Falla en la armadura de MRSA

A chink in the armour of drug-resistant MRSA

Biochemists have found a compound that lowers the defences of drug-resistant strains of the bacterium Staphylococcus aureus — the leading cause of infections worldwide. Researchers screened around 45,000 candidates before alighting on MAC-545496, which shows promise against MRSA (methicillin-resistant S. aureus) in lab tests. Rather than acting as an antibiotic itself, MAC-545496 makes MRSA more vulnerable to attack by the immune system, and weakens its resistance to existing drugs.

Forbes | 5 min read 
Reference: Nature Chemical Biology paper 

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# Lunares y pelirrojo... más riesgo de melanoma.

Published in Dermatology

Journal Scan / Research · November 26, 2019

High Nevus Count and Red Hair Phenotype Contribute to Increased Risk for Melanoma

The British Journal of Dermatology

TAKE-HOME MESSAGE

• This study performed in Queensland, Australia, included 611 participants with a personal history of melanoma and 656 controls. Phenotypically, red hair, blue/grey eyes, fair skin, high freckling score, and high total nevus count >5 mm (TCN5) were associated with melanoma risk. When MC1R genotypes were examined, R alleles were significantly associated with both red hair and melanoma risk, while only the R/r combination was significantly associated with a high TNC5.

• The highest risk of melanoma was found in individuals with R/R genotype and >20 nevi (OR, 25.1) compared with those with <5 nevi and wild-type/wild-type genotype). This risk was greater than the additive effects of R/R genotype and TNC together, suggesting a synergistic effect on melanoma risk. The authors estimate an overall risk of melanoma by age 75 of 23.3% in men and 19.3% in women with R/R genotype and >20 nevi, compared with 6% and 4% in men and women in the general population.

Abstract

BACKGROUND

A high total body naevus count is the highest risk factor for melanoma; the phenotype of red hair colour, freckling and pale skin that burns easily, produced by MC1R R alleles, also predisposes to melanoma.

OBJECTIVES

To determine whether the known melanoma risk factors of high naevus count and red hair or MC1R R alleles act synergistically to increase melanoma risk.

METHODS

The Brisbane Naevus Morphology Study involved 1267 participants from volunteers presenting at a melanoma unit, dermatology outpatient clinic, private dermatology clinics, the Brisbane Longitudinal Twin Study and the QSkin Study. We examined pigmentation characteristics, total body naevus ≥ 5 mm count, and MC1R, ASIP and CDKN2A genotype in participants with and without a personal history of melanoma, living in Queensland, Australia, which is an area of high ultraviolet radiation.

RESULTS

Cases were older than controls (median 57 vs. 33 years). Compared with individuals with dark brown hair and zero to four naevi, individuals with red hair and ≥ 20 naevi had a melanoma odds ratio of 10·0 (95% confidence interval 4·2-24·3). Individuals with MC1R R/R genotype and ≥ 20 naevi (≥ 5 mm diameter) had a melanoma odds ratio of 25·1 (95% confidence interval 8·4-82·7) compared with wild-type (WT)/WT individuals with zero to four naevi. The highest risk group is Australian men with the MC1R R/R genotype and ≥ 20 moles, who have an absolute risk of melanoma to age 75 years of 23·3%, compared with 0·8% for men with the WT/WT genotype and zero to four naevi.

CONCLUSIONS

Patients who live in areas of high ultraviolet radiation, and have many large naevi and the red hair colour phenotype, particularly those with the MC1R R/R genotype, have a high risk of melanoma above the threshold recommended for screening in other cancers. Therefore, they should undergo intensive physician-led surveillance. What's already known about this topic? A high number of acquired melanocytic naevi, the red hair phenotype and MC1R R alleles all independently increase melanoma risk. Women with atypical naevi have an increasing melanoma risk gradient from darker hair to lighter hair. Women with many naevi have an increasing melanoma risk gradient from those with no elements of the red hair phenotype, to those with freckles but not red hair, to those with red hair. What does this study add? In Queensland, Australia, people with ≥ 20 naevi (≥ 5 mm diameter) and MC1R R/R genotype have a 25-fold increased melanoma risk, relative to people with zero to four naevi and the MC1R WT/WT genotype. In Queensland, individuals with ≥ 20 naevi and the MC1R R/R genotype have an absolute melanoma risk to age 75 years of 23·3% for men and 19·3% for women. This effect is independent of CDKN2A genotype. Further research is required to determine the effect of areas of lower ultraviolet radiation, as this study took place in the Queensland, Australia, which is an area of high ultraviolet radiation. MC1R R/r genotype is associated with increased total body naevus count but this is not the case for R/R. What is the translational message? Patients with many large naevi and the red hair colour phenotype, particularly those with an MC1R R/R genotype, have an unusually high risk of melanoma. In a high ultraviolet environment, this risk exceeds the threshold recommended for screening in other cancers, and such individuals should undergo intensive, regular, physician-led surveillance. Patients with many large naevi but with non-red colour hair may benefit further from clinical MC1R genotyping.

The British Journal of Dermatology

High Naevus Count and MC1R Red Hair Alleles Contribute Synergistically to Increased Melanoma Risk

Br J Dermatol 2019 Nov 01;181(5)1009-1016, DL Duffy, KJ Lee, K Jagirdar, A Pflugfelder, MS Stark, EK McMeniman, HP Soyer, RA Sturm 

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No vaping

Canada May Have Found New Vaping Complication: Popcorn Lung

By Kelly Young

Edited by Susan Sadoughi, MD, and Richard Saitz, MD, MPH, FACP, DFASAM

Canadian physicians may have identified a new type of lung injury linked to vaping. In CMAJ, they report a potential case of vaping-associated bronchiolitis obliterans, a form of which is known as "popcorn lung."

Previously, a number of workers in factories making microwave popcorn developed "popcorn lung" after inhaling the flavoring chemical diacetyl, which is also used in e-liquids.

An otherwise healthy, 17-year-old male with a history of heavy, daily vaping presented with cough, dyspnea, and fever. Tests for infectious agents were negative. Computed tomography revealed a diffuse tree-in-bud pattern, which differs from what has been observed in patients with e-cigarette, or vaping, product use associated lung injury (EVALI).

The patient developed refractory hypercapnia and required extracorporeal membrane oxygenation, but he improved with corticosteroids. He was hospitalized for 47 days and still had impaired lung function at 4 months.

Separately, a correspondence in the New England Journal of Medicinedescribes autopsy findings from a young man who died from untreated EVALI.

CMAJ article (Free)

CMAJ editorial (Free)

NEJM correspondence on pathology of vaping-related lung illness (Free)

NEJM correspondence on pulmonary illnesses (Free)

Background: Physician's First Watch coverage of bronchiolitis obliterans in man who ate microwave popcorn (Free)

NEJM E-Cigarettes and Vaping-Related Disease page (Free)

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Peeling de Retinol

Published in Dermatology

Journal Scan / Research · October 17, 2019

An Advanced, Physician-Strength Retinol Peel Improves Signs of Aging and Acne Across a Range of Skin Types

Journal of Drugs in Dermatology

TAKE-HOME MESSAGE

• In this study, two to four treatments of a 3% retinol peel formulation were administered to 24 patients at 6-week intervals. Patients had a variety of skin concerns, including sun-damaged skin, acne, and melasma. Patients with skin of color were included. All dermatologist-graded aging parameters (including fine lines, laxity, and pore size, among others) were significantly improved after four peels in the photodamage group. Acne and melasma were improved as well, but groups were too small to draw statistical conclusions.

• A superficial chemical peel with a 3% retinol formulation was well-tolerated and led to an improvement of a variety of skin concerns in a diverse patient population.

– Caroline Crabtree, MD

Abstract

BACKGROUND

Facial chemical peels are highly sought after by patients with photodamage, acne, and melasma. An advanced, physician-strength superficial peel, containing 3% retinol with other firming and volumizing ingredients was developed to exfoliate, improve the appearance of fine lines and wrinkles, and plump and firm skin, while promoting a bright, even complexion.

OBJECTIVE

A clinical study was conducted to evaluate the tolerability, safety, and efficacy of the 3% retinol peel with a supportive homecare regimen across a range of peel candidates, females aged 18-65 years, with photodamage, acne, hyperpigmentation or melasma, and skin of color, over a series of 2-4 peels. Method: The 3% retinol peel formulation was administered under physician direction in 6-week intervals. Subjects with photodamaged skin, acne, hyperpigmentation/melasma, or skin of color (Fitzpatrick skin types IV-VI) received 2-4 peels along with a supportive homecare regimen. Dermatologist grading, self-assessment, and digital photography documented tolerability and efficacy parameters.

RESULTS

24 subjects participated in the study with a total of 78 peels administered (Photodamage group, n=14 [with an Acne subgroup, n=5]; Melasma group, n=5; Skin of Color, n=5). The 3% retinol peel along with the homecare regimen was well tolerated under physician direction in all skin types and conditions assessed. Obvious peeling was noticeable in many subjects 3 days post-peel and resolved by day 7. In the photodamaged group, dermatologist clinical grading of fine lines, wrinkles, pore size, laxity, mottled pigmentation, lack of clarity/radiance, and overall photodamage was significantly improved (P<0.05). Benefits were observed in all groups and supported by self-assessment. Digital photography demonstrated tolerability in the days immediately post-peel, along with benefits to photodamage.

CONCLUSION

The 3% retinol superficial peel was well tolerated and an efficacious cosmetic treatment under physician supervision in subjects of all skin types to firm skin, improve fine lines and wrinkles, and promote a bright, even complexion.

Journal of Drugs in Dermatology

An Advanced, Physician-Strength Retinol Peel Improves Signs of Aging and Acne Across a Range of Skin Types Including Melasma and Skin of Color

J Drugs Dermatol 2019 Sep 01;18(9)918-923, N Sadick, BL Edison, G John, KL Bohnert, B Green 

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Manejo del acne en el contexto de Lupus

American Journal of Clinical Dermatology

pp 1–8| Cite as

The Safe Management of Acne Vulgaris in Lupus Erythematosus: A Systematic Review with Evidence-Based Treatment Recommendations

• Authors
• Authors and affiliations

• Mahtab Forouzandeh
• Andrea D. Maderal

1. 1.

Systematic Review

First Online: 07 September 2019

• 2Shares
 
• 68Downloads

Abstract

Background

To date, there have been no studies that have specifically investigated which medications can and cannot be safely used to treat acne vulgaris in patients who have lupus erythematosus (LE). These patients require a highly individualized treatment approach, as the use of certain acne medications may exacerbate LE symptomology, such as photosensitivity and hypercoagulability.

Objective

In this systematic review, we examine safety outcomes associated with commonly prescribed oral acne medications, specifically in the context of LE.

Methods

A literature search, conducted on PubMed/MEDLINE, revealed 146 studies, of which 13 met the criteria. We assigned a level of evidence to each study and sought to determine evidence-based recommendations for each class of drug; each recommendation was then assigned a corresponding grade.

Results

There were very few high-quality studies available on this topic. Although we determined recommendations based on the existing literature, the grading was occasionally unfavorable due to the low-quality nature of the evidence supporting the recommendation. However, our recommendation against the use of combined oral contraceptive pills and in favor of spironolactone for the treatment of acne, in the setting of LE, received a satisfactory grading (grade A).

Conclusion

While no definitive recommendations for the treatment of acne in LE can be made based on the existing quality and quantity of studies available, this article aims to provide a comprehensive overview and analysis of oral acne medication safety in patients with LE, while emphasizing the immense need for higher quality studies and distinct acne treatment guidelines for this vulnerable patient population.

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Mitosis en melanoma

Journal Scan / Research · November 14, 2019

The Prognostic Value of Tumor Mitotic Rate in Children and Adolescents With Cutaneous Melanoma

Journal of the American Academy of Dermatology

TAKE-HOME MESSAGE

• Mitosis (≥1/mm2) was seen in 104 of 156 patients (67%) aged < 20 years with clinically localized cutaneous melanoma, and it correlated with increasing Breslow thickness. With a median follow-up of 61 months, 5-year melanoma-specific and recurrence-free survival rates were 91% and 84%, respectively. Mitotic rate was a stronger predictor of survival outcome than Breslow thickness, and the only independent predictor of recurrence-free survival. 

• In children and adolescents with localized cutaneous melanoma, mitotic rate may be an important predictor of survival and aid in prognostic stratification and treatment planning.

– InYoung Kim, MD PhD

Abstract 

BACKGROUND

Mitotic rate is a strong predictor of outcome in adult patients with primary cutaneous melanoma but for children and adolescent patients this is unknown.

OBJECTIVE

To assess the prognostic value of primary tumor mitotic rate in children and adolescents with primary melanoma.

METHODS

Cohort study of 156 patients aged < 20 years with clinically-localized cutaneous melanoma. Patients <12 years were classified as children and those 12-19 years as adolescents. Clinicopathological and outcome data were collected. Recurrence-free and melanoma-specific survival were calculated. Univariable and multivariable analyses were performed using Cox proportional hazard models.

RESULTS

Thirteen of the 156 patients (8%) were children. Mitotic rate was ≥1/mm2 in 104 patients (67%) and correlated with increasing Breslow thickness. A positive sentinel node was found in 23 of the 61 patients (38%) who underwent sentinel node biopsy. Median follow-up was 61 months. Five-year melanoma-specific and recurrence-free survival were 91% and 84%, respectively. Mitotic rate was a stronger predictor of outcome than tumor thickness, and the only factor independently associated with recurrence-free survival.

LIMITATIONS

single institution, small sample size CONCLUSION: Mitotic rate is an independent predictor of recurrence-free survival in children and adolescents with clinically localized melanoma.

Journal of the American Academy of Dermatology

The Prognostic Value of Tumor Mitotic Rate in Children and Adolescents With Cutaneous Melanoma: A Retrospective Cohort Study

J Am Acad Dermatol 2019 Nov 01;[EPub Ahead of Print], NA Ipenburg, SN Lo, RE Vilain, LHJ Holtkamp, JS Wilmott, OE Nieweg, JF Thompson, RA Scolyer 

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Factores dieteticos y metabolicos en HS

Journal Scan / Review · November 14, 2019

Dietary and Metabolic Factors in the Pathogenesis of Hidradenitis Suppurativa

International Journal of Dermatology

TAKE-HOME MESSAGE

• The authors analyzed 25 studies to investigate the role of diet and metabolic factors in hidradenitis suppurativa (HS). Patients with HS were found to be four times more likely to be obese. Weight-loss interventions demonstrated improvement; however, there were some cases of worsening HS after surgical intervention.

• Particular interventions with some supporting evidence included supplementation of vitamin D, zinc, and vitamin B12 and exclusion of dairy and yeast. Additionally, managing malnutrition associated with weight-loss interventions is important, particularly after bariatric surgery.

– Caroline K. Crabtree, MD

Abstract 

Hidradenitis suppurativa (HS) is a systemic recalcitrant inflammatory condition characterized by debilitating lesions with high morbidity. Its known association with obesity and smoking indicate correlation with other environmental factors, such as diet, suggesting a larger role for lifestyle modifications in disease treatment. This study seeks to assess the contribution of weight loss and dietary intake in HS management. A primary literature search was conducted using PubMed, Web of Science, and CINAHL in November 2018 to include association and intervention studies on the influence of diet and weight on HS. Twenty-five articles were included. Meta-analysis of nine case-control studies across Asia, Europe, and the United States showed that HS patients are four times more likely to be obese compared to the general population; random effects pooled odds ratio 4.022 (2.667-6.065), P < 0.001. Five articles assessed weight-loss interventions and revealed mixed findings. The remaining articles included three association studies on micronutrient levels, eight dietary intervention studies, and one article analyzing both micronutrient association and dietary intervention. Included articles in this systematic review reveal that low serum zinc and vitamin D levels are associated with increased lesion count in HS. Supplementation of zinc, vitamin D, vitamin B12, or exclusion of dairy or brewer's yeast can be effective in partial or complete lesion resolution. Reviewed data show that weight loss from bariatric surgery may lead to HS improvement but often results in more severe malnutrition that worsens or even leads to new onset HS post bariatric surgery. Future reporting is needed to conclusively determine the role of diet in HS.

International Journal of Dermatology

Dietary and Metabolic Factors in the Pathogenesis of Hidradenitis Suppurativa: A Systematic Review

Int. J. Dermatol 2019 Oct 25;[EPub Ahead of Print], F Choi, L Lehmer, C Ekelem, NA Mesinkovska 

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Biotina, y ...

Journal Scan / Research · November 09, 2019

Consumer Perception of Biotin Supplementation

Journal of cutaneous medicine and surgery

TAKE-HOME MESSAGE

• To determine the perception of biotin by consumers, the Amazon reviews on the top 1% of biotin products (16 products) were analyzed in this study. The mean review score was 4.38. The mean percentages of reviews on biotin helping hair, nails, and skin were 27.2%, 15.03%, and 2.8%, respectively. There were no FDA warnings regarding the potential to interfere with laboratory results on the reviewed products, and this warning was referred to by 1 reviewer.

• Biotin supplementation is prevalent despite limited evidence of improvement. No mention of the FDA warning by the biotin manufacturers highlights the importance of physicians' role in public and patient education regarding biotin's potential for laboratory interference.

– InYoung Kim, MD, PhD

Dermatology

Written by

 

 

Peter A Lio MD, FAAD

Etiam capillus unus habet umbram suam.

(Even a single hair casts a shadow.)

-Publilius Syrus

Although dermatologists remain the undisputed experts on hair and nail disorders in addition to the skin, there is no doubt that hair loss, in particular, can be extremely daunting from both a diagnostic and therapeutic perspective. Biotin represents an inexpensive and relatively safe vitamin that is frequently recommended in situations that lack a more specific therapy or as an adjunctive treatment. It is widely available in numerous over-the-counter nutritional supplements that promise to support hair and nail growth despite the fact that it may not do much outside of a fairly narrow set of rare conditions.1 Importantly, although biotin deficiency is thought to be rare in healthy patients, one provocative study suggested that some 38% of women presenting with hair loss may be biotin-deficient on laboratory testing.2 Finally, although biotin may be suggested because it "can't hurt," more recent evidence suggests that it is not totally benign and can potentially cause issues by interfering with diagnostic laboratory tests, including those for troponin and thyroid.3

A recent publication found that, of those surveyed taking biotin, 57% reported no noted improvement in the condition they for which they were taking it.4 In this clever paper by John and Lipner, they take this a step further by studying customer reviews on the online marketplace Amazon.com for biotin supplements. Through this strikingly modern (and somewhat unconventional) approach to research, what they found is fascinating. There were over 2000 biotin products on the marketplace, so they focused on the 16 products in the top 1 percentile. The mean review score was a surprisingly positive 4.38 out of 5 stars, with over 27% of the reviews specifically stating that the biotin helped their hair. Remarkably, not a single product examined listed a warning about the ability of biotin to interfere with laboratory testing. Their conclusion supports the idea that biotin supplementation is extremely common and, despite the lack of robust scientific evidence, seems to be well-liked by the patients who are using it. As we move toward a world where patient-reported outcomes are looming larger and "customer satisfaction" has very much become a part of medicine, it is increasingly difficult to disregard such findings. As the authors suggest, further studies are clearly called for; but, in the meantime, education about the potential effects on laboratory testing is critical since clearly patients are taking biotin whether we recommend it or not.

References

1. Patel DP, Swink SM, Castelo-Soccio L. A review of the use of biotin for hair loss. Skin Appendage Disord. 2017;3(3):166-169. https://www.karger.com/Article/FullText/462981
2. Trüeb RM. Serum biotin levels in women complaining of hair loss. Int J Trichology. 2016;8(2):73-77. http://www.ijtrichology.com/article.asp?issn=0974-7753;year=2016;volume=8;issue=2;spage=73;epage=77;aulast=Tr%FCeb
3. Li J, Wagar EA, Meng QH. Comprehensive assessment of biotin interference in immunoassays. Clin Chim Acta. 2018;487:293-298. https://www.sciencedirect.com/science/article/abs/pii/S0009898118305394
4. John JJ, Cooley V, Lipner SR. Assessment of biotin supplementation among patients in an outpatient dermatology clinic. J Am Acad Dermatol. 2019;81(2):620-621. https://www.jaad.org/article/S0190-9622(19)30008-8/fulltext

Abstract 

BACKGROUND

Biotin is an essential cofactor for metabolic pathways in humans. It is frequently self-prescribed by consumers and often recommended by dermatologists and primary care physicians, despite limited evidence of its effect on skin, hair, and nail disorders. A recent Food and Drug Administration (FDA) warning stated that biotin can interfere with laboratory tests.

OBJECTIVES

Our objectives were to determine the perception of biotin by Amazon consumers, including perception of improvement in hair, skin, or nails with biotin supplementation and consumers' awareness of the FDA warning on biotin.

METHODS

The keyword biotin was searched on Amazon.com, and the top 1 percentile of biotin products according to average consumer review were analyzed for dosage, indications, price, quantity, warnings, number, and average score of reviews.

RESULTS

From 16 biotin products analyzed, the mean review score was 4.38. The mean percentage of reviews stating that biotin helped hair, nails, and skin was 27.2%, 15.03%, and 2.8%, respectively. No biotin products mentioned the FDA warning, and only 1 reviewer referenced the warning.

CONCLUSIONS

These findings suggest that biotin supplementation is prevalent and perceived as helpful despite limited evidence of improvement. The majority of biotin users were unaware that biotin interacted with laboratory testing demonstrating the need for biotin manufacturers to include a warning label about the FDA warning and for physicians to warn their patients on the risks and benefits of biotin supplementation.

Journal of cutaneous medicine and surgery

Consumer Perception of Biotin Supplementation

J Cutan Med Surg 2019 Aug 13;[EPub Ahead of Print], JJ John, SR Lipner 

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Reduce de peso y reduce riesgo de cancer

Journal Scan / Research · November 14, 2019

Association of Bariatric Surgery With Skin Cancer Incidence in Adults With Obesity

JAMA Dermatology

TAKE-HOME MESSAGE

• In this Swedish study of 4047 obese patients, 2007 individuals underwent bariatric surgery, and the remaining 2040 were treated conventionally for obesity in the primary care setting. The authors found a reduced risk of skin cancer (adjusted subhazard ratio, 0.59; P=.047) and a reduced risk of melanoma (adjusted subhazard ratio, 0.43; P=.02; median follow-up, 18.1 years) among obese patients who underwent bariatric surgery.

• Obesity is a known risk factor for many cancers; however, this study provides evidence that it is also associated with skin cancers, including melanoma, and that undergoing bariatric surgery was associated with a significantly decreased risk of skin cancer.

– Caroline K. Crabtree, MD

 Dermatology

Written by

 

 

Robert T Brodell MD, FAAD

There is a growing literature linking melanoma and nonmelanoma skin cancer to obesity. While the molecular mechanisms underlying the association are not perfectly understood, it has been hypothesized that changes in the tumor microenvironment, including aberrant cell signaling and genomic instability related to a chronic inflammatory state, may explain this association. Of course, behavioral factors (weight loss leading to more time in the sun at the swimming pool) may also play a role. Of note, the morbidly obese patients who find it hardest to get into the doctor's office and who are the most difficult to get undressed, may be the most important to examine!

Reference

1. Karimi K, Lindgren TH, Koch CA, Brodell RT. Obesity as a risk factor for malignant melanoma and non-melanoma skin cancer. Rev EndocrMetab Disord. 2016;17(3):389-403. https://link.springer.com/article/10.1007%2Fs11154-016-9393-9

Abstract

IMPORTANCE

Obesity is a cancer risk factor, and bariatric surgery in patients with obesity is associated with reduced cancer risk. However, evidence of an association among obesity, bariatric surgery, and skin cancer, including melanoma, is limited.

OBJECTIVE

To investigate the association of bariatric surgery with skin cancer (squamous cell carcinoma and melanoma) and melanoma incidence.

DESIGN, SETTING, AND PARTICIPANTS

This nonrandomized controlled trial, the Swedish Obese Subjects (SOS) study, is ongoing at 25 surgical departments and 480 primary health care centers in Sweden and was designed to examine outcomes after bariatric surgery. The study included 2007 patients with obesity who underwent bariatric surgery and 2040 contemporaneously matched controls who received conventional obesity treatment. Patients were enrolled between September 1, 1987, and January 31, 2001. Data analysis was performed from June 29, 2018, to November 22, 2018.

INTERVENTIONS

Patients in the surgery group underwent gastric bypass (n = 266), banding (n = 376), or vertical banded gastroplasty (n = 1365). The control group (n = 2040) received the customary treatment for obesity at their primary health care centers.

MAIN OUTCOMES AND MEASURES

The SOS study was cross-linked to the Swedish National Cancer Registry, the Cause of Death Registry, and the Registry of the Total Population for data on cancer incidence, death, and emigration.

RESULTS

The study included 4047 participants (mean [SD] age, 47.9 [6.1] years; 2867 [70.8%] female). Information on cancer events was available for 4042 patients. The study found that bariatric surgery was associated with a markedly reduced risk of melanoma (adjusted subhazard ratio, 0.43; 95% CI, 0.21-0.87; P = .02; median follow-up, 18.1 years) and risk of skin cancer in general (adjusted subhazard ratio, 0.59; 95% CI, 0.35-0.99; P = .047). The skin cancer risk reduction was not associated with baseline body mass index or weight; insulin, glucose, lipid, and creatinine levels; diabetes; blood pressure; alcohol intake; or smoking.

CONCLUSIONS AND RELEVANCE

The results of this study suggest that bariatric surgery in individuals with obesity is associated with a reduced risk of skin cancer, including melanoma.

JAMA Dermatology

Association of Bariatric Surgery With Skin Cancer Incidence in Adults With Obesity: A Nonrandomized Controlled Trial

JAMA Dermatol 2019 Oct 30;[EPub Ahead of Print], M Taube, M Peltonen, K Sjöholm, Å Anveden, JC Andersson-Assarsson, P Jacobson, PA Svensson, MO Bergo, LMS Carlsson 

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