bluuebunny/crossref_metadata_2025_split huggingface dataset:
P070 The epidemiology of skin cancer in Greater Manchester 2017–22: a retrospective cohort study using primary care records
Authors: Lai Lana Y H , Sim Ben W M , Farragher Tracey , McMillan Brian , McMullen Emma , Venables Zoe C , Yiu Zenas Z N 
Published: June 2024

Abstract
Skin cancer is the commonest cancer in the UK, with increasing incidence, creating a significant workload for dermatology departments. Greater Manchester is one of the most populous areas in the UK, and understanding the regional skin cancer trends is vital for healthcare service planning and public health interventions. The Greater Manchester Care Record (GMCR) holds data from 99.5% of general practices on &gt; 3 million registered patients (Watkinson RE, Williams R, Gillibrand S et al. Ethnic inequalities in COVID-19 vaccine uptake and comparison to seasonal influenza vaccine uptake in Greater Manchester, UK: a cohort study. PLOS Med 2022; 19: e1003932). It was approved for research access for COVID-19 response analysis, which allowed this opportunity to understand the epidemiology of skin cancer in Greater Manchester. This retrospective observational cohort study of the GMCR included cases of basal cell carcinoma (BCC), cutaneous squamous cell carcinoma (cSCC) and malignant melanoma (MM) registered between January 2017 and December 2022. We calculated the crude incidence rate (IR) per 100 000 person-years by skin cancer type, age group and sex. To avoid duplication, we restricted cases to a timeframe of at least 2 weeks before a subsequent case was counted, based on expert advice and review of the data. The denominator was the summation of 1 year of follow-up for each registered patient as of December each year. We compared the IR from GMCR to the national cancer registry IR from the ‘Get Data Out’ skin initiative. We identified 42 370 cases of BCC, 7503 cSCC and 7924 MM between 2017 and 2022, with respective median (interquartile range) ages at diagnosis of 73.3 years (62.3–80.9), 73.6 years (62.2–81.9) and 62.0 years (49.1–73.8); the majority (&gt; 87%) of the population was White. The IR ranged from the lowest at 185, 44 and 36 per 100 000 person-years in 2020 (coinciding with the early stages of the pandemic) to the highest at 265 (2022), 35 (2019) and 54 (2022) per 100 000 person-years for BCC, cSCC and MM, respectively. The incidence rate ratios (95% confidence interval) for 2020 vs. 2019 were 0.79 (0.76–0.81), 0.98 (0.91–1.06) and 0.87 (0.80–0.94) for BCC, cSCC and MM, respectively. The male-to-female ratio was around 1 for BCC and cSCC until age 70 years, after which there was an increasing male preponderance, while for MM the same divergence started at age 50 years. We report lower IRs for both BCC and cSCC compared with England, and a higher IR for MM. We present the epidemiology of skin cancer in Greater Manchester from a novel primary care dataset, showing reductions in IR during 2020 of 21%, 2% and 13% for BCC, cSCC and MM, respectively. We report a lower than expected IR of cSCC, which is a likely underestimate and requires further investigation.
P075 A retrospective review of isotretinoin treatment-related psychosexual health side-effects in a tertiary dermatology clinic
Authors: Mitsaki Kyriaki Stefania , Chawla Sumir , Merika Eirini 
Published: June 2024

Abstract
Isotretinoin is the gold-standard treatment for severe acne. Growing concerns about its association with psychiatric and sexual side-effects have led to the introduction of new monitoring requirements by the Medicines and Healthcare products Regulatory Agency. Herein we present pivotal real-world data on treatment-related psychosexual side-effects. The primary aim of this review was to evaluate mental health outcomes in terms of depressive symptoms and quality of life in patients treated with isotretinoin. Our secondary endpoint was to evaluate the effect of isotretinoin on sexual function. We conducted a retrospective cohort study of 167 consecutive patients who completed treatment with isotretinoin for acne vulgaris between 1 November 2019 and 31 October 2023. Patient Health Questionnaire-9 (PHQ-9) scores, Cardiff Acne Disability Index (CADI) scores and subjective symptom reports were collected at baseline and each follow-up until completion of treatment. We compared data on baseline characteristics, clinical and biochemical side-­effects and dosing regimens for patients who met the criteria for moderate or severe depression vs. those with mild or no depressive symptoms. Mean PHQ-9 and CADI scores improved significantly following isotretinoin completion compared with baseline (P &lt; 0.05). Twenty patients (12.0%) met the criteria for moderate or severe depression at baseline. Of these, five patients were on antidepressive therapy and two patients experienced worsening of symptoms on isotretinoin. In total 11 patients (6.5%) met the criteria for moderate or severe depression at the final follow-up; nine of these had reported no or mild depressive symptoms at baseline. Logistic regression analysis did not identify potential risk factors for psychiatric adverse effects with isotretinoin, including no correlation with the average daily or total cumulative dose. We report no cases of suicidal ideation, suicide or erectile dysfunction. A single case of low libido was noted; however, symptoms were mild and did not warrant discontinuation of treatment. The mean follow-up duration after discontinuation of treatment was 209 days. Our analysis did not identify an association of isotretinoin with new-onset depressive symptoms or sexual dysfunction above the background prevalence. The findings support an overall favourable risk profile of isotretinoin at the population level, but the possibility of rare, idiosyncratic adverse events cannot be excluded.
P085 Efficacy and safety of 611 for the treatment of moderate-to-severe atopic dermatitis in adults
Authors: Zhang Jianzhong , Zhao Yan , Zhou Qinghong , Xu Yuyu 
Published: June 2024

Abstract
Atopic dermatitis (AD) is a chronic, recurring, inflammatory skin disease characterized by extensive rashes on the body, leading to symptoms such as persistent itching and exudation. There is still a need for safe and effective therapies to improve disease management for uncontrolled moderate-to-severe AD, as current treatments may not adequately control the disease. 611 is a novel monoclonal antibody that targets interleukin (IL)-4Rα. It can selectively bind to IL-4Rα, thereby obstructing the signalling pathways of both IL-4 and IL-13. This action aids in modulating immune function, offering potential relief for conditions such as AD and other related diseases. In this phase II study, the safety and efficacy of 611 was investigated in moderate-to-severe AD in adult patients. In total 93 patients were randomly assigned to three groups: group A received a loading dose of 600 mg of 611 followed by 300 mg every 2 weeks (Q2W), group B received a loading dose of 600 mg of 611 followed by 300 mg every 4 weeks (Q4W), and there was also a placebo group. The primary efficacy endpoint was the proportion of patients with Eczema Area and Severity Index (EASI) 75 response (≥ 75% reduction in score from baseline) at week 16. The results showed positive responses in primary and all secondary endpoints in adult patients with moderate-to-severe AD after treatment with 611. There was a significant difference between 611 and placebo in EASI 75 improvement, with a 60.0% response rate for 611 compared with 15.6% for placebo (P &lt; 0.001). The percentage of patients achieving IGA 0/1 (Investigator’s Global Assessment score of 0 or 1, and ≥ 2-point reduction from baseline) also exhibited a significant difference in the groups receiving 611 or placebo, with rates of 35.5% and 9.4%, respectively (P &lt; 0.05). The other endpoints, including EASI 90, EASI 50, and numerical rating scale reduction by ≥ 4 points, improved more in the groups receiving 611 than for placebo. Regarding safety data in the trial, treatment with 611 showed results comparable with placebo. 611 showed a positive effect in treatment of patients with moderate-to-severe AD in terms of efficacy and safety. 611 has potentially become a promising treatment product targeting IL-4Rα, following on from dupilumab.
P101 Sustained improvement in atopic dermatitis disease control and treatment satisfaction with dupilumab in clinical practice: 4-year follow-up results from the RELIEVE-AD study
Authors: Wang Zhixiao , Yang Min , Chao Jingdong , Martins Bruno , Chuang Chien-Chia , Shumel Brad , Sierka Debra , Carboni Margaret , Strober Bruce 
Published: June 2024

Abstract
Although atopic dermatitis (AD) typically affects children, it can persist into or start during adulthood. In the RELIEVE-AD study, which included adults with moderate-to-severe AD who initiated dupilumab in real-world clinical practice, results up to 3 years showed significant, sustained improvements in disease control, flares, skin symptoms, sleep, quality of life, and treatment satisfaction. We now report 4-year disease control, treatment satisfaction, and concomitant medication results from RELIEVE-AD. RELIEVE-AD is a single-arm, prospective, longitudinal patient survey study of adults with moderate-to-severe AD who were prescribed dupilumab, enrolled in the US dupilumab patient support programme. The patients had agreed to participate in online surveys at baseline and months 1, 2, 3, 6, 9, 12, 33–36 and 48. The outcomes presented here are (i) disease control [assessed by the six-item Atopic Dermatitis Control Tool (ADCT), with total score ranging from 0 to 24, with higher scores indicating less control, and score &lt; 7 indicating controlled disease]; (ii) treatment satisfaction (seven-point Likert scale from ‘extremely satisfied’ to ‘extremely dissatisfied’) and (iii) reported days with no intense episodes of itching. Statistical significance was determined using generalized estimating equations to account for correlated data from the same patients. Among 698 patients who completed the baseline survey and started dupilumab, 353 (50.6%) completed the month 48 survey. At baseline, the mean age was 46.2 years, 61.7% were female, and common comorbidities included nonseasonal allergies (36.0%) and asthma (32.2%). The mean total ADCT score was significantly lower (P &lt; 0.001) at all post-treatment initiation timepoints, decreasing from 15.8 at baseline to 3.7 at month 48. The proportion of patients with an ADCT total score &lt; 7, indicating controlled disease, increased from 5.9% at baseline to 61.0% at month 1, then 77.4%, 80.7% and 80.5% at months 12, 33 and 48, respectively (all P &lt; 0.001). The percentage of patients reporting no intense episodes of itching over the last week (0 days) increased from 3.2% at baseline to 61.2% at month 48 (P &lt; 0.001). Patient satisfaction with AD treatments improved over time, with 84.9% of patients satisfied at month 48 (P &lt; 0.001 for all timepoints during follow-up vs. baseline). A large majority of survey respondents at 4 years reported controlled disease, as well as fewer episodes of itching, and were very or extremely satisfied with their AD treatments. This research was sponsored by Sanofi and Regeneron Pharmaceuticals Inc. Medical writing and editorial assistance were provided by Rebecca Czolk, PhD, of Excerpta Medica, funded by Sanofi and Regeneron Pharmaceuticals Inc., according to the Good Publication Practice guideline.
P113 Ocular involvement and care provision in children with epidermolysis bullosa
Authors: Shatskikh Marina , Browne Fiona 
Published: June 2024

Abstract
Epidermolysis bullosa (EB) is a group of skin fragility conditions that result from defects in connective tissue proteins. Classification is based on the level of skin cleavage, with four major subtypes (Has C, Bauer JW, Bodemer C et al. Consensus reclassification of inherited epidermolysis bullosa and other disorders with skin fragility. Br J Dermatol 2020; 183: 614–27). Skin fragility is a cardinal feature of EB but mucosal involvement is highly variable depending on subtype. There are limited data evaluating ocular mani­festations of EB, associated management and related outcomes. The aim of this study was to assess ocular manifestations among children with EB attending the National EB Clinic and to compare management against current best practices [Chen VM. Eye care for EB patients: strategies to prevent blistering, scarring and vision loss. Lecture at the DEBRA Care Conference, 2018. Available at: https://www.debra.org/eb-care-tips/eye-care (last accessed 19 February 2024)]. This would provide a better understanding of patients’ needs, helping to identify gaps in care and develop strategies to support patients in obtaining care. We carried out a retrospective chart review, correlating patients’ genotype, phenotype, ocular symptoms and management of the same (access to ophthalmology and treatment adherence). Additionally we circulated a postal questionnaire to patients and carers. Records of 69 patients (52% female) aged 10 months to 22 years were reviewed. The average age at diagnosis was 1.7 years. Overall, 51% had EB simplex (EBS), 19% dominant dystrophic EB (DDEB), 17% recessive dystrophic EB (RDEB), 10% junctional EB (JEB) and 3% Kindler syndrome. In total, 38% of all patients had ocular involvement. Those most commonly affected had RDEB (35%) or JEB (23%). Patients with EBS (31%), DDEB (8%) and Kindler syndrome (4%) presented with mild ocular concerns including itch (27%), dryness (42%) or sticky eyes (27%). More severe ocular involvement presented as redness (12%), pain (19%), inability to open the eye (15%), excessive tearing (15%), blepharitis (8%), conjunctival or corneal erosions, ulcerations or scarring (27%), trichiasis (4%), astigmatism (4%), amblyopia (8%) and/or vision loss (35%), necessitating regular ophthalmology review. Only 36% of patients were referred to ophthalmology, either at diagnosis or at onset of symptoms. Of those, 16% attended annually, with follow-up for others generally limited to ‘as required’. Our results highlight gaps in care. Only a small proportion of patients are engaged with ophthalmology services; over 60% have never been formally assessed. Given the variability in the presentation and severity of eye disease, prompt ophthalmology review at the time of diagnosis is vital to manage symptoms and minimize long-term damage. A personalized approach to management is key to ensure that patients’ unique needs are met and outcomes improved.
BC01 Evaluation of effectiveness of fractional ablative CO2 laser and triple combination cream in the treatment of melasma: a randomized controlled study
Authors: Verma Kaushal , Patel Utpal , Bhari Neetu , Sethuraman G 
Published: June 2024

Abstract
Melasma is a common pigmentary disorder causing considerable cosmetic disfigurement and psychological distress. Treatment of melasma remains a challenge despite the availability of several therapeutic agents, due to its refractory and recurrent nature. Triple combination cream (TCC) consisting of hydroquinone (4%), tretinoin (0.05%) and fluocinolone acetonide (0.01%) is considered to be the first-line therapy for melasma. Ablative fractional lasers have been reported to be effective. We evaluated the effectiveness and safety of fractional ablative CO2 and TCC in melasma in a split-face randomized control study. Clinically diagnosed adult patients with symmetrical melasma were included in the study and were randomized to receive either fractional CO2 laser, once every 4 weeks plus TCC (group A), or TCC alone (group B) to either side of the face once daily for 12 weeks. The patients were evaluated every 4 weeks to determine treatment response and adverse effects, and were followed for another 12 weeks to determine relapse. There were 54 patients (19 male and 35 female; mean age 33.0 years, SD 7.7; age range 21–57 years). They had melasma for 0.5–15 years (mean duration 5.7 years, SD 3.5). Following treatment, the mean melanin index and modified Melasma Area and Severity Index (mMASI) scores decreased in both groups. The mean (SD) melanin index decreased from 46.5 (5.2) to 43.7 (5.6), P &lt; 0.001, in group A, and from 47.0 (5.5) to 44.3 (5.5), P &lt; 0.001, in group B. The mean (SD) mMASI decreased from 4.4 (1.8) to 2.8 (1.6), P &lt; 0.001, in group A, and from 4.4 (1.9) to 3.2 (1.7), P &lt; 0.001, in group B. The changes were statistically significant, but were comparable between the two groups (P = 0.47 and P = 0.20, respectively). However, improvement in Physician’s Global Assessment (PGA) was superior in group A vs. group B (60.8% vs. 39.1%, P &lt; 0.001. Also, the mean (SD) patient self-assessment scores were 5.9 (2.0) and 4.6 (2.0) in group A and group B, respectively (P &lt; 0.001) showing a better response in group A. There were no significant adverse effects. However, 67% of patients (34 of 51) had a relapse, with gradual increases in MI, mMASI, PGA and patient self-assessment scores in both groups during post-treatment follow-up. Therefore, the study has shown that fractional CO2 laser offers modest additional benefit and is safe in the treatment of melasma. Hence, further studies are required.
BC07 Hair oiling: a paradigm shift in the deep-rooted ritual from East to West
Authors: Hussain Fabliha , Dubash Faisal 
Published: June 2024

Abstract
For centuries, generations of African and South Asian women have continued the cultural practice of hair oiling. Pure coconut, castor, amla and argan oils have been used, typically as a prewash ritual. While there is limited clinical evidence on the role of hair oils in trichology, they remain both accessible and inexpensive with a relatively minimal risk profile. The continual rise of globalization and social media, and increased self-care awareness, are factors that have driven their popularity in recent years. The demonstrable shift in mainstream appeal for hair oiling in the West is evidenced by a surge in Google searches for hair oil routines, the emergence of trending social media hashtags such as #HairSlugging, and frequent features by popular media outlets such as Vogue and Grazia magazines. Deeply negative perceptions of the practice, previously held in the West, have undergone an unanticipated U-turn. As the cosmeceutical industry exploits this opportunity, the long-standing ritual has been repackaged to target the Western consumer. Advancements in manufacturing technology have resulted in the modernization of these ancient remedies, from pure oils and homemade blends of the past to more complex formulations that are lightweight, fragranced and more user-friendly. The now expansive hair oil market and widespread global uptake of the practice warrant clinician awareness and the ability to relay accurate evidence on the hair care practice. Benefits of regular hair oiling that are commonly claimed include treating hair loss, thinning and breakage. Studies have considered factors such as emollient effect, saponification, antimicrobial activity, ultraviolet protection and tensile strength. We reviewed the literature to examine the leading hair oils in current use, their biochemical profiles and potential therapeutic benefits. The results demonstrated that despite a plethora of carrier and essential oils in mainstream use, there is only evidence from a limited number of oils, for specific aspects of hair health. Greater evidence was observed for coconut-based hair oils, which demonstrate a protective role in prewash use, preventing increased hair porosity, providing colour protection and improving tensile strength, but not for hair growth. Randomized controlled trial evidence exists for rosemary oil, showing hair growth in androgenetic alopecia. We propose further comparative research of hair oils to delineate the evidence base for their use. This would help consumers differentiate between commercially labelled pseudoscientific benefits and any actual robust evidence base.
BH06 (P110) Comparative efficacy of low-dose oral minoxidil, topical minoxidil, and platelet-rich plasma with topical minoxidil in androgenetic alopecia: a randomized controlled trial
Authors: Janaani P , Kumaran Sendhil , Vinay K , Mehta Hitaishi , Sharma Vinod Kumar 
Published: June 2024

Abstract
Androgenetic alopecia (AGA) is conventionally managed with topical minoxidil, while platelet-rich plasma (PRP) and oral minoxidil present alternative options. Head-to-head trials are scarce, necessitating a comparative study. This randomized controlled trial aimed to compare the efficacy of low-dose oral minoxidil (2.5 mg once daily), topical minoxidil (5% twice daily), and PRP (four sessions, conducted every 4 weeks) combined with topical minoxidil 5% twice daily in individuals with AGA. Natural regulatory T cells (Tregs; CD4+ CD25high FOXP3+) reside within hair follicles, fostering the proliferation of hair follicular stem cells (HFSCs) through the NOTCH signalling pathway by elevating Jagged1 ligand expression. Additionally, the study explored the impact of these treatments on Treg cell populations – inducible Treg cells (CD4+ CD25low FOXP3+) and natural Treg cells (CD4+ CD25high FOXP3+) – and signalling molecules including cytotoxic T-lymphocyte-associated protein (CTLA)4, NOTCH and Jagged1. In total 66 male participants were randomly assigned to three groups of 22 patients each: oral minoxidil (Group 1), topical minoxidil (Group 2) and PRP with topical minoxidil (Group 3). Clinical and videodermoscopic assessments were conducted every 8 weeks, over 32 weeks. Treg cell populations and signalling molecules were analysed in skin biopsies (n = 5 from each group) obtained at baseline and 32 weeks. At 32 weeks, six (27%) patients each in Group 1 and Group 3, and three (14%) patients in Group 2 showed improvement in the grade of AGA. At 32 weeks, Group 3 significantly surpassed Groups 1 and 2 in increasing terminal hair density (P = 0.03 and P = 0.02, respectively). Group 1 had notably decreased vellus hairs compared with Group 3 (P = 0.02), and no significant difference was seen between Groups 2 and 3 (P = 0.2). Reduction in hair diameter diversity was observed with all three modalities, with earlier responses in Groups 1 and 3 (P &lt; 0.01). A proportionate significant increase in natural Treg cells and a decrease in inducible Treg cells was observed at week 32 compared with baseline, without significant modality-specific differences: Group 1, mean 36.2 (SD 15); Group 2, mean 22 (SD 3.4); Group 3, mean 33.7 (SD 10); P = 0.31. A mean decrease in CTLA4 level and an increase in NOTCH and Jagged1 levels with a weakly negative nonsignificant correlation was observed in all three groups at week 32, with no modality-specific differences. Combining PRP with topical minoxidil achieved superior terminal hair density, while oral minoxidil exhibited an advantage in reducing vellus hair density. The study endorses low-dose oral minoxidil as an alternative to topical use and indicates the benefits of combining oral or topical minoxidil with PRP.