News forum - In brief

Seaweed could protect against skin cancers
Chemicals contained within a type of brown seaweed could protect against skin cancers caused by UVB radiation. A US-led study investigating antioxidant brown algae polyphenols (BAP) found that applying them to the skin of hairless mice and adding them to their diet reduced the number of UVB-induced skin tumours by up to 60 per cent. In addition, tumours that did develop in BAP-treated mice were up to 43 per cent smaller than those in untreated mice.
Hwang H, Chen T, Nines RG et al. Int J Cancer 2006; 119: 2742-9

Characteristics of fast-growing melanomas
Fast-growing primary cutaneous melanomas occur more frequently in elderly men and people with fewer naevi and freckles, a study in Australia has found. Melanoma growth rates were assessed in 404 consecutive patients with invasive primary melanoma. Rapid growth was also associated with tumour thickness and mitotic rate; fast-growing tumours were more often symmetrical, elevated, amelanotic, regular in border and symptomatic. Nodular melanomas were found to be the fastest growing (median monthly rate 0.49mm).
Liu W, Dowling JP, Murray WK et al. Arch Dermatol 2006; 142: 1551-8

The impact of nurse-led care in dermatology
Faster access to treatment, reduced referrals and a better knowledge of their condition are benefits reported by patients that are associated with nurse-led care in dermatology, according to a review. The review found that nurses are treating a wide range of dermatological conditions, primarily using protocols, in a variety of clinical settings. However, some nurses in primary care lack confidence in treating some conditions and their educational needs are frequently unmet. But the authors say their results are generally positive, and also highlight reduced disease severity and more effective use of topical therapies as particular benefits associated with nurse-led care.
Courtenay M, Carey N. J Clin Nurs 2007; 16: 122-8

Recommendations for impetigo
A seven-day course of fusidic acid has been recommended first line for localised crusted impetigo by the authors of a treatment review. They advise using topical mupirocin only when the cause is MRSA. Other strategies, including topical neomycin, bacitracin and gramicidin, need further investigation, while there is insufficient evidence on topical antiseptics. The authors say there is also a lack of data to guide the management of extensive crusted or bullous impetigo, but suggest a seven-day course of oral flucloxacillin (or a macrolide if there is allergy) as an appropriate empirical choice.
Drug Ther Bull 2007; 45: 2-4

Psychological morbidity in atopic dermatitis
Adolescent males suffer greater mental distress associated with atopic dermatitis than females, the authors of a study in Norway have concluded. Self-reported mental distress was investigated among 4,384 girls and 4,433 boys aged 13–19 years. Girls reported more distress, atopic dermatitis, headache and neck or shoulder pain than boys, but the odds for reporting both mental distress and atopic dermatitis were higher for boys (OR = 2.1) than girls (OR = 1.3). The researchers say this indicates that boys perceive the condition as a heavier burden than girls.
Saunes M, Smidesang I, Holmen TL, Johnsen R. Br J Dermatol 2007; 156: 283-8

Finding a definitive treatment for warts
There is, as yet, no definitive therapy for common warts, according to a team of researchers from Iran. They undertook a placebo-controlled trial in which 30 patients were treated with 10% silver nitrate solution every other day for three weeks, and another 30 were treated with placebo (black ink). Treatment continued for another three weeks if lesions persisted. Complete regression of warts was achieved in 63 per cent of the silver nitrate group, with no significant side-effects. The researchers conclude that 10% silver nitrate solution can be used effectively in the treatment of warts.
Ebrahimi S, Dabiri N, Jamshidnejad E, Sarkari B. Int J Dermatol 2007; 46: 215-7

Clinical marker of past sunburn
Solar lentigos on the upper back and shoulders are generally considered to be a sign of solar-induced skin damage. A case-controlled study involving 145 cases and 145 matched controls from two outpatient clinics at French university hospitals appears to have confirmed this association. Recalled episodes of sunburn among participants were found to be independently associated with multiple solar lentigos, with odds ratios of 2.3 and 28.1 for moderate and severe sunburn, respectively. The researchers suggest that multiple solar lentigos could be used to identify people at higher risk of developing malignant melanoma. Derancourt C, Bourdon-Lanoy E, Grob JJ et al. Dermatology 2007; 214: 25-31

The healing power of insulin
Direct application of insulin to wounds can speed the healing process, researchers from the University of California, Riverside, have discovered. Topical insulin applied to skin wounds in rats resulted in epidermal cells covering the wound more quickly, with a faster rebuilding of underlying blood vessels. In vitro studies revealed that insulin stimulates proliferation of keratinocytes and the migration of keratinocytes and endothelial cells to wound tissue. The researchers, who presented their work at the 46th annual meeting of the American Society for Cell Biology, in San Diego, California, say insulin should be considered as a potential treatment for impaired wounds.
Liu Y, Yao M, Martins-Green M. Mol Biol Cell 2007; 17 (suppl): 74/B14; www.ascb.org/meetings/

Determining quality of life for family members

A patient’s quality of life can be measured using a variety of questionnaires. However, skin diseases are known to significantly impact on family members as well. Bearing this in mind, researchers at Cardiff University have developed a tool for assessing this secondary impact. The 10-item Family Dermatology Life Quality Index (FDLQI) has been validated and a strong correlation has been found between FDLQI scores achieved by family members and Dermatology Life Quality Index scores of patients. The researchers say their simple tool can be used as an additional outcome measure in practice and research. Basra MK, Sue-Ho R, Finlay AY. Br J Dermatol 2007; 156:528-38


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