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Dear Editor, Venous leg ulcers (VLUs) are painful and recalcitrant to therapy and represent a significant burden on patients' quality of life and society.[1] Therefore, innovative therapies are needed. GLO:F03/01may20:bjd18743-fig-0001.jpg PHOTO (COLOR): (a-c) Patient 1, with a right anterior leg ulcer, (a) before starting topical valsartan application, (b) 2 months after treatment and (c) 3 months after treatment. In diabetic aged mice and diabetic pigs, topical valsartan 1% gel significantly accelerated wound healing by selective blockage of AT1.[2] It has been suggested that systemic AT1 receptor blockers impair fibroblast migration and delay wound healing.[7] Therefore, topical treatment is a promising therapy, especially in patients receiving oral valsartan for their hypertension. [Extracted from the article]

The article discusses a randomized controlled evaluator-blind trial of microneedle-assisted incubation during aminolaevulinic acid photodynamic therapy of actinic keratoses.

Background Keloids are an overgrowth of fibrotic tissue outside the original boundaries of an injury and occur secondary to defective wound healing. Keloids often have a functional, aesthetic, or psychosocial impact on patients as highlighted by quality-of-life studies. Objectives Our goal is to provide clinicians and scientists an overview of the data available on laser and light-based therapies for treatment of keloids, and highlight emerging light-based therapeutic technologies and the evidence available to support their use. Methods We employed the following search strategy to identify the clinical evidence reported in the biomedical literature: in November 2012, we searched PubMed.gov, Ovid MEDLINE, Embase and Cochrane Reviews (1980-present) for published randomized clinical trials, clinical studies, case series and case reports related to the treatment of keloids. The search terms we utilized were 'keloid(s)' AND 'laser' OR 'light-emitting diode' (LED) OR 'photodynamic therapy' (PDT) OR 'intense pulsed light' OR 'low level light' OR 'phototherapy.' Results Our search yielded 347 unique articles. Of these, 33 articles met our inclusion and exclusion criteria. Conclusion We qualitatively conclude that laser and light-based treatment modalities may achieve favourable patient outcomes. Clinical studies using CO2 laser are more prevalent in current literature and a combination regimen may be an adequate ablative approach. Adding light-based treatments, such as LED phototherapy or PDT, to laser treatment regimens may enhance patient outcomes. Lasers and other light-based technology have introduced new ways to manage keloids that may result in improved aesthetic and symptomatic outcomes and decreased keloid recurrence. [ABSTRACT FROM AUTHOR]

Dear Editor, Pain is a routine part of medical care. Medical care is branded as painful, and pain and discomfort may affect patients' willingness to consent to such procedures. All patients experienced minimal pain, and half had no pain at all, describing a feeling of "light touch" and surprise in finding out the procedure was over. [Extracted from the article]

Linked Article: Dhaliwal et al. Br J Dermatol 2019; 180:289–296. [ABSTRACT FROM AUTHOR]

The article discusses research published within the issue which investigated the relationship between the history of chickenpox infection and prevalence of atopic dermatitis (AD) in children and adolescents in the U.S. Topics discussed include the increase in childhood vaccination against chickenpox resulting to a decrease in the incidence of varicella infection and inverse association between varicella infection and AD prevalence.

Hidradenitis suppurativa (HS) is a chronic, relapsing, inflammatory disease that results in painful, recurring subcutaneous nodules in skin folds, and leads to a physical and psychosocial burden on patients. ADA presence is consistently associated with lower serum drug concentrations.2 ADA can occur with other biologic drugs, but its relevance to HS management is unclear.3 Therapeutic drug monitoring (TDM) involves the measurement of trough drug level and ADA serum concentration to objectively assess treatment failure. All responders used biologics and treatment failure was common, with similar rates of primary and secondary treatment failure (Table 2). [Extracted from the article]

Summary: Background: The use of complementary and alternative medicine (CAM) is increasing in Western countries, including in the area of dermatology. However, Western healthcare providers have not integrated CAM into regular practice owing to a lack of reliable data supporting its use. To encourage high‐quality research related to the use of CAM and specifically herbal interventions, the CONsolidated Standards Of Reporting Trials (CONSORT) extension criteria on reporting herbal interventions (hCONSORT) were published in 2006. Objectives: To evaluate the adherence of randomized controlled trials (RCTs) investigating herbal interventions for acne, atopic dermatitis (AD) and psoriasis to the hCONSORT criteria. Methods: A comprehensive search of the PubMed, Embase and Cochrane Library databases was conducted. RCTs published between 2009 and 2014 assessing therapeutic outcomes of plant‐based interventions for acne, AD or psoriasis were included. Investigators determined the number of unique hCONSORT criteria satisfied per report. anova was used to examine differences in scores by disease entity. Results: The vast majority of reviewed studies reported < 50% of information recommended in the hCONSORT criteria. Limitations include the small number of dermatological conditions examined, exclusion of reports based on language and lack of assessment of overall adherence to CONSORT criteria. Conclusions: Our data indicate lack of adherence to hCONSORT extension criteria. Adherence to hCONSORT guidelines should be encouraged in order to provide high‐quality reporting of research on herbal interventions in dermatology. Doing so may ease the integration of CAM into conventional medical practice and provide actionable data to providers. [ABSTRACT FROM AUTHOR]

Summary: 西方国家越来越多地将补充和替代医疗(CAM)用于各种症状,包括皮肤相关症状。替代医疗是一种在西药范围之外的治疗方法,而补充医疗则将此类治疗与西药相结合。尽管CAM的使用范围越来越广,但由于缺少支持的可靠科学研究,因此西方的保健服务提供者尚未将其结合到实践中。有一种方法可以消除广泛的公共使用与缺少可靠数据之间的差距,那就是改进研究在医学期刊上的报告方式。2006年,业界发布了一些指南,旨在帮助科学研究人员对中医药的使用开展质量研究。这些指南被称为有关报告草药干预的CONSORT扩展标准(hCONSORT),于2006年发布。我们希望调查这些指南在皮肤医学中的应用情况。作为我们在美国开展的研究的一部分,我们查看了对将植物药物用于治疗三种常见皮肤症状进行调查的科学研究:痤疮、异位性湿疹和银屑病。我们专注于在2009年至2014年之间发布的文章,并将其对hCONSORT指南的遵守程度进行评级。出乎意料的是,我们发现大部分科学研究只遵守了不到50%的hCONSORT指南。基于这些发现,我们建议科学家在开展有关使用中医药的研究时应遵守这些指南,并且科学期刊的编辑在介绍评估中医药使用的文章时应鼓励遵守这些指南。这样将有助于西方保健服务从业者安全有效地将CAM结合到传统医学中。 [ABSTRACT FROM AUTHOR]

Summary: Complementary and alternative medicine (CAM) has been increasing in popularity in western countries for various conditions, including those that affect the skin. Alternative medicine is defined as treatment approaches that are outside the realm of western medicine and complimentary medicine combines the use of such treatments with western medicine. Despite this increase in prevalence, western healthcare providers have not integrated CAM into their practice due to a lack of reliable scientific studies that support its use. One way to close the gap between prevalence of public use and lack of reliable data is to improve the way studies are reported in medical journals. In 2006 guidelines were published to help scientific researchers conduct quality research regarding the use of herbal medications. These guidelines were called the CONSORT extension criteria on reporting herbal interventions (hCONSORT) and were published in 2006. We wanted to examine how well these guidelines we adopted in dermatology. As part of our research, based in the U.S., we reviewed scientific studies that investigated the use of plant‐based medications for the use of three common skin conditions: acne, atopic eczema, and psoriasis. We focused on articles published between 2009 and 2014 and graded their adherence to the hCONSORT guidelines. Surprisingly, we found that the majority of these scientific studies adhered to less than 50% of the hCONSORT guidelines. Based on these findings, we recommend that scientists adhere to these guidelines when conducting studies regarding the use of herbal medications and that editors of scientific journals encourage adherence to these guidelines when presented with articles that assess the use of herbal medications. Doing so will help western healthcare practitioners safely and effectively integrate CAM into conventional medicine. [ABSTRACT FROM AUTHOR]