Conference Highlights: American Academy of Dermatology 2018

Conference Highlights: American Academy of Dermatology 2018
New research was presented at AAD 2018, the annual meeting of the American Academy of Dermatology, from February 16 to 20 in San Diego. The features below highlight some of the studies presented at the conference.


Gene Expression Test Impacts Melanoma Management

The DecisionDX-Melanoma is a 31-gene expression profile (GEP) test designed to identify high-risk stage I and II melanoma patients based on biological information from 31 genes within their tumor tissue. For a prospective multicenter study, 247 stage I (181) and stage II (66) patients were enrolled at 15 dermatology, surgical oncology, and medical oncology centers. Participants had clinical management plans documented after their melanoma diagnosis and then underwent 31-GEP tests, after which changes in management plans were documented. DecisionDX-Melanoma resulted in a change in clinical management in nearly 49% of cases, with changes occurring most frequently in patients who were identified as being at high risk of metastasis.


Aggressive Skin Cancer Rates Skyrocketing

Merkel cell carcinoma (MCC) incidence rates are rising and strongly age-associated, relevant for an aging population. A team of researchers sought to determine MCC incidence in the United States and project incident cases through the year 2025. Registry data were obtained from the SEER-18 Database, containing 6,600 MCC cases. From 2000 to 2013, the number of reported solid cancer cases increased 15%, melanoma cases increased 57%, and MCC cases increased 95%. In 2013, the MCC incidence rate was 0.7 cases/100,000 person-years in the US, corresponding to 2,488 cases/year. MCC incidence increased exponentially with age, from 0.1 to 1.0 to 9.8 (per 100,000 person-years) among age groups 40-44 years, 60-64 years, and ≥85 years, respectively. Due to aging of the Baby Boomer generation, US MCC incident cases are predicted to climb to 2,835 cases/year in 2020 and 3,284 cases/year in 2025.


Acne More Harmful than Melanoma?

For the Global Burden of Disease Study, researchers evaluated 333 diseases and injuries in 195 countries and territories. Using 11,552 data sources from 2016, researchers divided more than 1,000 skin diseases into categories. the study’s primary unit of measurement was the disability-adjusted life-year, derived by combining the years of life lost with the number of years lived with disability. Inflammatory skin diseases were found to cause more harm than skin cancers when years of disability and mortality were added together. Overall, skin conditions accounted for 60 million disability-adjusted life-years, or approximately 2.5% of all evaluated diseases. A new system for ranking skin diseases by injury they cause may shift research priorities and change the way dermatologists see their patients.


Parents’ Views of Indoor Tanning

Prior research indicates that those who use indoor tanning beds are at an increased risk of  developing skin cancer, particularly young people. To investigate parents’ attitudes toward their children’s tanning behaviors, a team of researchers conducted a national survey of 1,205 parents of children aged 11-17. The responses indicated that fathers, parents who had used indoor tanning devices themselves, and those who reported that they had never received skin cancer prevention counseling from their child’s doctor were less likely to believe adolescent indoor tanning was harmful. Yet use of indoor tanning beds before age 35 can increase one’s risk of melanoma by 59%, a risk that increases with each use. According to this study, 45% of those who started tanning before the age of 16 did so with a family member.

Improving Hyperhidrosis in Children

Previous studies suggest that hyperhidrosis affects about 5% of the US population, with 17.1% of US teenagers reporting excessive sweating. In the randomized, vehicle-controlled ATMOS-1 and ATMOS-2 trials, patients with hyperhidrosis were assigned to a 4-week trial of topical anticholinergic glycopyrronium tosylate (GT)-containing towelettes. Use of the towelettes significantly decreased disease severity and sweat production and improved quality of life. A subgroup analysis showed that about 80% of pediatric patients with primary axillary hyperhidrosis had at least a 50% decrease in sweat production when using anticholinergic-containing towelettes. Overall, axillary sweat production decreased by two-thirds in children assigned to a 4-week trial of towelettes containing GT. The GT-containing wipes led to an 81% decrease in sweat production in the much larger group of adults enrolled in the trials.

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