International Journal of Women''s Dermatology最新文献

Background: In adult females, acne is usually a chronic condition, and its management remains challenging due to therapeutic failures or limited healthcare seeking, with repercussions on mental health. Oral contraceptives may provide an alternative to reduce acne and enhance psychological well-being.

Objective: To identify the change in the severity of acne in young university women who used the combined oral contraceptive pills of ethinylestradiol 20 µg/dienogest 2 mg, and its perceived psychological effects on self-esteem, social relations, and noncontraceptive benefits.

Methods: A prospective cohort was conducted between 2015 and 2016. Photographic monitoring of acne lesions was performed at 3, 6, 9, and 12 months after the start of the study. The photographs were evaluated by 2 specialists in dermatology, who established the degree of acne. Information was gathered regarding the perception of acne progression, the improvement of self-esteem, and noncontraceptive benefits. A descriptive analysis was performed.

Results: In total, 86 women were included. At 6-month follow-up, the percentage of mild comedonal acne changed from 5.8 to 37.8%. At 12 months, at least 35% of the women had no acne lesions, and 43% were classified with mild comedonal acne. Results above 68% indicated that there was a favorable perception in the improvement of self-esteem, and the participants recognized that these changes improved their social relations (first month: 58.6% to sixth month: 90.5%).

Limitations: A locally applied acne severity scale was employed, as it provides detailed lesion characterization but restricts comparability with other studies, and a lack of standardized scales for measuring perceived psychological and non-contraceptive benefits.

Conclusion: Young women with acne who use oral contraceptives with dienogest and ethinyl estradiol obtain the additional benefit of reducing acne severity.

Objective: To assess the safety of tumor necrosis factor inhibitors (TNFi) during pregnancy, specifically in relation to infant infection rates, vaccine efficacy, and vaccine-associated adverse events in infants exposed to TNFi in utero and through breast milk.

Data sources: A comprehensive literature review was conducted using PubMed and Google Scholar. The review included retrospective studies, prospective studies, and systematic reviews published until June 2024, focusing on TNFi exposure during pregnancy and breastfeeding.

Study selections: Studies reporting on infant infection rates, vaccination outcomes, and adverse events following in-utero or breastfeeding exposure to TNFi agents, including certolizumab pegol, adalimumab, infliximab, etanercept, and golimumab. Narrative reviews were excluded, while systematic reviews were considered.

Results: The review indicates that gestational exposure to TNFi does not increase the risk of severe infections in infants. Additionally, no significant rise in infections was found in infants exposed to TNFi through breast milk. Vaccination outcomes, including efficacy and adverse events, were comparable between exposed and unexposed infants. However, caution is advised when administering the Bacille Calmette-Guerin vaccine to infants exposed to TNFi, particularly within the first year of life.

Conclusion: TNFi appear to be safe during pregnancy and breastfeeding. The data indicate that TNFi does not increase the risk of severe infections or vaccine complications in infants, with the exception of the Bacille Calmette-Guerin vaccine, for which a more cautious approach is recommended. These findings reinforce the use of TNFi in women with inflammatory conditions who are pregnant or breastfeeding, providing benefits to both maternal and fetal health.

Background: Few studies have comprehensively assessed dermatologic conditions in women, particularly among different racial and ethnic groups.

Objective: This study characterizes common dermatologic diagnoses in adult women (acne), emphasizing conditions disproportionately affecting women of color (WOC) (hidradenitis suppurativa [HS], hypertrophic scars, and scarring and nonscarring alopecia).

Methods: This retrospective cohort study analyzed data from Northwestern Medicine's Enterprise Data Warehouse, covering 637,124 patient visits from 2018 to 2021. The dataset included 212,223 unique patients, with 398,431 visits by women. Patient demographics (age, race, and ethnicity) and clinical data (diagnoses, treatments) were analyzed using logistic and linear regression.

Results: Women accounted for 62.5% of dermatologic visits. Women were significantly more likely than men to present with acne, HS, and scarring and nonscarring alopecia. White women represented 77.4% of women, while WOC (Black, Asian, and Hispanic) comprised 16.3%. Acne was the most common diagnosis among women under 30. WOC were younger on average (44.6 years) compared with white patients (50.9 years) and had higher odds of alopecia, hypertrophic scars, acne, and HS. Cosmetic procedures were less frequent among WOC.

Limitations: Findings may have limited generalizability due to being conducted within a single medical system.

Conclusion: Women, and specifically WOC, are disproportionately impacted by many common dermatologic conditions. These conditions have significant morbidity, which is heightened by complications like hyperpigmentation and scarring in the skin of the color population. Accurate and timely diagnosis is necessary to improve women's dermatology outcomes.

Background: Lichen sclerosus (LS) is an inflammatory mucocutaneous disorder typically affecting the anogenital region with unknown etiology. It is postulated that infectious etiologies could play a role in pathogenesis.

Objective: Herein, we analyze for potential associations between LS and infectious agents.

Methods: The TriNetX research network was utilized to compare prevalence of prior infections in patients with versus without LS and risk of LS in patients with versus without prior infections.

Results: Patients with versus without LS had a higher prevalence of prior herpes simplex virus (HSV), human papillomavirus (HPV), gonorrhea, chlamydia, Lyme disease, hepatitis B virus, and hepatitis C virus diagnosis. Preceding infections with HSV and HPV were associated with increased risk of developing LS. Preceding vaccination for HPV was associated with decreased risk of LS.

Limitations: We were limited to ICD-10 codes and their accuracy. We could not confirm LS histopathologically, separate genital and extragenital LS, or assess specific HPV types.

Conclusion: Our study suggests that HSV and HPV infections may be potential LS risk factors.