2008 press releases

Scientists have discovered a way to potentially restore colour to white hair, new research in the British Journal of Dermatology will reveal this month.

A number of skin disorders cause the hair to fall out, and when it re-grows, it is often white. For many patients, this is almost as distressing as the initial hair loss.

Melanin, the pigment in skin and hair, is stimulated by a group of peptide hormones collectively known as ‘melanocyte stimulating hormone’ or MSH.

Researchers in Germany and the UK therefore examined whether a peptide called K(D)PT, which can be synthetically produced in the laboratory and is related to MSH, might have the same pigmentation stimulating effects as the naturally occurring MSH, and whether this could be used to restore colour to white hair after illness.

The team treated normal, isolated hair follicles from six women aged between 46 and 65 with different concentrations of K(D)PT. The research was carried out in the laboratory as it is not yet ready for direct use on patients.

In some of the test groups, the follicles were first treated with ‘Interferon type II’, commonly known as IFN-g, a proinflammatory stimulus that is linked to certain autoimmune disorders. The purpose of this was to mimic the sort of inflammation that is present in disorders that cause the hair to fall out, including ‘alopecia areata’, a skin disease that causes hair loss, and ‘telogen effluvium’, a disorder that causes thinning of the hair, often after an accident, illness or extreme stress on the body.
Hair frequently loses colour after this sort of inflammation, so that when the hair returns, it is often white, regardless of its colour prior to hair loss.

The test groups were either pre-treated with IFN-g then given K(D)PT, pre-treated with K(D)PT then IFN-g, treated with K(D)PT alone, treated with IFN-g alone, or in the case of the control group, treated with distilled water.
The study found that K(D)PT increased the amount of melanin (pigment) in the hair follicle significantly when administered after pre-treatment with IFN-g.

This pre-treatment with a proinflammatory stimulus appeared to be necessary for the pigment effect to occur, as it was absent in the group where K(D)PT was administered first and IFN-g second. Likewise, IFN-g alone inhibited rather than stimulated pigment production, and K(D)PT used alone did not significantly alter the hair pigmentation. It is thought that as yet unknown receptors for K(D)PT are elevated or present only in tissue inflamed by substantial IFN-g activity.

As the purpose of pre-treating with IFN-g was to mimic the sort of inflammatory changes that may contribute to hair turning white, to then see whether K(D)PT could restore the hair colour, these findings are of particular use to the treatment of hair that has turned white following illness.

The study’s senior author Dr Ralf Paus, of the University of Lübeck, Germany, and the School of Translational Medicine at the University of Manchester, said: “Since this tripeptide displays interesting hair pigmentation-stimulatory activities under proinflammatory conditions, clinically, K(D)PT deserves to be explored as an innovative new anti-greying agent.

“Specifically, topical application of K(D)PT may become exploitable for the treatment of postinflammatory hair whitening that is often seen during the recovery phase of alopecia areata.”

Nina Goad of the British Association of Dermatologists said: “It’s important to note that this is laboratory research and not yet ready for use on patients. However, while the research is still at a very early stage, these findings could potentially pave the way for new therapies that restore colour to white hair. At the moment, this research only applies to people whose hair has turned white following illness, but this is an important step for such patients.”

At this early preclinical stage, it is not possible to say for definite if it would restore hair to its full, original colour, although this is thought to be a reasonable possibility. However, there may indeed be patients whose hair follicle pigmentary system has been damaged beyond repair, who might not profit at all from such a treatment. Most likely, treatment would have to be re-administered, as long as the pro-inflammatory stimulus that caused hair whitening persists.

-Ends-

Notes to editors:

It is not possible to say whether the results could also apply to chemotherapy patients, since no chemotherapeutic agent was tested in this currently reported preclinical assays.

Test groups:
1.Pre-treated with IFN-g then given K(D)PT
2.Pre-treated with K(D)PT then IFN-g
3.KDPT alone
4.IFN-g alone
5.Control group – distilled water

1.If using this information, please ensure you mention that the study is being released in the British Journal of Dermatology, the official publication of the British Association of Dermatologists.

2.Articles in the BJD can be viewed online: http://www3.interscience.wiley.com/journal/117983344/home Study details: British Journal of Dermatology, DOI 10.1111/j.1365-2133.2008.08872.x, The a-melanocyte stimulating hormone-related tripeptide K(D)PT stimulates human hair follicle pigmentation in situ under proinflammatory conditions; K.C. Meyer*; T. Brzoska ²,³; C. Abels² and R. Paus*§
*Department of Dermatology, University of Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany
²Wolff Arzneimittel, Bielefeld, Germany
³Department of Dermatology, University of Münster, Münster, Germany
§School of Translational Medicine, University of Manchester, Manchester, U.K.

The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.

Wiley-Blackwell was formed in February 2007 as a result of the acquisition of Blackwell Publishing Ltd. by John Wiley & Sons, Inc., and its merger with Wiley’s Scientific, Technical, and Medical business. Together, the companies have created a global publishing business with deep strength in every major academic and professional field. Wiley-Blackwell publishes approximately 1,400 scholarly peer-reviewed journals and an extensive collection of books with global appeal. For more information on Wiley-Blackwell, please visit www.blackwellpublishing.com or http://interscience.wiley.com.

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New skin disorder caused by mobile phones discovered
For immediate release, Thursday October 16th 2008

Doctors are being warned to be alert to a new allergic skin disorder, caused by mobile phones, according to the British Association of Dermatologists.

A new phenomenon called “mobile phone dermatitis” has been discovered, in which people who spend long periods of time on their mobile phone develop an allergic reaction to the phone’s nickel surface.

The problem was identified in several published case reports of patients with unexplained rashes on their face and ear. Closer investigation revealed that the reaction was caused by nickel in the mobile phone handsets, where it is often found in the casing or buttons, particularly in the most fashionable models.

Now the British Association of Dermatologists is warning other doctors to be aware of the allergy, which is thought to be on the increase. Because the condition has only newly been identified, many cases may go unreported or untreated, which has prompted the scientists to share their findings.

Nickel allergy is the most common contact allergy in the UK and is thought to affect 30 percent of the population, with a rising incidence.* Women have a higher risk of developing mobile phone dermatitis, as they are more likely to have been previously sensitised to the metal following an allergic reaction to nickel-coated jewellery.

Dr Graham Lowe, from the British Association of Dermatologists, said: “The allergy results from frequent skin contact with nickel-containing objects. Prolonged or repetitive contact with a nickel-containing phone is more likely to cause a skin reaction in those who are allergic. If you have had a previous reaction to a nickel-coated belt-buckle or jewellery, for example, you are at greater risk of reacting to metal phones.

“In mobile phone dermatitis, the rash would typically occur on the cheek or ear, depending on where the metal part of the phone comes into contact with the skin. In theory it could even occur on the fingers if you spend a lot of time texting on metal menu buttons.

“It is worth doctors bearing this condition in mind if they see a patient with a rash on the cheek or ear that cannot otherwise be explained.”

In a study published earlier this year, doctors in the US tested for nickel in 22 popular handsets from eight different manufacturers, and found it present in ten of them.¹

Dr Lionel Bercovitch, one of the study’s authors from Brown University, Rhode Island, said: “Nearly half of the phones we spot tested contained some free nickel. The menu buttons, decorative logos on the headsets and the metallic frames around the liquid crystal display (LCD) screens were the most common sites... Those with the more fashionable designs often have metallic accents and are more likely to contain free nickel in their casings.

“Given the widespread use of cell phones, the presence of metal in the exterior casing of these phones and the high prevalence of nickel sensitization in the population, it is not surprising that cell phones can cause allergic contact dermatitis.”

Several other cases have been reported, prompting the British Association of Dermatologists to share the research with other doctors. The association is advising anyone who develops a rash on their face which might be attributable to prolonged mobile phone use to seek advice from their doctor.

-ends-

Note to editors:

* “Genetic Factors in Nickel Allergy”; Journal of Investigative Dermatology (2004) 123, xxiv–xxv; doi:10.1111/j.0022-202X.2004.23508.x; Veronique Bataille, Genetic Epidemiology and Twin Research Unit, St Thomas Hospital, London, UK
Recent case reports of mobile phone dermatitis:
¹ “Cellphone contact dermatitis with nickel allergy”; Lionel Bercovitch, MD* and John Luo; *Department of Dermatology, Warren Alpert Medical School of Brown University; Liberal Medical Education, Brown University, Providence, Rhode Island, USA.
CMAJ, January 1, 2008; 178 (1). doi:10.1503/cmaj.071233. http://www.cmaj.ca/cgi/content/full/178/1/23
“Mobile phone dermatitis: a modern presentation of contact allergy”; A. Waters, C.M. Green and S. Lewis-Jones; Ninewells Hospitall, Dundee, UK. Overview available in British Journal of Dermatology, BSPD abstracts 2008; Presented at British Society for Paediatric Dermatology Annual Symposium, November 2007.
“Cellular phone addiction and allergic contact dermatitis to nickel”; Contact Dermatitis
Volume 57 Issue 2, Pages 130 – 131; Cristina Livideanu 1 , Francoise Giordano-Labadie 1 Carle Paul 1; 1 University Paul-Sabatier, Department of Dermatology, Purpan University Hospital, Place du Dr Baylac Toulouse, France; 11 Jul 2007; http://www3.interscience.wiley.com/journal/117986581/abstract
“Mobile telephone as new source for nickel dermatitis”; Contact Dermatitis
Volume 56 Issue 2, Pages 113 – 113; Stefan Wöhrl 1 , Tamara Jandl 1 , Georg Stingl 1 Tamar Kinaciyan 1; 1 Department of Dermatology, Division of Immunology, Allergy and Infectious Diseases, Medical University of Vienna; 18 Jan 2007
http://www3.interscience.wiley.com/journal/117986455/abstract?CRETRY=1&SRETRY=0

The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.

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Bacteria in spring water could hold key to eczema treatment
For immediate release, September 8th 2008

Bacteria found in thermal spring water could help treat eczema when applied directly to the skin, new research in the British Journal of Dermatology will reveal.

Atopic eczema is a common skin disorder that is often accompanied by allergies and hayfever, and affects one in 10 children. Atopic people have an overactive immune system and their skin easily becomes inflamed. Additionally their skin ‘barrier’ does not work well, so that their skin may become dry and prone to infection.

‘Vitreoscilla filiformis’ is a type of harmless (non-pathogenic) bacteria found in the water of sulphurous thermal springs, as can be found throughout Europe. Benefits of visiting thermal spas have previously been reported by eczema patients, but changes to the skin following spa retreats are hard to assess as they could also be due to changes in diet and reduced stress. Scientists in France and Germany therefore studied the effects of V. filiformis on atopic eczema, to see whether this might be the cause of reported improvements.

51 patients with mild or moderate atopic eczema were divided into two groups – one receiving treatment with the bacteria applied to the skin in a cream, and the other with a similar cream containing no bacteria, over a one month period.

The researchers compared the patients by means of a clinical evaluation, the patients’ experiences of itching, and the presence of harmful (pathological) bacteria on the skin at the start of the study, after two weeks and again after four weeks.

Using SCORAD, a clinical evaluation tool that scores how severe a person’s eczema is, they found that clinical symptoms improved significantly in the V. filiformis group only, and this improvement could be noticed as early as two weeks after the start of treatment. In contrast, no significant difference could be observed in the control group.

The same was true for itching, which decreased significantly in the V. filiformis group, after just two weeks, compared to no significant improvement in the control group.

Improvement of eczema lesions in the V. filiformis group was also detectable by visual inspection. While the control cream did not improve lesions, the eczema lesions in the V. filiformis group cleared or showed marked improvement.

At the start of the study, a quarter of volunteer patients were found to have staphylococcus aureus on their skin, a bacterium that is commonly found in eczema patients and can cause skin infections. 12 percent were found to have Streptococci and/or E. coli on their skin. This is actually a low frequency of bacterial colonisation to start with, however, the levels reduced more significantly in the V. filiformis group than in the control group.

After a month, S. aureus was reduced by 30 percent and Streptocci and E.coli by 15 percent in the V. filiformis group, compared to 12 percent and four percent respectively in the control group.

Improved barrier function of the skin, measured according to water loss from the skin, was found equally in both groups and is thought to be due to the use of a cream alone, regardless of any bacterial content, which helps to moisturise the skin and keep it hydrated.

Dr Tilo Biedermann, dermatologist at Eberhard Karls University Tübingen in Germany and one of the researchers, said: “From our study there is clear evidence that V. filiformis is highly effective, significantly improving not only clinical symptoms but also reducing itching and consequently sleep loss. As only mild eczema was studied, sleep loss was not a frequent complaint of the volunteers, indicating that a study population with more severe eczema may reveal even more dramatic changes.”

As improvements were found in skin that was not colonised with harmful bacteria, it is thought that its effects are not purely antimicrobial (fighting harmful bacteria). The researchers believe that V. filiformis contains compounds that regulate the immune system.

“The improvement demonstrated in our study may be in part due to reduction of S. aureus, but seems to relate in most parts to a direct effect on skin-associated immune responses”, Dr Biedermann added.

The study was short term, but if the results are confirmed and consistent over a longer time, this may have direct clinical relevance.

Nina Goad of the British Association of Dermatologists said: “Dermatologists are at the forefront of eczema treatment and, if further studies suggest that this bacterium does indeed provide clinical results, would welcome the potential for new topical treatments to help combat this distressing disease.”

Non-pathogenic bacteria are already used to confer health benefits. One popular form is pro-biotics, live microorganisms which are thought to offer health benefits when ingested and are used as oral supplements to support gut health.

-Ends-
Notes to editors:
If using this information, please ensure you mention that the study is being released in the British Journal of Dermatology, the official publication of the British Association of Dermatologists.

Images showing the contrast between the two groups are available – please email nina@bad.org.uk or call 0207 391 6355. Image shows effects of Vitreoscilla filiformis on atopic eczema. Photographs of identical areas of three different and representative patients treated with placebo (A) or V. filiformis (B) are shown before and on day 29 of treatment.

Articles in the BJD can be viewed online: http://www.blackwell-synergy.com/loi/BJD
Study details: British Journal of Dermatology, estimated publication date October 2008, “Effects of nonpathogenic gram-negative bacterium Vitreoscilla filiformis lysate on atopic dermatitis: a prospective, randomized, double-blind, placebo-controlled clinical study” ; A. Gueniche, B. Knaudt*, E. Schuck*, T. Volz*, P. Bastien, R. Martin, M. Röcken*, L. Breton and T. Biedermann*; L’Oréal Recherche, Clichy, France; *Dept of Dermatology, Eberhard Karls University Tübingen, Liebermeisterstr. 25, 72076 Tübingen, Germany; DOI: 10.1111/j.1365-2133.2008.08836.x

The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.
Blackwell Publishing is a leading society publisher, partnering with 665 medical, academic and professional societies. Blackwell publishes over 800 journals and has over 6,000 books in print. In February 2007, Blackwell Publishing officially merged with John Wiley & Sons, Inc's Scientific, Technical and Medical business.

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Research questions inequality of skin cancer monitoring for transplant patients
For immediate release, September 3rd 2008

Kidney transplant patients, one of the most at-risk groups for skin cancer, are not being sufficiently educated or monitored for the disease, according to new research.

Kidney transplant recipients are three times more likely to develop skin cancer than people who have not received a transplant. 30 percent of UK renal (kidney) transplant recipients (RTRs) will go on to develop non-melanoma skin cancer, the most common type, within 10 years. This is because immunosuppressive drugs that prevent the body rejecting the transplanted organ, also increase the risk of skin cancer.

A study due to be released in the British Journal of Dermatology next month surveyed 56 UK centres, treating 82 percent of the population’s kidney transplant recipients, to see how many offered routine screening for skin cancer and what level of education was provided to patients about the disease. The same survey was conducted in Australia to compare procedures in both countries.

The researchers, based in Sheffield and Oxford in the UK and Melbourne in Australia, found that in the UK only 66 percent of centres managing RTRs provide annual skin cancer surveillance. In contrast, 97 percent of centres in Australia offer skin cancer screening.

Of UK centres offering surveillance, only 59 percent provide full skin examination (39 percent of all centres). According to the researchers, 20 percent of non-melanoma skin cancers in UK kidney transplant patients arise on body sites covered by clothes.

81 percent of the UK staff conducting the skin checks are not dermatologists, and less that a third (30%) of these non-dermatologists have received any formal training for the role. Training ranged from just one day to six months. In comparison, only 40 percent of staff in Australia conducting the checks are non-dermatologists.

One possible explanation provided by the researchers is the higher availability of dermatology services in Australia, which is likely to account for the greater involvement of dermatologists in the screening process; there are approximately 53 kidney transplant recipients per Consultant Dermatologist in the UK, compared to just 22 in Australia.

According to NICE guidance on skin cancer*, “patients should be educated about primary prevention of skin cancers”, however five percent of UK centres are failing to provide pre-transplant or post-transplant education on skin cancer risk and prevention.

The majority of education was delivered verbally – only 46 percent offered written information before and 66 percent after transplantation. Ideally all patients should be provided with written information, as verbal education at a stressful time, when so much other medical information is supplied, can be forgotten.

However, the study found significant improvements in services when compared to the results of the same survey carried out six years previously. While 66 percent of UK centres offered annual skin cancer surveillance in the latest survey (2006), this is a three-fold increase from 2000, when just 21 percent did so. And 39 percent now provide full skin examinations, compared to just 20 percent in 2000.

This improvement may be in part due to the inclusion of skin cancer services for transplant patients in the 2006 NICE guidance on skin cancer*, which states: “At present there is a paucity of services at regional and supraregional level that specialise in the care of high-risk or special groups, for example transplant patients… A survey of transplant physicians reported that closely integrated and well-coordinated specialist clinics for dermatological management of transplant patients are highly effective…. It is likely that there will be a need for a transplant patient skin clinic to be established in each of the existing 28 transplant units in England and Wales.”

Dr Seema Garg, Dermatology Registrar at Royal Hallamshire Hospital in Sheffield and one of the researchers, said: “Current guidance recognises the need for non-melanoma skin cancer surveillance and education for organ transplant recipients and recommends the development of dedicated services.

“This survey suggests that there has been a substantial increase in the access to skin cancer surveillance since 2000. It is of concern, however, that one third of UK centres who took part in the survey still do not offer skin reviews routinely and that screening is often done by individuals with no specific training for the role. Training in full skin examinations should be provided.
“A range of indices have been created to define those at highest risk, including previous history of skin cancer, duration of immunosuppression, eye colour and skin type. The development and application of these could allow for targeting of surveillance programmes to those at highest risk. This may prove more acceptable and affordable than offering routine surveillance to all.”

Nina Goad of the British Association of Dermatologists said: “There appears to be something of a ‘postcode lottery’ regarding whether or not transplant patients receive screening for skin cancer.

“Routine screening should either be undertaken by or supervised by a dermatologist, ideally in a special transplant patient skin clinic. The current lack of training for this role is of concern.

“All screening should be of the whole body – partial skin checks of visible skin could miss areas that patients find hard to check themselves, for example the back.

“While costs and staffing are obvious factors in the availability of screening services, and resources are needed to implement NICE guidance, education can be provided with very little expense. For example, the British Association of Dermatologists produces information leaflets about skin cancer for transplant patients, which are available free of charge. It would be helpful to patients if more centres took advantage of this.

“It is, however, encouraging that there has been a significant improvement in the availability of these services, and hopefully this expansion will continue.”

Matthew Patey, 39, received a kidney transplant in London in 2000. He said: “My treatment was second to none, and I received excellent care throughout. I have never been checked for skin cancer though, and I don’t recall receiving any leaflets about my increased risk and how to protect myself. There is some sound advice available on the websites of medical associations, but you do need to know to look for it in the first place. Printed information is helpful as you can review it at a later date, rather than trying to remember everything you’re told at an incredibly stressful time.”

Key findings:
• Only 66% of centres managing RTRs provide annual skin cancer surveillance, In contrast, 97% of centres in Australia offer skin cancer screening.
• Of centres offering surveillance, only 59% offer full skin examination (39% overall). However, 20% of non-melanoma in UK RTR’s arise on body sites covered by clothes.
• 81% of the UK staff conducting the skin checks are not dermatologists, and less that a third (30%) of these non-dermatologists have received any formal training for the role. In contrast, only 40% of staff in Australia conducting the checks are non-dermatologists.
• 5% of centres are failing to provide pre-transplant or post-transplant education on skin cancer risk and prevention.
• The majority of education was delivered verbally – only 46% offered written information before and 66% after transplantation.
• The study’s positive findings are that 66% of UK centres offer annual skin cancer surveillance, compared to just 21% in 2000. 39% provide full skin examinations, compared to just 20% in 2000.
-Ends-

Notes to editors:
*National Institute for Health and Clinical Excellence “Improving Outcomes for People with Skin Tumours including Melanoma”, February 2006.

If using this information, please ensure you mention that the study is being released in the British Journal of Dermatology, the official publication of the British Association of Dermatologists.

Articles in the BJD can be viewed online: http://www.blackwell-synergy.com/loi/BJD
Study details: British Journal of Dermatology, estimated publication date October 2008, “Skin cancer surveillance in renal transplant recipients: re-evaluation of UK practice and comparison with Australian experience.” S.Garg, R.P. Carroll*, R.G.Walker*, H.M. Ramsay and P.N. Harden¹; Dept of Dermatology, Royal Hallamshire Hospital, Sheffield, UK; *Department of Nephrology, Royal Melbourne Hospital, Australia; ¹Oxford Kidney Unit, Churchill Hospital, Oxford, UK; DOI: 10.1111/j.1365-2133.2008.08837.x

The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.
Blackwell Publishing is a leading society publisher, partnering with 665 medical, academic and professional societies. Blackwell publishes over 800 journals and has over 6,000 books in print. In February 2007, Blackwell Publishing officially merged with John Wiley & Sons, Inc's Scientific, Technical and Medical business. For more information on Blackwell Publishing, please visit www.blackwellpublishing.com or www.blackwell-synergy.com.

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Medical students receive inadequate training in one of commonest specialties
For immediate release July 3rd 2008

Medical students feel that they are receiving inadequate training in a common specialty, a new study has revealed.

More than half of medical students regard their level of education in dermatology as insufficient, and many do not feel confident in diagnosing or treating skin diseases, according to research presented at the British Association of Dermatologists’ annual meeting this week.

This worrying shortcoming is despite dermatology comprising a large proportion of the overall NHS workload.

Dermatology includes more than 1,000 diseases of the skin, hair and nails, and eight million people in the suffer from a skin disorder. One in five children suffer from eczema.

The number of people seeking help from their GP for skin diseases is increasing, and GPs now spend about 15 percent of their consultations dealing with skin problems.* In fact, skin disorders are the third commonest reason for a person to seek help from their GP.

As dermatology is integral not only to consultants but also to GPs and other medical professionals, a team of researchers from Liverpool, Manchester and Oxford carried out a survey of 449 final year medical students from 14 medical schools. The survey specifically focused on educational methods and confidence levels within each of 54 important learning outcomes that should be achieved by all medical graduates, as identified by a national panel in 2006. **

56 percent of respondents stated that the level of undergraduate training in dermatology was insufficient.

Half did not feel confident in treating skin disease patients. Furthermore, a third did not even feel adequately confident in assessing or diagnosing skin diseases in the first place.

Students who received teaching from dermatologists, dermatology specialist nurses and expert patients reported significantly higher levels of confidence.

This survey has also revealed that problem-based learning (an educational method using clinical scenarios to identify learning needs) and clinical exposure were associated with higher confidence levels.

Dr Yi Zhen Chiang from the Royal Liverpool University Hospital, who presented the research, said: “This survey has identified the methods that best improve medical student confidence in the practice of dermatology. These results will hopefully contribute to an understanding of how the delivery of dermatology education in the undergraduate course can be improved.”

President of the British Association of Dermatologists Dr Mark Goodfield said: “This study reveals a worrying lack of confidence in medical students with regards to dermatology, which is one of the most common reasons for people to consult their doctor.

“Students reported that practical learning was beneficial, so it would be good to see a higher proportion of the training curriculum dedicated to this type of learning.”

Ends
Notes to editors:

If using this study, please ensure you mention that the study is being released at the British Association of Dermatologists’ Annual Conference.
The conference was held at Liverpool ACC from 1st to 4th July 2007 and is attended by and worldwide dermatologists and dermatology nurses.

* Royal College of General Practitioners Curriculum Statement 15.10
** British Journal of Dermatology 2006; 155: 137-44)
Presentation details: “Undergraduate dermatology education: a survey of UK medical students”
Yi Zhen Chiang (1) presenting , Kian Tjon Tan (2), Yi Ning Chiang (3), Christopher Griffiths (2), Susan Burge (4) Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom (1), University of Manchester, Manchester, United Kingdom (2), University of Liverpool, Liverpool, United Kingdom (3), Oxford Radcliffe Hospitals NHS Trust, Oxford, United Kingdom (4)

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One in 17 under-16s use sunbeds, study reveals
For immediate release July 2nd 2008

A survey of secondary school children in the West Midlands has revealed a worrying level of sunbed use in under-16s.
The study, due to be presented at the British Association of Dermatologists Annual Conference in Liverpool this week, asked 872 children at a secondary school in Dudley, West Midlands about their UV exposure. All of the children were aged between 11 and 16.

Despite their young age, six percent had used an artificial tanning device. 70 percent of these were girls.

A quarter reported that they sun burnt easily and 30 percent had freckles, yet still used a sunbed.

However, this was not predominantly one-off use. 18 percent of those who used sunbeds did so at least once a week, while a further 41 percent used a sun bed at least once every three months.

Nearly half of the devices used were coin-operated. The majority of sun beds were located at tanning salons, although a significant number were home devices or at public gymnasia.

Furthermore, 12 percent of those who had used a sunbed had a family history of skin cancer.

92 percent had at least one family member using sun beds.

Results for all 872 children demonstrated that they spent on average two hours per day in the sun during the summer on a weekday, and three hours per day on weekends. An average of 14 days a year was spent on sunny holidays, with a median of five hours per day sun exposure.

However, the children who used sunbeds also had a higher exposure to outdoor sunshine in the and on sunny holidays.

Dr Ravi Suchak, dermatologist at Barts and the London NHS Trust and one of the researchers, said: “Our findings indicate that a significant number of schoolchildren use artificial tanning devices. Moreover, a significant proportion of them is fair skinned and has higher than average exposure to outdoor sunshine.

“Tougher licensing and regulation of tanning salons, and a restriction on un-staffed, coin-operated devices is overdue. Most users have family members who use sun beds and so health education of the population as a whole on the hazards associated with sun beds and overall excessive UV exposure should continue to be a high priority.”

President of the British Association of Dermatologist Dr Mark Goodfield said: “This study illustrates why we need proper licensing of the sunbed industry. Children of this age should not be able to access sunbeds in salons or gyms.

“Too many sunbeds are unsupervised, so children can use these devices as many times as they like, putting themselves at risk of developing skin cancer.

“We would like to see a ban on all coin-operated sunbeds, as well as the removal of sunbeds from gyms and other venues that can give the impression they are healthy. Furthermore, there needs to be better information on display about the health risks, as many salons fail to provide this.”

Mrs. Anna Pinto, Science Director at The Kingswinford School where the study was conducted said: “The use of sunbeds in the under 16’s has become a growing concern and as a Science College we were delighted to assist with this research project.”

Ends

Notes to editors:
If using this study, please ensure you mention that the study is being released at the British Association of Dermatologists’ Annual Conference. The conference is being held at Liverpool ACC from 1st to 4th July 2007 and is attended by and worldwide dermatologists and dermatology nurses.

Study details: Exposure to artificial tanning devices by young teenagers at a science college in Dudley , West Midlands . Ravi Suchak (1), Anna Pinto (2), Julie Devlin (2), Peter Limb (2), Rino Cerio (1); Barts and the London NHS Trust, London, United Kingdom (1); Kingswinford School , Dudley , West Midlands , (2)

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Dermatologists to hold UK’s largest mole check event
For immediate release, June 2nd 2008

The British Association of Dermatologists is to host the UK’s largest ever free mole check event next week.
As part of the association’s Sun Awareness campaign, teams of Consultant Dermatologists and specialist nurses will be holding mole check sessions at the BBC Gardeners’ World Live 2008 show at the NEC in Birmingham, from Tuesday June 10th to Sunday June 15th.
The association are hoping that through a mass mole check, they can highlight that people can get moles they are concerned about looked at free of charge through the NHS, and are not obliged to pay to do so at a private clinic.

Nina Goad of the British Association of Dermatologists said: “As well as teaching people of the importance of checking their skin for cancer, we hope that through the event we can inform people how to access care rapidly and free via the NHS.

“This follows a survey we carried out recently, which revealed that one in six people are not aware that a mole can be checked for free by a GP, instead believing this service has to be paid for. We are worried that this financial element could cause people to delay seeking help.”

Consultant Dermatologists are the experts in diagnosing a skin cancer, and GPs can refer anyone with a possible skin cancer to a local dermatology department, on the NHS. There are no long waiting lists – in fact if your GP suspects you have a melanoma or SCC, the two more dangerous types, you will be seen within just two weeks. Of course people may choose to go to a private mole screening clinic, but they are usually then referred back to the NHS.

As gardening enthusiasts spend a lot of time outdoors, exposed to skin damage from the sun, the Gardener’s World Show Live show seemed like an ideal venue to hold the biggest ever mole check event.

Nina Goad said: “More than 360,000 people attend the show, and our dermatologists will be busy trying to screen as many people as possible. It’s hard to say how many people will be seen, as each person will have different requirements, but we’ve certainly never held a six day event before, so we’re expecting to see several hundred people at least.”

The event, being held in support of the skin cancer charity SKCIN, will start with a special mole check session for the media and the show’s judges on June 10th, before the show opens to the public the following day.

However, mole check events are not just limited to people attending the BBC Gardener’s World Show, as the association is planning other events around the UK.

This year’s Sun Awareness campaign focuses on ‘early detection’ of skin cancer, teaching people to check their skin for possible signs of cancer, and to make sure they see a doctor if there are any concerns.

As part of the campaign, the association has created a list of signs to look out for in a mole that may indicate a melanoma – the deadliest form of skin cancer:

Asymmetry - the two halves of the area may differ in shape

Border - the edges of the area may be irregular or blurred, and sometimes show notches

Colour - this may be uneven. Different shades of black, brown and pink may be seen

Diameter - most melanomas are at least 6mm in diameter. Report any change in size, shape or diameter to your doctor

Expert - if in doubt, check it out! If your GP is concerned about your skin, make sure you see a Consultant Dermatologist, the most expert person to diagnose a skin cancer. Your GP can refer you via the NHS

Consultant Dermatologists are the experts in diagnosing and treating skin cancer, and the British Association of Dermatologists recommends reporting any unusual changes to the skin (not only those in its ABCDE guide) to a GP so that a referral can be made. This can be done on the NHS.

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Note to editors:
Case studies are available and spokespeople on skin cancer are also available on request. For more information about skin cancer and Sun Awareness, please visit the Sun Awareness area of this website.

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Washing powders not cause of eczema, study confirms
For immediate release, 21.05.08

Healthcare professionals should not attribute skin reactions to bio washing powders, a new study will warn.

According to research due to be released in the British Journal of Dermatology, bio washing detergents are no more harmful to people with eczema than their non-bio counterparts, despite a popular belief to the contrary.

Biological (bio) laundry detergents differ from non-biological (non-bio) products in that they contain enzymes, which were first added to assist stain removal. In addition, their efficiency at low temperatures and their biodegradability both offer environmental benefits.

However, for years it has been suggested that bio laundry detergents can trigger skin reactions, and that they should be avoided by people with eczema, as the enzymes might worsen the disorder. Interestingly, this line of thought is unique to the UK.

This suspicion is thought to have arisen from cases where proteolytic enzymes, the type most commonly used, produced skin irritation, mainly when used occupationally by workers producing a detergent enzyme. Links to eczema when used in normal circumstances have, however, remained unclear and anecdotal.

A team of researchers from Nottingham and London therefore conducted a review of evidence, looking at both the actual exposures through use of the product, and at exaggerated levels that would not normally occur through normal use.

Dr Sarah Wakelin, Dermatologist at St Mary’s Hospital in London and one of the researchers, said: “In the UK, the background awareness of questions about allergy and irritation has translated into concern among some consumers and consumer groups that enzyme-containing detergents may be related to a variety of consumer skin complaints. Anecdotally at least, a similar view appears to be held by a variety of healthcare professionals.

“In this review, we looked at the facts, asking whether there is evidence that the hazards identified for enzymes translate into any risk for consumer health.”

The researchers concluded that the possible irritant and allergic reactions that could be caused by enzyme raw materials do not translate into a risk of skin reactions when used in washing powders.

Dr Wakelin explained: “What we have found is that ultimately, the balance of all the evidence is that enzymes in laundry detergents are not a cause of either skin irritation or skin allergy. Investigations of numerous individuals with skin complaints attributed to laundry products demonstrate convincingly that enzymes were not responsible. Indeed, enzyme-containing laundry products have an extensive history of safe use. Thus, the supposed adverse effects of enzymes on skin seem to be a consequence of a mythology.”

The evidence:
In this latest study, the researchers reviewed a wide range of evidence on the subject.
This includes a 1969 study in Ohio, US, in which 739 subjects took part in tests involving a range of main wash and pre-soak detergents, with and without proteolytic enzymes. With the tests employing exaggerated use conditions, there was no significant increase in skin irritation in any of the hand or arm immersion assays that could be attributed to the presence of enzyme. Products were then used normally in a total of 5943 subjects and the hands examined by a dermatologist. No differences were observed between the enzyme and control treatments.

The same scientists then conducted a study of 360 babies, in which their nappies were washed in the test and experimental products and the nappies worn. There was no difference in the incidence or severity of nappy rash between groups of infants wearing nappies laundered in the products with or without enzymes.

In 1975, German researchers specifically tested the enzymes used in detergents, rather than the detergents themselves. These tests were carried out not only on normal skin but also on irritated or damaged skin. The enzyme solutions caused no irritation or other damage to the normal or slightly lesioned skin, even in response to close contact lasting several days. Irritation only occurred when the sin was damaged to an extent that allowed the enzymes to penetrate the lower layers of skin, and in such cases the enzyme concentrations far exceeded those used in commercial detergents. The researchers therefore concluded that any effects caused by laundry detergents are due not to the enzyme content of these detergents, but to other factors.

Several studies have also looked at the effects of product residues left on clothes after washing. These studies used fabrics containing detergent residues and a variety of exaggerated exposure tests. In all the studies, no evidence that residues in the fabrics caused irritancy was obtained.

Dr Wakelin said: “In terms of allergy, the evidence is consistent with what we know of the physiology of skin allergy.

“Substances must penetrate the outer skin barrier to reach the lower layers and do so in a sufficient quantity to activate the immune system in such a manner as to lead to an allergic response. By virtue of their size, enzymes are unlikely to penetrate the skin to any great degree. Also, enzymes in laundry products are encapsulated in robust, inert barrier. This means that actual skin exposure will be extremely low.

“Thus, the only occasions when there is likely to be some degree of exposure is either to the wash solution (when the enzyme encapsulate has dissolved) or from any enzyme residues on fabrics. As shown by various studies, contact with wash solutions does not lead either to irritation or to allergy, and residues on fabrics are also trivially low and do not give rise to any skin effects.”

Dr Colin Holden, President of the British Association of Dermatologists said: “This study highlights that flare-ups of eczema should not just be written of as caused by washing powder. This serves as a reminder to medical professionals that an expert dermatologist should explore all the other potential causes, as bio detergents may well not be the culprit.”

-Ends-
Notes to editors:
1. If using this information, please ensure you mention that the study is being released in the British Journal of Dermatology, the official publication of the British Association of Dermatologists.

2.Articles in the BJD can be viewed online: http://www.blackwell-synergy.com/loi/BJD
Study details: British Journal of Dermatology June 2008, doi:10.1111/j.1365-2133.2008.08561.x, pp1177-1181
“Enzymes, detergents and skin: facts and fantasies”, D.A. Basketter *†, J.S.C. English ‡, S.H. Wakelin § and I.R. White †
*DABMEB Consultancy, Sharnbrook, Beds, U.K.†St John’s Institute of Dermatology, St Thomas’ Hospital, London, U.K., J.S.C. English‡‡Department of Dermatology, Nottingham University Hospital, Nottingham, U.K., S.H. Wakelin§§Department of Dermatology, St Mary’s Hospital, London, U.K. and I.R. White††St John’s Institute of Dermatology, St Thomas’ Hospital, London, U.K.
The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.
Blackwell Publishing is a leading society publisher, partnering with 665 medical, academic and professional societies. Blackwell publishes over 800 journals and has over 6,000 books in print. In February 2007, Blackwell Publishing officially merged with John Wiley & Sons, Inc's Scientific, Technical and Medical business. For more information on Blackwell Publishing, please visit www.blackwellpublishing.com or www.blackwell-synergy.com.

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Warning from dermatologists as UK children have Europe’s highest skin cancer rates
For immediate release, 02.05.08

British parents are confused about the need to protect their children in the sun, despite the fact that children and teenagers in the UK have the highest rates of skin cancers of any European country.
That’s the warning from the British Association of Dermatologists today, to mark the start of Sun Awareness Week.

According to a study* on skin cancer incidence throughout Europe, the UK has the highest skin cancer rates both for children, aged 0 to 14, and teenagers, aged 15 to 19.

Furthermore, cases of melanoma - the deadliest type of skin cancer - increased four-fold in UK teenagers over just two decades (1978 to 1997).

Despite this alarming rise, a survey by the British Skin Foundation last year found that a quarter of British parents don’t think it necessary to apply sun protection to their children before they go to school in the summer months, even though many schools do not have shade in the playground. The charity also found that 37 percent of parents buy sunscreens with lower than the recommended SPF30 for their children.

Nina Goad of the British Association of Dermatologists said: “Sun Awareness Week starts on a bank holiday as this is when many families will be spending the day outdoors. On the rare occasions that we do get good weather, of course we want to make the most of it – however, often we forget that we need to protect ourselves in the sun, and this is especially true for children whose skin is more sensitive to UV light.

“Sunburn as a child can as much as double the chances of skin cancer later in life, so kids need to be protected with sunscreen, clothing and shade when spending time outdoors on sunny days.”

-ends-

Note to editors:

* European Journal of Cancer 2006, Volume 42, Issue 13, Pages 2170-2182 (September 2006)
Skin cancer incidence and survival in European children and adolescents (1978–1997). Report from the Automated Childhood Cancer Information System project
E. de Vriesa, E. Steliarova-Foucherb, A. Spatzc, E. Ardanazd, A.M.M. Eggermonte, J.W.W. Coeberghaf

The British Association of Dermatologists runs the annual Sun Awareness Week, this year May 5-11, and the Sun Awareness campaign throughout the summer. Case studies are available for the media to complement feature articles and spokespeople on skin cancer are also available on request.

For more information about skin cancer and Sun Awareness, visit: http://www.bad.org.uk/public/cancer/

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Tomatoes found to fight sun damage
For immediate release 28.04.08

Tomatoes could be the new weapon in the fight against sun damage, research at the Universities of Manchester and Newcastle has revealed.
According to a study presented by Dr Muneeza Rizwan at the British Society for Investigative Dermatology in Oxford earlier this month, eating tomato paste could help protect against sunburn and sun induced skin ageing.

At the University of Manchester, researchers compared the skin of 20 people, half of whom were given five tablespoons (55g) of standard tomato paste with 10g of olive oil every day, with the other half receiving just olive oil, over a period of 12 weeks.

By exposing the skin to ultraviolet (UV) light, such as is produced by the sun, at the beginning and end of the trial, the team found significant improvements in the skin’s ability to protect itself against UV in the group who had been eating tomato paste.

Many of the harmful effects of UV light are due to the excess production of harmful molecules known as ‘reactive oxygen species’ which can damage important skin structures. Sun damage from UV exposure includes premature wrinkles and skin cancer.

The tomato’s key skin saving property is a powerful antioxidant called ‘lycopene’, which is able to neutralise or ‘quench’ the harmful molecules.

Lycopene is the bright red pigment found in a number of red fruit and vegetable, but with its highest levels in cooked tomatoes. As tomato paste contains a high concentration of cooked tomatoes, it is an ideal source of lycopene.

Compared to the control group, the group who had eaten the paste were found to have 33 per cent more protection against sunburn, which can lead to skin cancer. The researchers calculated the protection offered by the tomato paste to be equivalent to a sunscreen with a sun protection factor (SPF) of 1.3.

By looking at the effects on skin ageing by studying skin samples taken from both groups, before and after trial, the Manchester team discovered that the tomato diet had boosted the skin’s levels of procollagen, a molecule which gives the skin its structure and loss of which leads to skin ageing and lack of elasticity.

Meanwhile, colleagues at Newcastle University found that the lycopene had reduced damage to mitochondrial DNA in the skin, which is also believed to be linked with skin ageing.

Professor Lesley Rhodes, dermatologist at the University of Manchester, said: “The tomato diet boosted the level of procollagen in the skin significantly. These increasing levels suggest potential reversal of the skin ageing process. This is in addition to the significant reduction in sunburn.
“These weren’t huge amounts of tomato we were feeding the group. It was the sort of quantity you would easily manage if you eating a lot of tomato-based meals.
“People should not think that tomatoes in any way can replace sun creams, but they may be a good additive. If you can improve your protection through your diet then over several years, this may have a significant effect.”

Professor Mark Birch-Machin, dermatology scientist from Newcastle University, said: “Eating tomatoes will not make you invincible in the sun, but it may be a useful addition to the sun protection tool box along with sunscreens, shade and clothing.
“The protective effect of eating tomatoes on our mitochondria is important as they are the energy producers in all our body cells including skin. Therefore being kind to our mitochondria is likely to contribute to improved skin health which in turn may have an anti-ageing effect.”

Dr Colin Holden of the British Association of Dermatologists said: “While the protection offered by lycopene is low, this research suggests that a diet containing high levels of antioxidant rich tomatoes could provide an extra tool in sun protection.”

The team are now looking to start a new, longer-term study into the protective effects of lycopene on the skin.

-Ends-
Notes to editors:
1. The study was an oral presentation at the British Society of Investigative Dermatology annual meeting in Oxford on April 7th to 9th 2008. Presentation: “Lycopene protects against biomarkers of photodamage in human skin”; M. Rizwan, I Rodriguez-Blanco, A. Harbottle*, M. Birch-Machin*, R.E.B. Watson and L.E. Rhodes; Dermatological Sciences, University of Manchester and *Dermatological Sciences, Newcastle University, UK.

The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.

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Brits unaware of skin cancer risk, new survey reveals
For immediate release 04.04.08

HALF of Britons would not recognise the signs of a possible skin cancer, and a quarter never checks their skin for the disease, a shocking snapshot survey by the British Association of Dermatologists has revealed.
The survey, to launch this year’s Sun Awareness campaign, revealed that a quarter of respondents never examine their body for changes to their moles.

Even more startling, one in six people are not aware that a mole can be checked for free by a GP, instead believing this service has to be paid for.

85 percent of respondents still don’t realise that skin cancers make up a third of all UK cancers, with the majority thinking that less than one in 10 cancers affect the skin.

And despite skin cancer rates increasing faster than any other cancer, with figures doubling every 10 to 20 years, a staggering one in eight people do not know that skin cancer is on the rise at all.

However, it is not just sun exposure that causes cancer, and an alarming one in six believe that sunbeds could be a useful way of producing Vitamin D for the body.

The British Association of Dermatologists states that perceived health gains from sunbed use, such as vitamin D production, can easily be achieved by other means including diet and supplements. It is therefore not felt that sunbeds carry useful health benefits, but instead increase a person’s risk of skin cancer.

President of the British Association of Dermatologists Dr Colin Holden said: “While it is disheartening that there is little understanding about quite how common skin cancer is, what I find of particular concern is that so many people are unaware of certain signs of skin cancer, and furthermore do not know that they can have a suspicious mole checked free of charge. This could pose a huge obstacle to the early detection of skin cancer in these individuals.”

Sun damage and cosmetic appearance:

The survey showed that we are not just ignorant of the health risks of UV exposure – many people are also unaware that sun protection can keep the skin looking younger.

When asked about how to best prevent premature skin ageing, a quarter favoured applying a daily moisturiser, eating a healthy diet, drinking plenty of water or using facial massage and facial exercises over sun protection.

And interestingly, it seems we are a nation still willing to risk our health for our appearance, with over half (56 percent) of respondents finding people with a tan more attractive, and 91 percent thinking that fashion influences people’s sunbathing habits.

Maria Tabou, Sun Awareness campaign officer at the British Association of Dermatologists said: “The vast majority of premature ageing is caused by excess sun exposure. Smoking also ages the skin, but the methods of prevention chosen by a quarter of people – such as using a moisturiser, drinking eight glasses of water a day, facial massage or facial exercises – will have nowhere near the anti-ageing impact of sun protection.

“Many people don’t realise the extent to which UV irradiation can damage the skin. UV has strong links to skin cancer and also affects the elastin in the skin and leads to wrinkles and sun-induced skin ageing, for example leathery skin and uneven pigmentation.”

With skin cancer rates rising faster than any other cancers, the British Association of Dermatologists’ Sun Awareness campaign aims to educate the public and health professionals on ‘early detection’ of skin cancer, and where members of the public can seek help should they be concerned about their skin.

As part of this, the British Association of Dermatologists have created the ABCD-Easy guide to mole checks, to detect the signs of melanoma – the deadliest type of skin cancer. Look out for:

Asymmetry - the two halves of the area may differ in shape

Border - the edges of the area may be irregular or blurred, and sometimes show notches

Colour - this may be uneven. Different shades of black, brown and pink may be seen

Diameter - most melanomas are at least 6mm in diameter. Report any change in size, shape or diameter to your doctor

Maria Tabou explained: “While many women are aware of the need to carry out self breast examinations, so few people check their skin for cancer. As skin cancer makes up a third of all cancer, we really need to address this.”

Survey summary:
• 44 percent are unable to recognise key signs of skin cancer, such as a mole growing or having an irregular border or colour.
• 17 percent are unaware that you can get a mole checked for free
• Only 34 percent check their moles at least once a month
• A quarter never check their moles
• 85 percent of respondents don’t realise that a third of UK cancers are skin cancer, with the majority thinking the figure is less than 1 in 10
• 13 percent do not know that skin cancer is on the rise
• 17 percent think that sunbeds might be a useful way of producing Vitamin D for the body
• 24 percent chose moisturising, a healthy diet, 8 glasses of water a day, not drinking alcohol, or facial massage / facial exercises, over protecting skin from the sun as the most effective way to prevent premature skin ageing.
• 56 percent of respondents find people with a tan more attractive
• 91 percent think that fashion influences people’s sunbathing habits

- Ends-
Note to editors:
Sun Awareness Week takes place from 5 – 11 May. We have case studies available to the media to complement feature articles. Spokespeople are available to comment on skin cancer. The Sun Awareness campaign runs throughout the summer.

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Traditional Chinese herbal medicine may benefit eczema patients
For immediate release 12.03.08

A traditional Chinese herbal medicine consisting of five herbs may benefit people with eczema, new research in the British Journal of Dermatology will reveal.
Scientists at the Chinese University of Hong Kong evaluated the effects of ‘pentaherbs formulation’ on patients aged between five and 21 with atopic eczema, the most common type of the disease which affects at least one in ten children.

The pentaherbs formulation capsules contain extracts of five raw herbs based on a widely used ancestral Chinese concoction - Flos lonicerae (Japanese honeysuckle), Herba menthae (peppermint), Cortex moutan (root bark of peony tree), Atractylodes Rhizome (underground stem of the atractylodes herb) and Cortex phellodendri (Amur cork-tree bark).

The first study was a clinical trial of 85 patient divided into a control group receiving a placebo, and a group taking the pentaherbs formulation. Using a questionnaire index that measures how much a skin problem affects a patient, the scientists found that the quality of life improved by a third in the group taking the herbs, compared to no improvement in the placebo-treated group.

The researchers also found that the herbal remedy reduced patients’ needs for the conventional treatment of topical steroids, with the duration of use reduced by an average of four days per month in the herbal group, compared to one day per month in the placebo group.

The team went on to explore the clinical effects of pentaherbs on the immune system. This is because people with eczema have been found to have higher blood levels of certain cytokines, a group of proteins and peptides that have a pivotal role in the immune system and which trigger inflammation in eczema.

The herbs reduced the expressions of four proteins and cytokines thought to have inflammatory effects linked with eczema.* This was confirmed in tests done both by adding an extract of the pentaherbs formulation to blood cells in a test tube (in vitro testing), and by testing the blood of 28 children taking the supplements (in vivo testing).

One of the studies’ authors Dr Ting-fan Leung said: “Our recent clinical trial showed that pentaherbs formulation reduced topical corticosteroid usage and improved quality of life in children with moderate to severe atopic eczema. Our latest study further clarifies this by showing that the herbs suppress the production of atopic eczema-related inflammatory mediators. Further studies are needed to explore this in more depth; however this is an interesting first step.”

Nina Goad of the British Association of Dermatologists said: “These early studies shows that children with atopic eczema may benefit from a specific concoction of traditional Chinese herbs, which could eventually pave the way for this remedy to find its way into mainstream medicine.

“However, we would warn against using Chinese herbal medications without first speaking to your doctor. Some retailers may not be reputable and the product they sell you may be of a low standard or could contain harmful ingredients.”

*Brain-derived neutrotrophic factor (BDNF); Interferon-g; Tumour necrosis factor-a; Thymus and activation-regulated chemokine (TARC).

2. Articles in the BJD can be viewed online: http://www.blackwell-synergy.com/loi/BJD
Study details: British Journal of Dermatology, estimated publication date April 2008, “In vitro and clinical immunomodulatory effects of a novel Pentaherbs concoction for atopic eczema”, T.F. Leung, K.Y. Wong, C.K. Wong*, K.P. Fung¹, C.W.K. Lam*, T.F. Fok, P.C. Leung¹, K.L.E. Hon; Departments of Paediatrics and Chemical Pathology*, and Institute of Chinese Medicine¹, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong. DOI 10.1111/J.1365-2133.2008.08502.X
Previous study: British Journal of Dermatology Aug 2007, 157 issue 2, p357-363, “Efficacy and tolerability of a Chinese herbal medicine concoction for treatment of atopic dermatitis: a randomized, double-blind, placebo-controlled study”, K.L.E. Hon, T.F. Leung, P.C. Ng, M.C.A. Lam, W.Y.C. Kam, K.Y. Wong, K.C.K. Lee, Y.T. Sung, K.F. Cheng, T.F. Fok, K.P. Fung and P.C. Leung. DOI: 10.1111/j.1365-2133.2007.07941.x

The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.

Blackwell Publishing is a leading society publisher, partnering with 665 medical, academic and professional societies. Blackwell publishes over 800 journals and has over 6,000 books in print. In February 2007, Blackwell Publishing officially merged with John Wiley & Sons, Inc's Scientific, Technical and Medical business. For more information on Blackwell Publishing, please visit www.blackwellpublishing.com or www.blackwell-synergy.com.

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If in doubt, check it out! Sun Awareness 2008 launched
For immediate release, 10.03.08

New statistics show that skin cancer is now the fastest growing cancer in the UK, and as early detection is crucial in its treatment, the British Association of Dermatologists (BAD) is launching a campaign to raise awareness of the importance of mole checking through its ABCD-Easy guide to mole checks.

Malignant melanoma kills around two thousand people a year, and the Association is keen to promote the use of its easy to use mole check guidelines. TV favourite Anne Robinson is supporting the campaign and turning her no-nonsense approach to the nation’s skin. She said: “I doubt I would be here today if a dermatologist hadn’t spotted that the mole in the middle of my back looked dangerous. It wasn’t visible to me. It took two operations to clear my melanoma; the result of years of sunbathing when I was young without bothering too much about protection -or realizing the risk to someone as fair skinned as I am. I’m lucky to be alive.”

Anne’s case highlights the importance of checking you skin for signs of cancer, and the Association’s ABCD-Easy guide to mole checks focuses on the changes that may indicate a “melanoma” - the deadliest form of skin cancer:

Remember - if in doubt, check it out! If your GP is concerned about your skin, make sure you see a Consultant Dermatologist, the most expert person to diagnose a skin cancer. your GP can refer you via the NHS.

Asymmetry - the two halves of the area may differ in shape

Border - the edges of the area may be irregular or blurred, and sometimes show notches

Colour - this may be uneven. Different shades of black, brown and pink may be seen

Diameter - most melanomas are at least 6mm in diameter. Report any change in size, shape or diameter to your doctor

Nina Goad of the British Association of Dermatologists said: “Early detection of skin cancer can make all the difference to successful treatment and by promoting how easy skin checking can be, literally as easy as ABC, we want to encourage more people to make it part of their health routine.”

Dermatologists are the experts in diagnosing and treating skin cancer, and BAD recommends reporting any unusual changes in your skin (not only those in its ABCDE guide) to your doctor so that a referral can be made.

The vast majority of skin cancers are caused by excess exposure to the sun. In fact, more than four out of five cases of skin cancer are thought to be preventable. Simply being more aware of the general health of your skin and checking moles regularly – at least four times a year – could make all the difference.

-ends-

Note to editors:
The British Association of Dermatologists runs the annual Sun Awareness Week, this year May 5-11, and the Sun Awareness campaign throughout the summer. Case studies are available for the media to complement feature articles and spokespeople on skin cancer are also available on request.

Latest statistics on skin cancer and perceptions of the disease as result of a new survey are also available.

For more information about skin cancer and Sun Awareness, visit: http://www.bad.org.uk/public/cancer/

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Link between psoriasis and obesity gene
For immediate release, 20.02.08

Dermatologists have discovered a link between a hormone created by the obesity gene, and the skin disease psoriasis, according to new research due to be published in the British Journal of Dermatology.

Leptin, the product of the obesity gene, is a peptide hormone. It plays a key role in regulating body weight through the energy acquired and used by the body, controlling appetite, telling the brain when the body has consumed enough food and can stop eating, and increasing metabolism. However, high levels of leptin are linked to obesity.

Psoriasis is a common skin disorder affecting about two to three percent of the population. Severe cases frequently require hospitalisation, and the psychological impact of the disease can be significant.

The cause of the disease is not fully understood, but it is thought that the dramatically increased rate of skin cell turnover is caused by the immune system, when T cells - a type of white blood cell that usually fights against infection - move to the skin and release cytokines, a group of proteins and peptides that have many roles in inflammation and infection. In psoriasis they trigger a rapid renewal of epidermal cells and inflammation.

Because leptin causes the production of a group of certain cytokines, called ‘type 1 cytokines’, the researchers in China and the US speculated that leptin might play a role in the development of psoriasis.

They therefore conducted a study of 144 patients with psoriasis and 54 people without psoriasis. Women were found to have much higher blood levels of leptin than men generally, but the main differences were observed between the patient and control groups, where the serum leptin levels were significantly higher in patients with psoriasis.

Blood leptin levels in male patients were 37 percent higher than in healthy males, and were a third higher (32 percent) in female patients compared to the female controls group.

The researchers further broke this down according to different types of psoriasis: vulgaris (commonly known as plaque psoriasis and the most common type), generalised pustular (including pus spots), palmoplantar pustulosis (includes pus spots and involves only the palms and soles), erythrodermic (severe and widespread inflammation that requires immediate medical attention) and arthropathic (accompanied by arthritis).

For plaque psoriasis, male patients’ levels were 39 percent higher and female patients’ were 32 percent higher.

For the generalised pustular and palmoplantar pustulosis types, there were not enough male patients with these types to make a significant comparison between male patients and male controls, so the researchers only compared the female patients with the female control group. Likewise there were very few female patients suffering from erythrodermic or arthropathic psoriasis in the study, so only male participants were compared for these specific types of the disease.

However, the study revealed that women with generalised pustular psoriasis had leptin levels that were 50 percent higher than women without psoriasis. Furthermore, levels were 30 percent higher in female patients with palmoplantar pustulosis.

Leptin levels were a third higher (34 percent) in men with erythrodermic type psoriasis, and 52 percent higher in men with arthropathic type psoriasis.

Dermatologist Dr Hong-Duo Chen, one of the study’s authors, said: “Leptin regulates body weight through inhibiting food intake and stimulating energy consumption. In this study, we measured serum leptin levels in psoriasis patients to elucidate its correlation with the disease and its different subtypes.

“Our study has, for the first time, demonstrated that serum leptin levels in psoriasis patients are significantly higher than those of normal controls. While we do not yet know the exact reason for this, it seems that leptin might play an important role in the development of psoriasis, through promoting the cytokines that trigger the accelerated renewal of skin cells and inflammation.”

Dr Colin Holden, President of the British Association of Dermatologists, said: “We do not yet understand whether mechanisms link psoriasis and obesity, but it is interesting that psoriasis patients have higher blood levels of a hormone related to being overweight. This could help to explain why if you have psoriasis and become obese, your psoriasis can worsen or be more difficult to control.

Most patients with psoriasis are not overweight and it is clear that suffering from psoriasis would precede weight gain, so being overweight does not directly cause the disease. However the disease may play some part in a person gaining weight. Previously it has been suggested that a lack of mobility due to severe symptoms could be the cause, but generally the exact link has been unclear. People with psoriasis who are also obese will suffer a more severe form of the disease, and their symptoms may be harder to treat.

“Psoriasis has a huge physical and emotional impact on the patient. In fact, the emotional impact of psoriasis is such that as many as one in ten patients contemplate suicide, especially those of younger age.
“Dermatologists deal with hundreds of diseases for which we do not fully understand the cause, so any breakthrough such as this that can lead to further research is most welcome.”

About psoriasis:
The skin is a complex organ made up of several layers of different types of cell. Those in the outer layer - the epidermis – skin cells change gradually as they move towards the surface where they are continually shed. This process normally takes between 3 and 4 weeks. In psoriasis, the rate of turnover is dramatically increased within the affected skin, so that the process takes as little as 3 or 4 days. The reasons for this are still not fully understood. Patches of psoriasis (often known as plaques) are red but covered with silvery white scales. The severity of psoriasis can vary greatly, but more severe cases require hospitalisation. There is no known cure, however treatment to control the signs and symptoms is usually effective, although can be a great burden to the patient.

-Ends-

Notes to editors:
1. If using this information, please ensure you mention that the study is being released in the British Journal of Dermatology, the official publication of the British Association of Dermatologists.

2. Articles in the BJD can be viewed online: http://www.blackwell-synergy.com/loi/BJD
Study details: “Psoriasis is associated with increased levels of serum leptin”, correspondence to British Journal of Dermatology, Y. Wang*², J. Chen³, Y.Zhao*, L. Geng*, F. Song*, H-D. Chen*
* Department of Dermatology, No.1 Hospital of China Medical University, 155N Nanjing Street, Shenyang 110001, China. ²Department of Dermatology, Shengjing Hospital of China Medical University, Shenyang, China. ³Associates in Dermatology, Tuscon, AZ, USA. DOI: 10.1111/J.1365-2133-2008.08456.x

The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.

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Survey reveals major discrepancies in care of patients with psoriasis
For immediate release 18.02.08

Psoriasis patients across the UK are experiencing differing and sometimes sub-standard levels of care, according to a new survey by the British Association of Dermatologists and Royal College of Physicians.
Dr Colin Holden, President of the British Association of Dermatologists said: “Psoriasis is a chronic inflammatory skin disease which can have a huge physical and psychological impact, and as such patients require a high standard of care. This audit has produced data clearly showing that on a national level, the NHS is failing to provide patients with the level of care they deserve. Basic elements such as bathing facilities, appropriately trained staff and access to treatments are lacking to a worrying degree.”

Key survey results of hospital dermatology departments:

• 20% of units have no dermatology specialist nurses
• 32% do not have adequate bathing and showering facilities for adult in-patients
• In 41% of units, topical treatments were applied by nurses who had no dermatology training, or by the patients themselves
• Only 40% of units had clinical psychology services available for patients
• 5% of units did not have the appropriately trained person, a medical physicist, monitoring the UV output of the phototherapy equipment, despite this being mandatory
• 39% are restricted in prescribing the new ‘biologic therapies’ which target the cause of psoriasis rather than the symptoms
• However, the average waiting time for routine appointments is only 10 weeks – below the maximum 12 week wait

Background:

Psoriasis is a chronic, recurrent disease that affects between one and three percent of the population and can require lengthy in-patient hospital treatment.

Dr David Eedy, dermatologist in County Armagh and one of the study’s authors, said: “Until recently most skin disease has been managed either by GPs, or for more severe or persistent cases, in hospital by specialist dermatologists with access to day-care and in-patient services. However, the Government’s initiative to provide ‘Care Closer to Home’ is changing the way such services are delivered. The care for patients with psoriasis is also changing with the advent of more effective treatments such as the biologics.

“We therefore conducted an audit of a hundred Dermatology Departments (‘units’) in the UK to assess their staffing and facilities for patients with psoriasis. The results exposed major discrepancies and a ‘postcode lottery’ in the care of patients. We will be making the government aware of our findings.”

1. Staffing

More than one in ten units (11%) have consultants who work in isolation, without other dermatologists. Furthermore, specialist dermatological nurses greatly enhance patient care, but one in five departments had no specialist nurses.

Dr Holden said: “Our audit shows that some dermatologists still work alone, but we would like to see clinical networks developed so that all consultants work within teams and have the support of colleagues. Also worrying is that 20 percent of units do not have dermatology specialist nurses to support and educate patients with chronic inflammatory skin diseases, which enhances patients self-managing their treatment. This shortfall needs to be addressed.”

However, one positive finding of the audit is that patients with inflammatory skin diseases were waiting a median of 10 weeks for routine appointments – below the maximum 12 week wait.

2. Infrastructure and resources

The nature of certain topical treatments is such that precise application by trained staff is required to ensure no damage to healthy skin occurs, and that bathing facilities are available to remove the medication safely after the treatment time is complete.

However, according to the audit, a third of units did not have adequate bathing and showering facilities for adult in-patients. In addition, in 41 percent of units, topical treatments were applied by nurses who had no dermatology training, or by the patients themselves.

Dr Holden said: “Patients must have access to baths or showers - it is greatly disappointing that such basic facilities were perceived to be inadequate in a third of units. It is also worrying that so many nurses caring for dermatology inpatients have had no dermatological training and many in-patients have to apply their own treatments.”

The effect of the psychological, social and physical burden borne by patients with psoriasis is considerable. Indeed the emotional impact of psoriasis is such that as many as one in ten patients contemplate suicide, especially those of younger age.

However, the survey revealed that clinical psychology services were available for adults and children in only around 40 percent of units.

Dr Holden said: “The cumulative effect of the psychological, social and physical burden borne by patients with chronic skin diseases, such as psoriasis, is considerable and clinical psychology services should be much more widely available for dermatology patients.”

3. Treatments

Conventional treatments for psoriasis include phototherapy (treatment with ultraviolet light), as well as tar preparations and a medication called dithranol, which are both applied to the skin. According to the survey, thirty-eight percent of units would consider using more crude coal tar and forty-six percent more dithranol if facilities were staffed by trained nurses, as skill and expertise are needed to apply and remove such treatments. Scalp treatments were not provided in a quarter (26%) of units. Over one third of pharmacies could not readily provide coal tar or dithranol preparations.

In 95% of units, a medical physicist monitored the UV output of the phototherapy equipment. It is mandatory that the UV output of phototherapy machines is monitored by a medical physicist- the safety of patients is compromised in those units (5%) without such arrangements.

According to Dr Holden: “Old fashioned treatments such as dithranol or tar are safe, effective and relatively cheap, albeit messy. Coal tar and dithranol still have a place in the management of some patients with psoriasis - both outpatients and inpatients - but units should invest in trained nurses and pharmacies to apply and supply the treatments respectively. Scalp psoriasis is particularly problematic for some patients, but a quarter of units denied patients the opportunity of outpatient scalp treatment.”

Advances in our understanding of psoriasis in the last two decades have emphasised the importance of the immune system in the development and maintenance of plaques of psoriasis. This has led to the development of a range of new therapies known as the ‘biologics’, which target the disease in the immune system rather than treating the symptoms. Evidence from large randomized, controlled trials demonstrates that biologic therapies significantly reduce the physical severity of psoriasis and improve quality of life. Biologic therapies seem likely to play an increasingly important part in the treatment of chronic inflammatory skin diseases such as psoriasis.

However, thirty-nine percent of units stated that prescribing of biologics for psoriasis was restricted for financial reasons. Dr Holden said: “This somewhat exposes the myth of one NHS for all. Patients are experiencing a ‘postcode lottery’ for biologics in the treatment of psoriasis, where there are wide differences in availability of the drugs. This is similar to the differing prescription charges across the borders.”

Dr Holden concluded: “Apart from feeding back to the individual hospital trusts we plan to feed key findings from this audit to parliamentary bodies. We will work with patient support groups to bring organizational deficiencies to the doorstep of the government.”

Chief Executive of the Psoriasis Association Gladys Edwards said: “The Psoriasis Association welcomes this much needed, long overdue initiative to clarify the treatment people with psoriasis are receiving. Sadly this report indicates that services for people with psoriasis, in many areas, falls short of acceptable standards. This report clearly highlights where there is room for improvement and we look forward to working with the BAD to emphasise the problems and ensure that people with psoriasis get a better deal in future.”

David Chandler, psoriasis patient and Chief Executive of the Psoriasis and Psoriatic Arthritis Alliance, said: "The report supports anecdotal evidence from those that contact us about the inconsistencies of treatment and facilities in the UK. Living with a disease that affects you 24 hours a day, 365 days a year is depressing enough, but to then find out that if you lived in a different location you would get better care is just an added burden."

-ends-
Notes to editors:

Spokespeople and report authors available for interview on request.

Click here to see the full report (775KB). Study details: “An audit of provision of dermatology services in secondary care in the United Kingdom with a focus on the care of people with psoriasis”, commissioned by the British Association of Dermatologists, conducted by the British Association of Dermatologists and the Clinical Effectiveness and Evaluation Unit, Royal College of Physicians. Responses from 100 units in England, Scotland, Wales and Northern Ireland were received between February and August 2007 and the national report compiled in January 2008.

The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.

The Royal College of Physicians is a registered charity that aims to ensure high quality care for patients by promoting the highest standards of medical practice. It provides and sets standards in clinical practice and education and training, conducts assessments and examinations, quality assures external audit programmes, supports doctors in their practice of medicine, and advises the Government, public and the profession on health care issues. The RCP Clinical Standards Department produces guidelines and clinical audits, working closely with specialty societies and other organisations in the field to improve patient care.

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Resin from spruce tree can help skin disease
For immediate release 15.02.08

A traditional Finnish folk medicine concoction of resin from the Norwegian spruce tree mixed with salt-free butter has been found to be effective at treating severe pressure ulcers, new research in the British Journal of Dermatology will reveal.

Resin salve treatment has been used for centuries in Finnish Lapland as self-care in treatment of wounds and skin ulcers. However, until now reports on its efficacy have been merely anecdotal and no formal testing has been done.

A team of scientists in Finland therefore conducted a study of 22 patients with a total of 29 severe pressure ulcers – open sores caused by pressure or friction and common in people who have reduced mobility, perhaps due to long term bed-rest or old age.

They compared the effect of the traditional resin salve with a control of ‘sodium carboxymethylcellulose hydrocolloid polymer’, an accepted treatment for pressure ulcers. Both treatments were accompanied by dressings, which were changed either daily or every three days depending on the level of infection.

During the six month treatment period, all ulcers healed in 92 percent of the resin group, compared to just 44 percent of the control group. Also, the speed of ulcer healing was significantly faster in the resin group. Furthermore, the resin salve was found to be more effective at reducing the size and healing the ulcer as well as reducing the bacteria present.

Interestingly, the superior effect of the resin salve only showed after three months of treatment. The team therefore think that as well as its antimicrobial qualities, the resin salve may also induce cell and tissue regeneration, suggesting it does not just fight infection but actively encourages healing as well.

According to the study, the resin has significant antibacterial activity against certain skin bacteria, including MRSA, and also has antifungal properties.

Dr Arno Sipponen, one of the researchers, said: “This study has documented a statistically significantly better healing rate of severe pressure ulcers among patients who were treated with a traditional resin salve than among those who were treated conventionally with a ‘modern’ option considered to be the most available treatment at present.”

The study’s authors estimate that as many as a third of people in acute or long-term care develop pressure ulcers. A previous study* estimated that the cost of pressure ulcers in the UK is between £1.4 billion and £2.1 billion annually – four percent of total NHS expenditure.

Nina Goad of the British Association of Dermatologists said: “Pressure ulcers can be very difficult to treat, and cause great pain and discomfort to the patient. The disorder basically involves having a large open wound that will not heal and can become infected.

“Unfortunately current treatments aren’t always successful, so any advances that could lead to new therapies are worth investigating. It will be interesting to see what larger, follow-up studies into resin reveal.”

By simply using a sharp knife, the resin was collected from the trucks of Norway spruce trees in Finnish Lapland, and prepared in the traditional way by mixing it with salt-free butter, boiling the concoction and allowing it to cool to form a salve.

Pressure ulcers particularly affect people with mobility problems and people with poor diets who are malnourished. Diabetes, certain drugs and smoking also increase the risk.

-Ends-
Notes to editors:

1. If using this information, please ensure you mention that the study is being released in the British Journal of Dermatology, the official publication of the British Association of Dermatologists.

2. Articles in the BJD can be viewed online: http://www.blackwell-synergy.com/loi/BJD
Study details: British Journal of Dermatology, est. publication date March 2008, “Beneficial effect of resin salve in treatment of severe pressure ulcers: a prospective, randomized and controlled multicentre trial.” A. Sipponen, J.J. Jokinen*, P. Sipponen¹, A. Papp², S. Sarna³, J. Lohi ‡;

Dept of Surgery, Rheumatism Foundation Hospital, Heinola, Finland; *Dept of Cardiothoracic Surgery, Helsinki University Hospital, Finland; ¹Divisision of Pathology, Helsinki University Hospital, Finland; ²BC Professional Firefighters’ Burn Unit, Vancouver General Hospital, Canada; ³Dept of Public Health, University of Helsinki, Finland; ‡Rovaniem Health Care Centre, Finland. DOI: 10.1111/J.1365-2133.2008.08461.X

3. *Statistics relating to cost of pressure ulcers in the UK can be found in: Age and Ageing 2004; 33: 230-235, “The cost of pressure ulcers in the UK”, Gerry Bennett*, Carol Dealey² and John Posnett³; *Barts and the London, Queen Mary’s School of Medicine and Dentistry, London, UK; ²School of Health Sciences, University of Birmingham and University Hospital Birmingham NHS Trust, UK; ³University of York and Smith & Nephew Wound Management, Hull, UK

The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.

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Pepper could hold answer to vitiligo treatment
For immediate release 14.02.08

Black pepper could provide a new treatment for the skin disease vitiligo, groundbreaking new research in the British Journal of Dermatology will reveal.

Vitiligo is a condition in which areas of skin lose their normal pigment and so become white. It is common, and affects about one in every hundred people. It is of particular concern in people with darker skins. Current treatments include corticosteroids applied to the skin, and phototherapy using UV radiation (UVR) to re-pigment the skin. Both, however, carry possible long-term side effects and are not always effective. In particular, less than a quarter of patients respond successfully to corticosteroids, while UVR causes a re-pigmentation that is spotted and patchy and in the long-term could lead to a higher risk of skin cancer.

But now a team of scientists at King’s College London have discovered that piperine - the compound that gives black pepper its spicy, pungent flavour - and its synthetic derivatives can stimulate pigmentation in the skin, especially when combined with UVR treatment.

The researchers compared the effects of piperine and its analogues tetrahydrpiperine (THP), cyclohexyl analogue of piperine (CHP) and reduced CHP (rCHP) when applied to the skin of mice, either alone or followed by UVR. Treatment was also interrupted in certain groups to see how long-term the effects would be.

While CHP did not show significant results, piperine, THP and rCHP did induce pigmentation in the skin. Used alone, the compounds stimulated pigmentation to an even, light brown colour within six weeks.
However, by accompanying use of piperine or THP with UVR, the skin became significantly darker, and within only seven weeks. Furthermore, the pigmentation was even, compared to the patchy pigmentation caused by UVR treatment alone.

The researchers also found that for skin treated with a piperine compound, just four exposures of UVR were sufficient to significantly darken the skin. However, when using UVR alone, more than 10 exposures were needed to produce a similar but less even response.

The results also took longer to fade in those treated with both a piperine compound and UVR, and did not disappear completely. By contrast, there was no remaining detectable pigmentation within the same timeframe for skin treated only with UVR.

Additionally, when treatment was resumed, results were noticeable faster in the group treated with piperine compounds.

The team believe that their remarkable findings are due to piperine stimulating the production of the skin’s pigment cells, called melanocytes.

Lead investigator and Associate Professor, Oregon Health & Science University, USA, Dr Amala Soumyanath said: “This is an important step in a multidisciplinary drug discovery program. We have moved from testing plant extracts in pigment cell cultures, to identifying active natural compounds and designing novel chemical analogues, and now confirmed activity of these compounds in whole animals. Our next goal is to move the work to humans through safety studies and clinical trials.”

Professor Antony Young, Photobiologist at St John’s Institute of Dermatology, King’s College London, and another of the study’s authors, said: “We have shown that topical treatment with piperine stimulates even pigmentation in the skin. Combining this with UVR significantly enhances the pigmentation with results that are cosmetically better than conventional vitiligo therapies. This provides strong support for the future clinical evaluation of piperine and its derivatives as novel treatments for vitiligo.”

Nina Goad of the British Association of Dermatologists said: “These findings could potentially lead to the development of treatments that not only provide improved results, but could also reduce the need for UV radiation in vitiligo treatment, in turn lowering the risk of skin cancer.

“Vitiligo is a highly visible disease that can greatly affect patients psychologically and emotionally. Any breakthrough in treatments of this disease is most welcome.”

-Ends-

2. Articles in the BJD can be viewed online: http://www.blackwell-synergy.com/loi/BJD
4. Study details: “In vivo evaluation of piperine and synthetic analogues as potential treatments for vitiligo using a sparsely pigmented mouse model”, L. Faas*, R. Venkatasamy*, R.C. Hider*, A.R. Young², A. Soumyanath*; DOI 10.1111/J.1365-2133.2008.08464.X; expected publication March 2008
*Department of Pharmacy, King’s College London; ²St John’s Institute of Dermatology, Guy’s Hospital, London

The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.

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Quote from Dr Colin Holden, President of the British Association of Dermatologists, re. virus linked to skin cancer (see PA story below)
For immediate release 17.01.08

"Merkel cell cancer is rare but very serious type of skin cancer which has a poor prognosis. Any hint of what causes it would help identify possibilities for medical treatment and perhaps preventative measures. The research is sophisticated and exciting that may be applicable to other skin cancers." Dr Colin Holden, President of the British Association of Dermatologists

PA story: Embargoed to 1900 Thursday January 17
NEW VIRUS LINKED TO DEADLY SKIN CANCER
By John von Radowitz, PA Science Correspondent

Scientists have linked a newly discovered virus to a rare but deadly form of skin cancer.
Merkel cell carcinoma (MCC) is a highly aggressive disease which develops in the nerve cells that respond to touch.
It spreads rapidly to other tissues and organs, killing two thirds of its victims within five years.

Researchers today reported that a previously unknown virus, named Merkel cell polyomavirus (MCV), is closely associated with the disease.

While they cannot yet confirm that MCV triggers the cancer, other members of the polyomavirus family have been shown to cause cancers in animals for more than 50 years.

MCV shares some of the characteristics of human papilloma virus (HPV) which is responsible for cervical cancer.
Scientists in Pittsburgh, US, took almost 10 years to track down the virus.

They made the discovery by analysing nearly 400,000 genetic sequences from four samples of MCC tumour tissue. These were then compared with gene sequences from the complete genetic code book mapped by the Human Genome Project.
Subtracting the known human sequences left the genetic thumb print of the new polyomavirus.

Professor Patrick Moore, from the University of Pittsburgh School of Medicine, who led the research, said: "This is the first polyomavirus to be strongly associated with a particular type of human tumour. Although polyomaviruses have been studied in relation to cancer development for years, the weight of scientific evidence had been leaning toward the view that these viruses do not cause human cancers.

"If these findings are confirmed, we can look at how this new virus contributes to a very bad cancer with high mortality and, just as importantly, use it as a model to understand how cancers occur and the cell pathways that are targeted. Information that we gain could possibly lead to a blood test or vaccine that improves disease management and aids in prevention."
MCC and three other rare cancers together make up about 1% of the 67,500 cases of skin cancer diagnosed in the UK each year.

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Quote from Nina Goad of the British Association of Dermatologists, re. skin cancer stem cell research (see PA story below)
For immediate release 16.01.08

"Stem cells involved in cancer can prove elusive, so discovering those that may cause melanoma could be an important breathrough, especially if this leads to treatments that could target the damage caused by these cells. Melanoma is the deadliest type of skin cancer, killing 2000 people every year in the UK alone, so research developments in this area are most welcome." Nina Goad of the British Association of Dermatologists

PA story, Embargoed to 1800 Wednesday January 16

HOPES FOR NEW SKIN CANCER TREATMENTS WITH STEM CELL DISCOVERY

By John von Radowitz, PA Science Correspondent

Rogue stem cells that trigger and fuel malignant skin cancer have been discovered, paving the way to new treatments.

Stem cells, unspecialised "mother" cells that can develop along different pathways, are thought to be the driving force behind many cancers.

Their ability to resist treatment is thought to make some tumours especially dangerous. However, only a
handful of cancer stem cells have been found so far.

Stem cells for malignant melanoma, a deadly form of skin cancer and one of the most aggressive cancers
known, have now joined the list.

They were identified by a team of international scientists led by Dr Markus Frank, from Harvard Medical School in Massachusetts, US.

The elusive stem cells were recognised by their ability to produce high levels of a protein called ABCB5. The protein helps pump drugs out of cells, making them resistant to chemotherapy.

Tumours containing the stem cells grew faster and spread more quickly than those without, the scientists reported in the journal Nature.

Transplanted into immunodeficient mice, ABCB5-producing cells from human melanomas triggered many more melanomas than those not producing the protein.

The cells also divided into separate subtypes, a behaviour typical of stem cells.

Mice treated with an antibody that neutralised the protein produced tumours that grew far more slowly.

The researchers hope human versions of the same antibody might prove an effective treatment for melanoma.

They wrote: "Identification of tumour-initiating cells with enhanced abundance in more advanced disease but susceptibility to specific targeting ... has important implications for cancer therapy."

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Eco lightbulbs may cause reactions in patients with light sensitive skin diseases
For immediate release 03.01.08

ENVIRONMENTALLY friendly light bulbs are causing a rash of skin complaints, a group of charities have warned.

Thousands of people will be unable to use electric light in their own homes, visit family and friends, or have access to employment and public services if the government’s ban on incandescent lighting goes ahead without exemptions.

The stark warning has been issued by SPECTRUM, an alliance of charities working with people with light sensitive conditions.

The government wants to ban traditional, incandescent bulbs by 2011, but the new, energy-saving variety produces a more intense light and can exacerbate a range of existing skin problems. Currently, the government has made no allowances for those with light sensitive conditions who often suffer severe and painful reactions to fluorescent lighting and other forms of non-incandescent lighting.

SPECTRUM is therefore running a campaign to raise awareness of the impact on people’s health in response to the government decision to ban incandescent light bulbs. They claim as many as 350,000 people could be affected.

Andrew Langford, chief executive officer of the Skin Care Campaign, one of the charities involved, said: “Incandescent light bulbs are the only source of electric light for many thousands of people with light sensitive conditions. Add to this the thousands of people whose conditions or treatments may secondarily cause them to be light sensitive, and you have a large number of people potentially being isolated in the dark.

“The government simply must allow incandescent light bulbs to be available to these people, their families, friends and employers, and at a fair price.”

Dr Colin Holden, President of the British Association of Dermatologists, said: “It is important that patients with photosensitive skin eruptions are allowed to use lights that don't exacerbate their condition.

“Photosensitive eruptions range from disabling eczema-like reactions, to light sensitivities that can lead to skin cancer. It is essential that such patients are able to protect themselves from specific wavelengths of light emitted by fluorescent bulbs, especially as they are often trapped indoors because they can't venture out in natural sunlight.”

SPECTRUM is urging the government to maintain the availability of incandescent light bulbs purely to those who affected, which will enable the protection of the environment without penalising those unable to live with fluorescent lighting. One option could simply be to allow the purchase of environmentally-friendly, energy efficient incandescent light bulbs which GE Consumer and Industrial is currently developing and hopes to market in 2010.

SPECTRUM argues that the total social exclusion for thousands of vulnerable, sick and disabled people, resulting from an unconditional ban, would contradict many other policies of the government, including Disability Equality Duty, which came into force on 4 December 2006, and the Green Paper on Welfare Reform published in January 2006.

-ends-

Note to editors:

Comprising a group of charities, SPECTRUM brings together the Skin Care Campaign, Lupus UK, Eclipse Support Group, ES-UK and the XP Support Group. SPECTRUM works with people with health conditions that can result in some form of light sensitivity. These conditions include the autoimmune disease Lupus, Xeroderma Pigmentosum, Albinism, Polymorphic light eruption, Vitiligo, Actinic prurigo, and certain forms of eczema and dermatitis.

For more information, please contact:Carys Thomas Ampofo, Ash Healthcare (for Skin Care Campaign and SPECTRUM), 0207 734 5666, Carys@ashcommunications.com

For more information please contact Nina Goad, British Association of Dermatologists, 0207 391 6355, comms@bad.org.uk

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web master

New research finds way to restore colour to white hair following illness For immediate release, 13.11.08

New skin disorder caused by mobile phones discovered For immediate release, Thursday October 16th 2008

Bacteria in spring water could hold key to eczema treatment For immediate release, September 8th 2008

Research questions inequality of skin cancer monitoring for transplant patients For immediate release, September 3rd 2008

Medical students receive inadequate training in one of commonest specialties For immediate release July 3rd 2008

One in 17 under-16s use sunbeds, study reveals For immediate release July 2nd 2008

Dermatologists to hold UK’s largest mole check event For immediate release, June 2nd 2008

Washing powders not cause of eczema, study confirms For immediate release, 21.05.08

Warning from dermatologists as UK children have Europe’s highest skin cancer rates For immediate release, 02.05.08

Tomatoes found to fight sun damage For immediate release 28.04.08

Brits unaware of skin cancer risk, new survey reveals For immediate release 04.04.08

Traditional Chinese herbal medicine may benefit eczema patients For immediate release 12.03.08

If in doubt, check it out! Sun Awareness 2008 launched For immediate release, 10.03.08

Link between psoriasis and obesity gene For immediate release, 20.02.08

Survey reveals major discrepancies in care of patients with psoriasis For immediate release 18.02.08

Resin from spruce tree can help skin disease For immediate release 15.02.08

Pepper could hold answer to vitiligo treatment For immediate release 14.02.08

Quote from Dr Colin Holden, President of the British Association of Dermatologists, re. virus linked to skin cancer (see PA story below) For immediate release 17.01.08

Quote from Nina Goad of the British Association of Dermatologists, re. skin cancer stem cell research (see PA story below) For immediate release 16.01.08

Eco lightbulbs may cause reactions in patients with light sensitive skin diseases For immediate release 03.01.08

New research finds way to restore colour to white hair following illness
For immediate release, 13.11.08

New skin disorder caused by mobile phones discovered
For immediate release, Thursday October 16th 2008

Bacteria in spring water could hold key to eczema treatment
For immediate release, September 8th 2008

Research questions inequality of skin cancer monitoring for transplant patients
For immediate release, September 3rd 2008

Medical students receive inadequate training in one of commonest specialties
For immediate release July 3rd 2008

One in 17 under-16s use sunbeds, study reveals
For immediate release July 2nd 2008

Dermatologists to hold UK’s largest mole check event
For immediate release, June 2nd 2008

Washing powders not cause of eczema, study confirms
For immediate release, 21.05.08

Warning from dermatologists as UK children have Europe’s highest skin cancer rates
For immediate release, 02.05.08

Tomatoes found to fight sun damage
For immediate release 28.04.08

Brits unaware of skin cancer risk, new survey reveals
For immediate release 04.04.08

Traditional Chinese herbal medicine may benefit eczema patients
For immediate release 12.03.08

If in doubt, check it out! Sun Awareness 2008 launched
For immediate release, 10.03.08

Link between psoriasis and obesity gene
For immediate release, 20.02.08

Survey reveals major discrepancies in care of patients with psoriasis
For immediate release 18.02.08

Resin from spruce tree can help skin disease
For immediate release 15.02.08

Pepper could hold answer to vitiligo treatment
For immediate release 14.02.08

Quote from Dr Colin Holden, President of the British Association of Dermatologists, re. virus linked to skin cancer (see PA story below)
For immediate release 17.01.08

Quote from Nina Goad of the British Association of Dermatologists, re. skin cancer stem cell research (see PA story below)
For immediate release 16.01.08

Eco lightbulbs may cause reactions in patients with light sensitive skin diseases
For immediate release 03.01.08