence and trace the trend of adult female acne in Colombia over the last five years. They found a significant increasing trend in prevalence over that period. The investigators also found that the prevalence peaked in patients between 25 and 29 years. This study did not focus on risk factors or reasons behind the increase, so the authors state that further studies are necessary to understand this trend.
Cutaneous mosaicism: Special considerations for women
An article published in the International Journal of Women’s Dermatology detailed some of the aspects of cutaneous mosaicism that only affect women. They also address factors physicians should consider when treating female patients with this condition. The researchers noted that while mosaicism can affect any tissue, it is easily visualized on the skin.
According to the authors, certain mosaic conditions manifest exclusively in women because they arise from mutations on the X chromosome. They state that genetic diseases caused by mutations on the X chromosome can be lethal when male embryos inherit the mutation on their single X chromosome. As a result, women with these diseases have a significant risk of spontaneous abortion, especially when pregnant with a male baby. Additionally, mosaic diseases that affect endocrine tissue can trigger precocious puberty in young female patients and cause infertility later in life.
“When considering a career in aesthetics, seek out a reputable company with strong medical and business leadership that will help foster your success in the industry. Do not “settle” and work for a mediocre company just to get a foot in the door. Make sure to do plenty of research to ensure you join a group that is growing financially with a strong business team with seasoned medical leadership. Furthermore, personal success cannot be rushed in the field of aesthetic dermatology and the learning never stops; it takes years to master bedside presence and technique with patients seeking aesthetic procedures. So be patient and enjoy the journey.”
— Emily Kaye Perbellini, California-based board-certified family nurse practitioner (NP) specializing in aesthetic dermatology.
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