Researchers Uncover Molecule Responsible for Sunburn Pain

Image courtesy of WebMD

Welcome back to my general dermatology blog. An interesting new breakthrough in sunburn research recently made waves in the scientific community. According to a study published in the Proceedings of the National Academy of Sciences, the red skin developing from sunburn is caused by a molecule called TRPV4. This molecule, which is abundant in the skin’s epidermis, could be blocked to greatly protect against the pain caused by sunburn.

This discovery originated from a collaboration between researchers at Duke University, the University of California-San Francisco, and Rockefeller University’s Laboratory of Mammalian Cell Biology and Development. Rockefeller University researchers discovered TRPV4, an ion channel shown to be involved in other pain processes, more than ten years ago.  Duke’s Wolfgang Liedtke and Rockefeller’s Elaine Fuchs recently began testing the role of TRPV4 in the epidermis by building a mouse model missing TRPV4 in the outermost layer of its skin. The mouse’s hind paws, which most closely resemble human skin, were exposed to UVB rays. According to the researchers, unlike normal mice, the mutant mice showed little tissue injury and sensitivity.

Researchers then uncovered the sequence of events in the pain pathway. They found that UVB exposure on the skin activates TRPV4, which causes an influx of calcium ions into the skin cells, which then brings in endothelin (the molecule causing pain and itching in humans), which causes TRPV4 to send additional calcium into skin cells. Finally, researchers attempted to blow the pain pathway by applying GSK205 (a compound that selectively inhibits TRPV4) to the hind paws of normal mice. After doing so, the mice were resistant to the pain-inducing and skin-disrupting effects of sunburn.

These results seem to suggest that blocking TRPV4 channels could keep the epidermis from communicating with the skin’s sensory neurons and ease pain from sunburn. Additional tests will be necessary, but TRPV4 could be a new target for treating and preventing sunburn. TRPV4 might also potentially combat chronic sun damage such as skin cancer and skin photo-aging. For now, however, make sure you are still wearing sunscreen.

View Rockefeller University’s press release here: http://newswire.rockefeller.edu/2013/08/08/researchers-find-molecule-that-causes-sunburn-pain/

Thanks for reading,

Sudhir Polisetty 

You can learn more about me on LinkedIn or read more of my dermatology blog posts on my Wordpress blog: http://sudhirpolisetty.wordpress.com/

Treating Varicose Veins with Minimally Invasive Ablation Techniques

This image from WebMD depicts varicose veins
in a patient's legs.

Welcome back to my general dermatology blog. As a general and surgical dermatologist, I help patients treat and control a number of skin conditions. One condition that usually requires surgical treatment is varicose veins, defined as enlarged veins near the surface of the skin filled with an abnormal amount of blood. New information presented at the American Academy of Dermatology (AAOD)’s Annual Summer Meeting in New York indicates that two minimally invasive techniques could serve as an alternative to surgery for individuals with varicose veins.

Todd Cartee MD, an assistant professor of dermatology at Penn State’s Hersey Medical Center, presented data to AAOD conference attendees regarding two ablation techniques:

• Endovenous laser ablation: This procedure involves putting patients under using local anesthesia and a ¼” incision. An infrared laser directs heat to the vein, through the incision, in order to destroy the affected vein.

• Radiofrequency ablation: This process utilizes radiofrequency energy and waves to heat veins and spur their collapse.

According to Cartee, these two procedures allow patients to recover more quickly than traditional methods that require general anesthesia and a long recovery time. He adds that with these two ablation techniques, patients can expect to return to their normal routine one day after the procedure is completed.

Patients who seek treatment for their varicose veins often do so after complaining of leg pain, rashes, blood clots, fatigue, cramping in the calves, skin darkening, itching, and burning. Spider veins, which are similar to varicose veins but smaller and closer to the surface of the skin, do not produce severe symptoms but are instead treated for cosmetic reasons. Cartee reminded attendees that leg vein problems are treatable and then encouraged patients to seek out a board-certified dermatologist if they are concerned by the appearance of their legs or are experiencing problematic symptoms.

View a summary of the presentation here: http://www.healio.com/dermatology/lasers/news/online/%7BDF039561-F519-42DD-B9F9-839426B1B806%7D/Minimally-invasive-ablation-techniques-used-to-treat-varicose-veins

Thanks for reading,

Sudhir Polisetty

Learn more about me by following my blog on Tumblr: http://sudhirpolisetty.tumblr.com/

Are Pimples Starting Younger?

Adolescent acne (above) is becoming more common.

Welcome back to my general dermatology blog. Although I do not perform cosmetic dermatology procedures, I often see patients with questions about these services. One popular topic, especially among teenagers, is how to treat acne.

Acne vulgaris is a human skin disease characterized by pimples, blackheads, whiteheads, and sometimes scarring. Skin areas that are most frequently affected are those with dense sebaceous follicles, including the face, back, and top half of the chest. Conventional wisdom is that acne occurs most commonly during adolescence and continues in adulthood. Acne’s prevalence during the teenage years is attributed to an increase in testosterone, with testosterone levels typically dropping by age 25. I recently read an interesting article from NBC News that suggests more and more elementary school-aged children are developing pimples.

Recent anecdotes from dermatologists indicate that cases of pediatric acne are becoming more common, even in kids as young as 7. Doctors hypothesize that earlier onset puberty is to blame, as this process causes levels of pimple-producing adrenal androgens to increase. Dr. Andrea Zaenglein estimated in the article that she now sees 10-15 new pediatric acne cases each month. She responded by authoring a new set of guidelines for treating kids of all ages, which the American Academy of Pediatrics then endorsed. Zaenglein presented this information at the summer’s American Academy of Dermatology meeting, explaining that the principles of adolescent and preadolescent acne are the same and should both be treated aggressively to get symptoms under control.

Fortunately, parents of children with acne are more likely to make sure the child sticks to the dermatologist’s prescribed treatment plan. Parents should recognize that acne in adolescents is a major problem that could require professional care. Pre-teen acne can be an indicator of more severe acne in teenage years, so it is important to recognize the problem and get children the care they need.

Thanks for reading,

Sudhir Polisetty

To learn more about me by following me on Twitter or read more of my Dermatology blog posts on my website: http://sudhirpolisetty.com/

Consumers Prefer Dermatologists for Cosmetic Procedures

Welcome back to my general dermatology blog. As a general and surgical dermatologist, I do not handle cosmetic dermatology procedures. I do, however, often get questions from patients seeking advice. It is no surprise that a new study from the American Society for Dermatologic Surgery (ASDS) found that for consumers considering cosmetic procedures, dermatologists are most likely to influence that decision.

The ASDS conducted its first-ever blind Consumer Survey on Cosmetic Dermatologic Procedures by reaching out to 6,300 consumers. Each participant shared his or her opinions on cosmetic treatments in general and then provided ratings for ten specific procedures. 6.4% of those surveyed had undergone a cosmetic treatment before while roughly 30% indicated that they are considering such a procedure. When respondents were asked to choose a provider for these procedures, nine out of ten picked dermatologists. Additionally, nine out of ten identified dermatologic surgeons as the dermatologist of choice for all but one of the identified procedures.

When it comes to patient trust, respondents noted that dermatologists have the greatest influence on decisions to have cosmetic procedures. They also added that the specialty in which a physician is board certified is the most important factor when contemplating a decision, making it more important than cost or physician referral. In short, patients were more likely to adhere to advice from board certified dermatologists over recommendations from friends or other physicians.

The cosmetic condition that bothers respondents the most is excess weight, which affected 80% of respondents. Other unwanted conditions included lines and wrinkles around the eyes (63%); skin texture and/or discoloration (62%); sagging facial skin (61%); excess fat under the chin (60%); and wrinkles, lines, and/or folds in the mid-face around the mouth and cheeks (60%).

Learn more about the study here: http://www.healio.com/dermatology/aesthetic-cosmetic-surgery/news/online/%7B5A128759-AEC9-4CE1-AC9B-170A38564D7A%7D/Consumers-prefer-dermatologists-for-cosmetic-procedures

Thanks for reading,

Sudhir Polisetty

Read more of my dermatology blog posts on my Wordpress blog or learn more about me on my about.me page: http://about.me/sudhir.polisetty