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In This Issue of JAMA Dermatology
February 2015

Highlights

JAMA Dermatol. 2015;151(2):115. doi:10.1001/jamadermatol.2014.2901
Research

Cancer worry is an emotional reaction to the threat of cancer, and it is unclear whether cancer worry is beneficial or detrimental to screening behaviors. In this pretest-posttest study, Moye et al evaluated patients with atypical mole syndrome before and after they underwent total-body digital photography (TBDP) and found low baseline levels of melanoma-related worry. The TBDP was a clinically useful tool that pigmented lesion clinics can use to help decrease worry about developing melanoma in at-risk patients.

Editorial

Atopic dermatitis (AD) is a chronic pruritic skin disorder with an increasing prevalence rate that mirrors the increasing prevalence rate of obesity during a similar timeframe. Atopic dermatitis is associated with multiple potential risk factors for obesity and high blood pressure (BP), including chronic inflammation, sleep disturbance, and mental health comorbidity. In this observational case-control study, Silverberg et al uncover several new associations related to metabolic issues in children with AD, particularly related to central obesity and elevated BP. The mechanism of association between obesity and AD remains unknown. These data suggest that pediatric patients may benefit from routine adiposity and BP screening.

Invited Commentary

Hypertension is prevalent among patients with psoriasis and is an important modifiable cause of premature morbidity and mortality from cardiovascular disease. In this population-based cross-sectional study, Takeshita et al demonstrate a significant positive dose-response relationship between objective measures of psoriasis severity and uncontrolled hypertension. The mechanisms underlying poor BP control among patients with psoriasis remain poorly understood. The effect of psoriasis therapy on coexisting hypertension and whether improving hypertension management affects psoriasis severity are topics that merit further study.

Tyrosine kinase inhibitors (TKIs) have emerged as important antineoplastic therapies that provide better molecular selectivity in tumor cell death than conventional chemotherapy. These agents offer renewed hope for effective cancer therapy with reduced toxic effects. Cabozantinib S-malate is an antiangiogenic and antitumorigenic TKI with potential efficacy against several cancers. Cutaneous reactions are some of the most frequently observed adverse effects associated with TKIs, and in this observational study, Zuo et al demonstrate that most patients experience cutaneous adverse effects from treatment. Cabozantinib treatment is typically of longer duration than conventional chemotherapy, and early detection and management of adverse effects may increase patient adherence to therapy.

Continuing Medical Education

Keratosis pilaris (KP) is a common skin disorder of follicular prominence and erythema that typically affects the proximal extremities. Available topical therapies offer limited benefit, so less conventional strategies have been explored. In this randomized clinical trial, Ibrahim et al demonstrate that 3 treatments with 810-nm diode laser induced significant improvements in skin texture and roughness/bumpiness in patients with KP, but erythema was not improved. Complete treatment of erythema and texture in KP may require diode laser treatment combined with other laser or medical modalities.

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