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Microbiome modification mooted as a future treatment for metastatic melanoma patients

Dermatologists from Germany and the UK have called for more research into the so called “obesity paradox” in melanoma survival. Studies have shown that obesity at the onset of systemic treatment of metastatic melanoma is associated with improved survival rates in males compared to patients with a ‘normal’ BMI.

In a letter to the editor of the British Journal of Dermatology (BJD), the dermatologists have suggested that the gastrointestinal microbiome, the microorganisms in the gut which amongst other things break down food and protect us from germs, may be an important mechanism behind this apparent paradox. Several recent studies have reported that the gut microbiome may influence a patient’s response to immunotherapy, improving the effectiveness of treatment.

Twin studies have shown in the past that obesity is associated with a reduced overall gastrointestinal bacterial diversity. Subsequently the gut microbiome has been reported to potentially play an important role in the development of metabolic syndrome* and chronic inflammatory skin diseases, including psoriasis.

The authors of the BJD letter point to this as evidence that there is an important interaction between the various human microbiomes (skin and gut) and the immune system. However, more research is necessary to shed light on this.

If the link can be proven then it opens up the possibility of modifying the microbiome of individual metastatic cancer patients to improve their response to immunotherapies, thus increasing survival rates.

Dr Ewan Langan, one of the authors of the letter with joint affiliation to the universities of Manchester and Lübeck, said:

“At this stage we are working with limited data, long-term, prospective data is lacking. However, this is an intriguing field of study, and more research should be done to solve this “obesity paradox” in melanoma survival. If it can be solved then perhaps the answer can open up new approaches for the treatment of cancer.”

Matthew Gass of the British Association of Dermatologists said:

“An understanding of why men in the obese BMI category have better survival rates when it comes to the treatment of this advanced type of melanoma is important, and could lead to changes in how we treat this condition. With ever rising rates of skin cancer in the UK this call for more research is timely.

“This is not about the health benefits or risks of obesity, rather it is about understanding the mechanisms that mean some people respond better to treatments.”

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Notes to editors:

If using this press release, please ensure you mention that the research letter was published in the British Journal of Dermatology.

*Metabolic syndrome is the term used to describe a combination which can include diabetes, obesity, high blood pressure and high cholesterol.

For more information please contact the media team: comms@bad.org.uk, 0207 391 6084. Website: www.bad.org.uk

About us:
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. For further information about the charity, visit www.bad.org.uk
 

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Tired tropes in animated films reinforcing negative stereotypes of skin issues, according to new study

Animated films are falling into the trap of using skin disorders, blemishes, and wrinkles as a visual shorthand for negative traits, a study published in the British Journal of Dermatology claimed today.

The study found that 76.5 per cent of villainous characters or those with negative associations had any form of what the authors call dermatologic findings, this compares to 25.9 per cent of the characters meant to appear good. These dermatologic findings include a wide array of issues including scars, baldness, wrinkles, and moles.

The study analysed characters from the top 50 highest grossing animated films as of January 2017. The main protagonists and antagonists of each film were identified and examined for dermatologic findings. All animal characters were excluded from the analysis and four movies were excluded based on mechanical or robotic characters and one due to its PG-13 rating.

Two additional categories were used for characters that didn’t neatly fit into these clearly good or bad roles. Atypical protagonists were moral characters who also had attributes or roles with negative or evil connotations, such as being a caveman, thief, or vampire. In another cinematic context, these attributes would make them more likely to be villainous than good. Hidden antagonists were characters that initially presented as benevolent but were later revealed to have insidious motives when they betrayed protagonists.

Ninety-two per cent of the movies were released after the year 2000, and 50 per cent were released after 2010.

Previous studies have highlighted the same issue in prominent films of the 20th century and shown that notorious film villains have a statistically significant higher proportion of dermatologic findings compared to heroes.

Michael Ryan, one of the researchers from the University of Texas, said:

“The depiction of skin issues in movies and its association with evil over good could be a factor contributing to the stigma of skin disease. By repeatedly portraying protagonists as characters with flawless skin, there is the potential to cause distress in those whose appearance does not fit this unrealistic ideal.

“Real life examples of this can be seen in dermatology clinics where cosmetic treatments are performed to remove harmless moles, eliminate wrinkles, and alter many of the natural skin changes that develop with age and solar exposure. Societal perceptions and beliefs regarding beauty and youthfulness are likely underlying the desire for these treatments. The association between evil and skin findings in film could be one factor that contributes to these beliefs.”

Matthew Gass of the British Association of Dermatologists said:

“The animated films we watch as children tend to stick with us, with many of us being able to fondly recall our favourites with ease. We watch them in formative years when we are learning about good and evil, and whether they mean to or not, it’s likely that they impact our biases and associations.

“One thing that thing that we know is that the creators of these works are capable of producing emotional, nuanced, and thoughtful works. We hope that this means that they will be open to considering this research when making animated films in future.”

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Notes to editors:

For more information please contact the media team: comms@bad.org.uk, 0207 391 6084. Website: www.bad.org.uk

About us:
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. For further information about the charity, visit www.bad.org.uk

Dermatologic Depictions in Animated Movies BJD-2018-0144.R2

The abstract for this manuscript is as follows:

Background: Living with skin disease can be distressing for dermatology patients and can adversely affect their wellbeing. Inaccurate dermatologic depictions in media may contribute to this angst and reinforce the stigma of skin disease.

Objective: To determine if different dermatologic depictions exist among character categories in animated movies.

Methods: This cross sectional study examined major characters from the top 50 highest grossing animated movies and separated them into four categories based on roles. The metrics mean findings per character and proportion with one or more skin findings were compared between categories and tested for significance.

Results: Characters with villainous roles or negative attributes had a higher number of findings than characters meant to appear good. Only 25.9% of traditional protagonists and hidden antagonists had any skin findings at all and averaged 0.37 findings per character, while 76.5% of traditional antagonists and atypical protagonists had skin findings, averaging 1.56 findings per character (p< .0001).

Conclusion: Increased skin findings for evil characters in animated children’s movies can reinforce stigmas surrounding skin disease and may contribute to the distress felt by dermatology patients.
 

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Over half of people who have ever had acne feel it has affected their self-confidence

A new survey, released today to mark the launch of Acne Support (www.acnesupport.org.uk), shows that 54 per cent of British adults who have ever experienced acne feel that it has had a negative impact on their self-confidence, and 22 per cent feel that it has had a negative impact on their social interactions.

The Acne Support website, sponsored by Frezyderm, is the British Association of Dermatologists’ new flagship acne resource, providing information on acne types, causes, treatments, prevention, scarring, as well as emotional support, and practical tips for covering acne.

Acne, unlike most common skin conditions, doesn’t have a dedicated charity or patient support group offering advice to the public, even though 48 per cent of people reported having had acne*, and 19 per cent of adults 25 and older reported having had adult acne**. Because of this, misinformation is rife and many people, even those we severe forms of acne, are ignorant about effective treatments. When prompted with a list of treatments and remedies, 34 per cent of people didn’t know which were effective and safe acne treatments, of those that did provide an answer, 22 per cent picked the option ‘sweating it out’, a completely ineffective approach.

The website, developed by consultant dermatologists with an expertise in acne, features over 40 videos, covering every topic. These include videos filmed with top makeup artists and skin camouflage experts, explaining common mistakes people make when covering their acne and showing how best to do it.

Acne can have a significant impact on various aspects of people’s lives, which should not be underestimated or trivialised. To illustrate this, survey respondents were asked a series of ‘would you rather’ statements, to see how experiencing a month-long case of severe acne compared to other scenarios.

? 24 per cent would rather see their favourite sports team lose
? 15 per cent would rather see the party they voted for lose a general election
? 11 per cent would rather get a speeding ticket
? 10 per cent would rather forget a parent’s birthday
? 7 per cent would rather go over their overdraft by £500
? 5 per cent would rather a friend lost their job
? 3 per cent would rather be dumped by their partner

Amongst people who reported that they had had severe acne before, these statistics almost doubled across the board:

? 41 per cent would rather see their favourite sports team lose
? 28 per cent would rather see the party they voted for lose a general election
? 21 per cent would rather get a speeding ticket
? 20 per cent would rather forget a parent’s birthday
? 15 per cent would rather go over their overdraft by £500
? 11 per cent would rather a friend lost their job
? 7 per cent would rather be dumped by their partner

Dr Nick Levell, President of the British Association of Dermatologists, said:

“We launched the Acne Support website because there are so many people with acne out there who will never see a dermatologist, but who find many aspects of their lives are harder owing to this condition. We hope that this will help them.

“What we wanted to illustrate with this survey, is that for many people this is not a trivial condition, and that they need and deserve impartial, expert advice on how to manage their acne.

“Although it may be surprising to some people, for those with experience of severe acne, being acne-free can be more important than sports, politics, financial stability, even relationships in some cases. This shouldn’t be viewed as a weakness, or anything of the sort, rather it is an indication of quite how awful an experience it is for many.”

John Anastasiou, President and CEO of Frezyderm, said:

“As a condition which has an impact on how we look, acne can have a big emotional toll. If we are unhappy with our appearance then this can often spill into other areas of our lives, for example the 19 per cent of those who’ve ever had acne who felt that their acne had negatively affected their romantic relationships.

“What these people need is more information, to help them manage all aspects of the condition and understand what works for them. This is why we supported the development of this website, Acne Support is an impartial resource that people can trust, which will provide advice to people in need.”

About Acne

Acne is a very common skin condition characterised by comedones (blackheads and whiteheads) and pus-filled spots (pustules). It usually starts at puberty and varies in severity from a few spots on the face, neck, back and chest, which most adolescents will have at some time, to a more significant problem that may cause scarring and impact on self-confidence.

Acne can develop for the first time in people in their late twenties or even the thirties. It occasionally occurs in young children as blackheads and/or pustules on the cheeks or nose.

What causes acne?

The sebaceous (oil-producing) glands of people who get acne are particularly sensitive to normal blood levels of certain hormones, which are present in both men and women. These cause the glands to produce an excess of oil. At the same time, the dead skin cells lining the pores are not shed properly and clog up the follicles. These two effects result in a build-up of oil, producing blackheads (where a darkened plug of oil and dead skin is visible) and whiteheads.

The acne bacterium (known as Propionibacterium acnes) lives on everyone’s skin, usually causing no problems, but in those prone to acne, the build-up of oil creates an ideal environment in which these bacteria can multiply. This triggers inflammation and the formation of red or pus-filled spots.

Some acne can be caused by medication given for other conditions or by certain contraceptive injections or pills. Some tablets taken by body-builders contain hormones that trigger acne and other problems.

Acne can be associated with hormonal changes. If you develop unusual hair growth or hair loss, irregular periods or other changes to your body, then mention this to your doctor in case it is relevant.

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Notes to editors:

* Interestingly this is much lower than rates identified by clinical observations, though this could be to do with issues of self-reporting
** Adult acne refers to acne in people over the age of 25

All figures, unless otherwise stated, are from YouGov Plc. Total sample size was 2147 adults. Fieldwork was undertaken between 24th and 25th May 2018. The survey was carried out online. The figures have been weighted and are representative of all GB adults (aged 18+).

Acne Support is brought to you by the British Association of Dermatologists (BAD) to offer you expert, impartial advice on acne. Website: www.acnesupport.org.uk

For more information please contact the media team: comms@bad.org.uk, 0207 391 6084. Website: www.bad.org.uk

About us:
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. For further information about the charity, visit www.bad.org.uk

FREZYDERM was established in 1986 and is a respected brand name, currently present in 20 countries. We specialise in high quality dermoceuticals and medical device products which are created using the finest raw materials (of pharmaceutical grade). We invest more than 15% of our turnover in research and development (R&D) and our products are manufactured in our plant in Greece, where they also pass through stringent quality control checks. Our dermoceutical products aim to provide care to every skin type and relief from the symptoms of various skin conditions. Our range of products offers dermatologists the opportunity to recommend effective regimens to work synergistically with pharmaceutical therapies or on their own, tailored to each patient’s needs.

FREZYDERM's R&D studies oily and acne-prone skin and combines its findings with scientific data to create formulations for FREZYDERM’s Ac-Norm range. FREZYDERM Ac-Norm products are designed to target the symptoms of acne and provide optimum care for oily, acne-prone skin. With a wide range of products, Ac-Norm offers solutions and innovative regimens, tailored to each skin’s demands. The products can be used alongside prescribed acne medication or as part of an independent skincare regime. The line consists of cleansers, oil-regulating products, sunscreen protectors, lip care products and emollients. Our range for acne treatment can be used long-term and is suitable for every patient, including teenagers, pregnant women and breastfeeding mothers.

Acne can significantly affect our mood and quality of life. In FREZYDERM we understand the importance of using products designed for our own skin’s needs and avoiding products that will deteriorate skin conditions. We have designed the Ac-Norm range to cover each of your skin’s needs and therefore improve your quality of life through restoring your self-confidence.

To learn more about FREZYDERM and our acne products, please visit: https://www.frezyderm.co.uk
 

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