This week in aesthetics, researchers investigate how patients with alopecia areata and thyroid health were related, Dustin Portela, DO, explains what hidradenitis suppurativa is and watches TikTok videos of patients experiences, and Allergan and SkinBetter Science use their DREAM initiative to support the development and distribution of a new atlas.

Patients with Alopecia Areata at Increased Risk of Thyroid Disease

Investigators also found that patients with alopecia areata were also had significant inflammatory immune injury and vitamin D deficiency when compared to healthy subjects.

Portela: What is Hidradenitis Suppurativa?

In this week’s Pointers with Dr Portela, the 208SkinDoc watches several TikTok videos in which creators share their experience with hidradenitis suppurativa.

The two companies are using their DREAM initiative to support the diverse dermatology index.

Articles

This week in aesthetics, we highlight this week’s “Pointers With Dr Portela”, alopecia areata patients risk of thyroid disease and more. 

This Week in Aesthetics: October 11-15

Allergan Aesthetics, an AbbVie company, and SkinBetter Science announced in 

 that they used their DREAM (Driving Racial Equity in Aesthetic Medicine) initiative to support the development and distribution of the “The Full Spectrum of Dermatology: A Diverse and Inclusive Atlas.” This dermatology atlas will display images of the most-seen dermatology conditions in an array of skin tones.

The goal of the full-color atlas is to advance education among physicians, with the intent to visually teach dermatologists, dermatology residents, and other clinicians to recognize various skin conditions in different skin tones. This resource includes high-quality images taken by dermatologists trained in medical photography which provide side-by-side images of the most commonly seen dermatology conditions in a full spectrum of skin tones, according to the release.

The Atlas was developed by co-editors Misty Eleryan, MD, MS, a micrographic surgery and dermatologic oncology fellow at the University of California, in Los Angeles, and Adam Friedman, MD, professor and chair of dermatology at GW School of Medicine and Health Sciences, in Washington, DC, and published by SanovaWorks and Educational Testing & Assessment Systems.

"To effectively diagnose and manage skin diseases in all patients, dermatologists need to be fluent in the diverse array of clinical presentations of even the most common skin diseases in all skin tones," said Friedman. "The investment being made by leaders of our dermatology community and industry in this innovative project validates and highlights its extraordinary importance."

"As physicians, we take an oath to do no harm to our patients; we can now better live up to this oath for ALL of our patients, especially those with darker skin, by educating ourselves on the variations of presentations of common dermatoses on all skin tones," said Eleryan,

The Atlas received funding from both SkinBetter Science and Allergan Aesthetics as it aligned with the DREAM initiative and it will make copies available to all dermatology residents and program directors in the United States.

"Understanding the need for racial equity in all sectors of society, Skinbetter Science and Allergan Aesthetics, as part of their DREAM Initiative, supports the Atlas' efforts to advance the education of healthcare practitioners. This comprehensive collection of images is designed to better serve the full spectrum of skin tones--hopefully providing physicians and other healthcare practitioners the opportunity to advance diagnosis," said Jonah Shacknai, executive chairman of SkinBetter Science, in Irvine, California.

"The DREAM Initiative is committed to furthering the principles of racial and ethnic diversity, inclusion, respect and understanding in the fields of dermatology and plastic surgery. We're proud of the release of this Atlas and continue to work with SkinBetter Science to create meaningful, positive change within our own companies, and with our customers," said Carrie Strom, senior vice president, AbbVie and president, Global Allergan Aesthetics, in Phoenix, Arizona.

Contributing fellows and members of the Atlas Advisory Committee include:

1. Dream initiative releases, the full spectrum of dermatology: a diverse and inclusive atlas. Published September 29, 2021. Accessed October 11, 2021. https://www.prnewswire.com/news-releases/dream-initiative-releases-the-full-spectrum-of-dermatology-a-diverse-and-inclusive-atlas-301383427.html

Allergan and SkinBetter Science Support Inclusive Atlas

Dustin Portela, DO, a board-certified dermatologist and dermatologic surgeon at Treasure Valley Dermatology in Boise, Idaho, reviews what hidradenitis suppurativa (HS) is and watches videos of patients currently living with the condition.

This video is in response of a comment Portela had on a previous video, in which one of his viewers asked for more information on HS. He watches not only current patients, but also other physicians who help treat the condition. Want to learn more? Watch the video below.

Opinions expressed are that of Portela and do not express the views or opinions of Aesthetic Authority™.

Videos

Pointers With Dr Portela: What is Hidradenitis Suppurativa?

A recent investigation form China evaluated several immune and 

 in an attempt further understand the pathogenesis of the disease.

Though the etiopathogenesis of the disease was not established, investigators noted the importance of monitoring levels of triiodothyronine (T3), tetraiodothyronine (T4),), thyroid peroxidase antibodies (TPOAbs), and antinuclear antibodies (ANA) in patients with alopecia areata, considering them to be “indispensable”.

The team, led by Jing Gao, MD, Department of Dermatology, The Second Affiliated Hospital of Anhui Medical University in Hefie, referenced the myriad of theories regarding the pathogenesis of alopecia areata such as genetic factors, inflammation, and autoimmunity.

Among those, investigators believed autoimmune dysfunction was worth exploring in their study, as it was supported by a high rate of association between alopecia areata and other immune-mediated diseases such as 

In their study, the team discussed the variability of serum thyroid hormones and thyroid antibodies in patients with the disease.

Gao and colleagues set out to measure the levels of serum autoimmune and inflammation-related parameters including 25(OH)D, CRP, triiodothyronine (T3), tetraiodothyronine (T4), thyroid-stimulating hormone (TSH), thyroid peroxidase antibodies (TPOAbs), thyroglobulin antibodies (TGAbs), ANAs, complements (C3, C4), and immunoglobulins (IgA, IgM, IgG).

As such, a retrospective method was adopted for their research.

A total of 672 patients with alopecia areata who were treated at a third-class hospital in Hefei from January 2016 to May 2020 were included in the study. A total of 580 age- and sex-matched healthy subjects who were treated at the same hospital were also included.

Antibody kits for each serum autoimmune and inflammation-related parameter.

Additionally, 4 milliliters of fasting venous blood were drawn from each participant, before having serum ANA, IgA, IgM, IgG, and CRP determined by an enzyme-linked immunoassay (ELISA). Velocity Nephelometry was used to determine C3 and C4.

Gao and investigators found no statistically significant differences between TSH, TGAbs, C3, C4, IgA, IgM, and IgG levels between patients with alopecia areata and healthy controls.

However, T3, T4, TPOAbs, and ANA values were significantly abnormal in the former.

Serum T3 and T4 were significantly higher in AA patients (6.44 ± 4.5 nmol/L) than in the control group (2.23 ± 0.82 nmol/L), and the difference was statistically significant (

The frequency of TPOAbs was also significantly higher in the AA group (17.26%) than in the healthy control group (3.45%) (

 < 0.001), though the difference in TGAbs between the 2 groups was not statistically significant (

The positive rates of ANA in the AA and control groups were 38.74% and 14.17%, respectively, with the positive rate of ANA in the disease group being higher than that in the control group.

Gao and colleagues were not yet able to determine whether ANA was a risk factor for alopecia areata, despite being significantly related to the disease.

Despite this, alopecia areata was “strikingly associated” with higher T3 and TGAb levels, which they believed encouraged the act of monitoring thyroid function indexes to provide better prevention for patients with the disease.

Overall, Gao and investigators found that patients with alopecia areata were at a higher risk of thyroid disease and had significant inflammatory immune injury and vitamin D deficiency.

We believe that our results could provide valuable insights regarding the detection of immune and inflammation- related markers for future clinical research on AA,” the team wrote.

“Evaluation of several immune and inflammatory indicators and their association with alopecia areata,”

 was published online in the Journal of Cosmetic Dermatology.

This article was initially published by our sister publication

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This week in aesthetics, Will Kirby, DO, FAOCD, talks with Joe Niamtu, III, DMD, in this month’s “Meet the Aesthetic Expert”, Dustin Portela, DO, compares 3 different fluid sunscreens, and Coppertone issues a voluntary recall for 12 lots of its aerosol sunscreen.

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