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Jerry Tan

Western University Canada, Schulich School of Medicine and Dentistry, Adjunct

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Clinical dermatologist with wide research interests including - skin imaging, QoL measures, outcome evaluations, shared decision making and evidence based practice. Focus areas are Acne, Rosacea, Hidradenitis Suppurativa.
Phone: (519) 971-7594
Address: 2224 Walker Road, Suite 300
Windsor, Ontario, Canada
N8W 5L7

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Fondazione Policlinico A. Gemelli Roma

MARCO ALEXANDRE ROCHA

Universidade Federal de São Paulo (UNIFESP)

Hang Tuah University Surabaya

Bethanee Schlosser

Hassan Galadari

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Papers by Jerry Tan

A New Era for Truncal Acne: Emerging from a Legacy of Neglect

Dermatology and Therapy, 2021

Evaluation of psychological well-being and social impact of atrophic acne scarring: A multinational, mixed-methods study

JAAD International, 2022

Background Most people with acne are at risk of developing acne scars, but the impact of these sc... more Background Most people with acne are at risk of developing acne scars, but the impact of these scars on patients' quality of life is poorly researched. Objective To assess the perspective of patients with acne scars and the impact of these scars on their emotional well-being and social functioning. Methods A 60-minute interview of 30 adults with acne scars informed and contextualized the development of a cross-sectional survey of 723 adults with atrophic acne scars. Results The main themes identified in the qualitative interviews included acceptability to self and others, social functioning, and emotional well-being. In the cross-sectional survey, 31.6%, 49.6%, and 18.8% of the participants had mild, moderate, and severe/very severe acne scarring. The survey revealed that 25.7% of the participants felt less attractive, 27.5% were embarrassed or self-conscious because of their scars, 8.3% reported being verbally and/or physically abused because of their scars on a regular basis, and 15.9% felt that they were unfairly dismissed from work. In addition, 37.5% of the participants believed that their scars affected people's perceptions about them, and 19.7% of the participants were very bothered about hiding their scars daily. Moreover, 35.5% of the participants avoided public appearances, and 43.2% felt that their scars had negatively impacted their relationships. Limitations The temporal evaluation of the impact was not estimated. Conclusion Even mild atrophic acne scarring can evoke substantial emotional, social, and functional concerns.

18277 Development of a patient decision aid for hidradenitis suppurativa: Facilitating informed shared decision making

Journal of the American Academy of Dermatology, 2020

Angioscopy enables macroscopic pathological diagnosis of cardiovascular diseases from the inside.... more Angioscopy enables macroscopic pathological diagnosis of cardiovascular diseases from the inside. This imaging modality has been intensively directed to characterizing vulnerable coronary plaques. Scoring of plaque color was developed, and based on prospective studies; dark yellow or glistening yellow plaques were proposed as vulnerable ones. Colorimetry apparatus was developed to assess the yellow color of the plaques quantitatively. The effects of lipid-lowering therapies on coronary plaques were confirmed by angioscopy. However, since observation is limited to surface color and morphology, pitfalls of this imaging technology became evident. Dye-staining angioscopy and near-infrared fluorescence angioscopy were developed for molecular imaging, and the latter method was successfully applied to patients. Color fluorescence angioscopy was also established for molecular and chemical basis characterization of vulnerable coronary plaques in both in vitro and in vivo. Drug-eluting stents (DES) reduce coronary restenosis significantly, however, late stent thrombosis (LST) occurs, which requires long-term antiplatelet therapy. Angioscopic grading of neointimal coverage of coronary stent struts was established, and it was revealed that neointimal formation is incomplete and prevalence of LST is higher in DES when compared to bare-metal stent. Many new stents were devised and they are now under experimental or clinical investigations to overcome the shortcomings of the stents that have been employed clinically. Endothelial cells are highly antithrombotic. Neoendothelial cell damage is considered to be caused by friction between the cells and stent struts due to the thin neointima between them that might act as a cushion. Therefore, development of a DES that causes an appropriate thickness (around 100 m) of the neointima is a potential option with which to prevent neoendothelial cell damage and consequent LST while preventing restenosis.

Beyond the Face: The Hidden Burden of Truncal Acne

Acta Dermato Venereologica, 2021

Identifying and appraising patient‐reported outcome measures on treatment satisfaction in acne: a systematic review*

British Journal of Dermatology, 2020

BACKGROUND After dermatitis, acne is the second skin disease most contributing to the burden of s... more BACKGROUND After dermatitis, acne is the second skin disease most contributing to the burden of skin diseases worldwide. Recently, seven core outcome domains have been identified that together form an Acne Core Outcome Set (ACORN project). One of these was satisfaction with acne treatment. OBJECTIVE Our aim was to identify studies that described the development of patient-reported outcome measures (PROMS), evaluated one or more measurement properties of a PROM, or evaluated the interpretability of a PROM in patients with acne regarding treatment satisfaction. METHODS The COSMIN search strategy for identifying PROMS on acne treatment satisfaction was used. We searched Pubmed, MEDLINE, Embase, LILACS, Web of Science, Cochrane Library, Emcare, PsychINFO and Academic Search premier (June 2020). Study selection, data extraction, and assessment of methodological quality according to COSMIN guidance were carried out independently by two authors. RESULTS Only one study could be included, describing the development of a treatment satisfaction measure in patients with acne. The development was assessed as inadequate, and data on measurement properties were lacking. Additionally, we found 188 studies reporting treatment satisfaction solely as an outcome, using a wide variety of methods, none of them standardised nor validated. CONCLUSIONS We could not find a PROM on treatment satisfaction to recommend for a core outcome set in acne. There is an unmet need for a PROM measuring treatment satisfaction in acne that is robustly developed, designed and validated.

A Split-Face Study Assessing the Clinical Benefit, Tolerability and Subject Satisfaction of a Dermocosmetic in Subjects with Rosacea Associated with Erythema and Sensitive Skin

Clinical, Cosmetic and Investigational Dermatology, 2020

This study was conducted to evaluate effects of somatic embryos (SEs) induction with different ki... more This study was conducted to evaluate effects of somatic embryos (SEs) induction with different kinds and concentrations of osmoticum, with gelrite and SEs germination with different abscisic acid (ABA) and embryogenic tissue lines (ETLs) in Japanese red pine (Pinus densiflora). In comparison of somatic embryos induction with different kinds and concentrations of osmoticum, the highest record (45/90 mg FW) was obtained from the treatment of 0.1 M maltose+3.75% PEG 4000. In addition, the higher one was also recorded from 0.2 M maltose (41 SEs), it turned out this treatment was also effective in induction of SEs with previous one. In effects of various gelrite concentrations for SEs production, no SEs were occurred in the treatment of 0.4 or 0.6% gelrite, however, the highest no. of SEs shown in 1.0% gellrite (41 SEs), and some comparable results were also marked with 0.8 (37.3 SEs) or 1.2% (39.7 SEs) gelrite. Therefore, SEs can be produced from above 0.8% concentration of gelrite. Finally, in comparison of SEs germination with different concentrations of ABA, ETLs, and AC, the best germination rates (45%) were obtained from the SEs derived from both concentrations of 150 and 200 μM ABA in 06-6 ETL and when cultured on germination supplemented with 0.2% AC. When SEs were cultured on germination medium without AC, best germination rate (28.9%) came from the SEs which cultured on 250 μM ABA in 06-6 ETL

Evaluating patients' unmet needs in hidradenitis suppurativa: Results from the Global Survey Of Impact and Healthcare Needs (VOICE) Project

Journal of the American Academy of Dermatology, 2019

Background: A needs assessment for patients with hidradenitis suppurativa (HS) will support advan... more

Evidence‐based treatments for rosacea based on phenotype approach

British Journal of Dermatology, 2019

Rosacea is a common, chronic skin condition causing flushing, redness, red pimples and pus-filled... more Rosacea is a common, chronic skin condition causing flushing, redness, red pimples and pus-filled spots (pustules) on the face. It affects about 1-20% of people worldwide. Rosacea can also cause inflammation of the eyes/eyelids (ocular rosacea) and thickening of the skin, especially the nose (rhinophyma). Although the cause of rosacea is unclear, treatments are available for this distressing disease. This review from the Netherlands, U.K. and Canada aimed to find out which treatments are effective for rosacea. The authors included data from 152 studies. For reducing redness, brimonidine and oxymetazoline worked from three up to 12 hours after being applied. For reducing pimples and pustules with topical (applied to the skin) treatments, azelaic acid, ivermectin and metronidazole were effective and safe. Ivermectin was slightly more effective than metronidazole. Minocycline foam also showed a large reduction in pimples and pustules. With oral (taken by mouth) antibiotics, tetracycline, doxycycline 40 mg or minocycline 45 mg reduced the number of pimples and pustules. Doxycycline 40 mg was likely as effective as 100 mg, with fewer side effects like diarrhoea and nausea. Oral minocycline 100 mg was as effective as doxycycline 40 mg. Azithromycin may be as effective as 100 mg doxycycline. Isotretinoin 0.25 mg/kg decreased pimples and pustules by 90%, and increased quality of life and patients' satisfaction. Isotretinoin 0.3 mg/kg appeared to be slightly more effective than 50-100 mg doxycycline. However, isotretinoin is known to cause serious birth defects, so pregnancy must be avoided when using it. For treating dilated blood vessels, laser therapy and intense pulsed light therapy were both effective, but these studies had limited data. In ocular rosacea, ciclosporin 0.05% ophthalmic emulsion increased quality of life and improved the amount/quality of tears, and was slightly more effective than oral doxycycline. Omega-3 fatty acids likely improve dry eyes and tear gland function.

Putting the Patient in Patient-Centred Care: Pilot Testing an Updated Patient Decision Aid for Plaque Psoriasis

Journal of Cutaneous Medicine and Surgery, 2019

Proceeding report of the Second Symposium on Hidradenitis Suppurativa Advances (SHSA) 2017

Experimental Dermatology, 2018

The 2nd Annual Symposium on Hidradenitis Suppurativa Advances (SHSA) took place on 03‐05 November... more The 2nd Annual Symposium on Hidradenitis Suppurativa Advances (SHSA) took place on 03‐05 November 2017 in Detroit, Michigan, USA. This symposium was a joint meeting of the Hidradenitis Suppurativa Foundation (HSF Inc.) founded in the USA, and the Canadian Hidradenitis Suppurativa Foundation (CHSF). This was the second annual meeting of the SHSA with experts from different disciplines arriving from North America, Europe and Australia, in a joint aim to discuss most recent innovations, practical challenges and potential solutions to issues related in the management and care of Hidradenitis Suppurativa patients. The last session involved clinicians, patients and their families in an effort to educate them more about the disease.

Defining treatment success in rosacea as 'clear' may provide multiple patient benefits: Results of a pooled analysis

The Journal of dermatological treatment, Jan 15, 2017

Background Rosacea treatment success is usually defined as a score of 1 ("almost clear"... more Background Rosacea treatment success is usually defined as a score of 1 ("almost clear") or 0 ("clear") on the 5-point Investigator Global Assessment (IGA) scale. Objective To evaluate whether after successful treatment, "clear" subjects had better outcomes than "almost clear" subjects. Methods A pooled analysis was performed on 1366 rosacea subjects from 4 randomized controlled trials with IGA before and after treatment (ivermectin, metronidazole or vehicle). Assessments included the Dermatology Life Quality Index (DLQI) questionnaire and subject assessment of rosacea improvement. In one trial, patients were followed after the treatment period to measure time to relapse (IGA score ≥ 2). Results At end of treatment, more "clear" than "almost clear" subjects had a clinically meaningful difference in DLQI (59% vs. 44%; P<0.001) and a final DLQI score of 0-1 indicating no effect on quality of life (84% vs. 66%; P<0.001)....

Oral isotretinoin: ensuring safe use while not limiting access to those who need it

CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, Apr 3, 2017

Olumacostat glasaretil, a novel topical sebum inhibitor, in the treatment of acne vulgaris: A phase IIa, multicenter, randomized, vehicle-controlled study

Journal of the American Academy of Dermatology, 2017

Background: Olumacostat glasaretil (OG) inhibits acetyl-coenzyme A carboxylase, the enzyme respon... more Background: Olumacostat glasaretil (OG) inhibits acetyl-coenzyme A carboxylase, the enzyme responsible for the first, rate-limiting step in de novo fatty acid synthesis. OG inhibited in vitro human sebocyte lipid production and reduced in vivo sebaceous gland size in hamster ears. Objectives: Safety and efficacy of OG 7.5% gel were evaluated in patients with moderate to severe facial acne vulgaris. Methods: Patients were randomized (1:1) to twice-daily application of OG or vehicle for 12 weeks. Efficacy was measured through changes in lesion counts and improvement in acne severity scores. Results: A total of 108 patients received OG (n = 53) or vehicle (n = 55); these groups had mean baseline counts of 29.7 and 28.6 inflammatory and 40.9 and 38.8 noninflammatory lesions, respectively. At week 12, OG treatment showed greater reductions from baseline in inflammatory lesions (À63.9% vs À45.9%; P = .0006) and noninflammatory lesions (À48.1% vs À28.8%; P = .0025), and more patients with greater than or equal to 2-grade improvement in investigator global assessment score (24.5% vs 7.3%; P = .0070) than vehicle. Application-site adverse events (typically mild or moderate intensity) were more common with OG. Limitations: Larger trials are needed to optimize OG dosing and confirm the current results. Conclusion: OG was well tolerated and showed evidence of efficacy, suggesting further development is warranted.

Canadian Clinical Practice Guidelines for Rosacea

Journal of cutaneous medicine and surgery, Jan 17, 2016

Rosacea is a chronic facial inflammatory dermatosis characterized by background facial erythema a... more Rosacea is a chronic facial inflammatory dermatosis characterized by background facial erythema and flushing and may be accompanied by inflammatory papules and pustules, cutaneous fibrosis and hyperplasia known as phyma, and ocular involvement. These features can have adverse impact on quality of life, and ocular involvement can lead to visual dysfunction. The past decade has witnessed increased research into pathogenic pathways involved in rosacea and the introduction of novel treatment innovations. The objective of these guidelines is to offer evidence-based recommendations to assist Canadian health care providers in the diagnosis and management of rosacea. These guidelines were developed by an expert panel of Canadian dermatologists taking into consideration the balance of desirable and undesirable outcomes, the quality of supporting evidence, the values and preferences of patients, and the costs of treatment. The 2015 Cochrane review "Interventions in Rosacea" was used...

How People with Facial Acne Scars are Perceived in Society: an Online Survey

Dermatology and therapy, Jan 18, 2016

Atrophic scarring occurs throughout the course of inflammatory acne and across the spectrum of se... more Atrophic scarring occurs throughout the course of inflammatory acne and across the spectrum of severity. This study evaluates perceptions of the general population toward individuals with clear skin and acne scars. An online survey administered in the USA, UK, Japan, Germany, France and Brazil to respondents 18 years and over presented three facial pictures of clear skin or digitally superimposed acne scars (but no active acne lesions) in a random fashion. At least one clear and one scar picture were presented to each participant. Among the 4618 responders, 33% themselves had facial acne scars. The skin was the first thing noticed about the face by 41% when viewing pictures with scars vs 8% viewing clear skin (p < 0.05). Those with scars were less likely to be considered attractive (17% vs 25%), confident (25% vs 33%), happy (23% vs 30%), healthy (21% vs 31%) and successful (17% vs 24%), and more likely to be perceived as insecure (15% vs 8%) and shy (23% vs 14%) compared with th...

Development and Evaluation of a Rosacea Screening Instrument (Rosascreen)

Journal of cutaneous medicine and surgery, 2016

There are no current instruments to facilitate population screening for rosacea. To develop and e... more There are no current instruments to facilitate population screening for rosacea. To develop and evaluate a screening instrument for rosacea applicable for population surveys. A rosacea-specific screening instrument (Rosascreen), consisting of a subject-completed questionnaire and screening algorithm, was developed based on current diagnostic criteria for rosacea. Three iterations were pilot tested and refined for clarity and sensitivity in adult outpatients with and without rosacea. Three subject groups were consecutively evaluated with iterations of the questionnaire at each centre (overall N = 121). The final version had a sensitivity of 93% to 100% for key diagnostic criteria, and use of the algorithm had a sensitivity of 100% for detection of rosacea and specificity of 63% to 71%. Most subjects found the questionnaire easy to understand and complete. Rosascreen, a subject-completed questionnaire and diagnostic algorithm, is a highly sensitive screening instrument that may facili...

New Patient-Oriented Tools for Assessing Atrophic Acne Scarring

Dermatology and Therapy, 2016

Introduction: Scarring on visible areas such as the face is associated with negative psychologica... more Introduction: Scarring on visible areas such as the face is associated with negative psychological impact. Many patients with acne have clinically relevant scarring for which they seek treatment, implying that there is an impact on their lives. Currently there are no validated tools to assess the burden of atrophic acne scarring from the patient's perspective or to assess treatment benefit. Methods: Two patient-reported outcome measures, the self-assessment of clinical acne-related scars (SCARS) and the facial acne scar quality of life (FASQoL) tools, both specific to facial atrophic acne scarring, were developed according to Food and Drug Administration guidance methodology. Patient interviews were conducted first to elicit patient-important concepts about scarring, then to validate patients' understanding of wording in the On behalf of the Global Alliance to Improve Outcomes in Acne.

Oral contraceptives in the treatment of acne

Skin therapy letter

Oral contraceptives (OCs) can reduce acne by lowering the production of adrenal and ovarian andro... more Oral contraceptives (OCs) can reduce acne by lowering the production of adrenal and ovarian androgens, by inhibiting 5-alpha-reductase, which in turn, reduces the levels of dihydrotestosterone, and by stimulating sex hormone binding globulin (SHBG), thus reducing the levels of free testosterone. In newer OCs, such as Tricyclen and Diane-35, the progestin component is minimally androgenic and anti-androgenic respectively, thereby enhancing the favorable profile of these products in the treatment of hyperandrogenic disorders, including acne. The efficacy of these agents and their long-term safety profile supports their use in various grades of acne in females: * As adjunctive therapy to topical agents for women with mild non-scarring acne desiring oral contraception * As primary therapy for patients with moderate non-scarring acne in combination with topical therapy and systemic antibiotics * As one of two preferred methods of contraception in patients with scarring and severe inflamm...

Perceptions on the Psychological Impact of Facial Erythema Associated with Rosacea: Results of International Survey

Dermatology and therapy, 2015

Rosacea (including facial erythema) has a negative impact on psychological and emotional health. ... more Rosacea (including facial erythema) has a negative impact on psychological and emotional health. This survey aimed to assess the impact of facial erythema on subconscious perceptions and the initial reactions of others and how this affects attitudes in different settings. The survey also measured the impact of facial erythema on a person's emotional and psychological wellbeing. A total of 6831 participants from eight countries completed online computer-assisted web interviewing psychological assessments based on the implicit association test. Traditional questionnaires provided data on the impact of facial erythema and perceptions of people with rosacea from other participants. Facial erythema was strongly associated with poor health and negative personality traits with participants reporting negative impacts of rosacea emotionally, socially and in the workplace. Nearly 80% reported difficulty in controlling facial erythema but those with physician-diagnosed rosacea had signific...

Psychosocial impact of acne vulgaris: evaluating the evidence

Skin therapy letter

This paper reviews current evidence presented by recent studies on the impact of acne on psychoso... more This paper reviews current evidence presented by recent studies on the impact of acne on psychosocial health. Study methodologies, including case-control and cross-sectional surveys, have demonstrated psychological abnormalities including depression, suicidal ideation, anxiety, psychosomatic symptoms, including pain and discomfort, embarrassment and social inhibition. Effective treatment of acne was accompanied by improvement in self-esteem, affect, obsessive-compulsiveness, shame, embarrassment, body image, social assertiveness and self-confidence. Acne is associated with a greater psychological burden than a variety of other disparate chronic disorders. Future studies with a longitudinal cohort design may provide further validation of the causal inference between acne and psychosocial disability provided by the current literature.

A New Era for Truncal Acne: Emerging from a Legacy of Neglect

Dermatology and Therapy, 2021

Evaluation of psychological well-being and social impact of atrophic acne scarring: A multinational, mixed-methods study

JAAD International, 2022

Background Most people with acne are at risk of developing acne scars, but the impact of these sc... more Background Most people with acne are at risk of developing acne scars, but the impact of these scars on patients' quality of life is poorly researched. Objective To assess the perspective of patients with acne scars and the impact of these scars on their emotional well-being and social functioning. Methods A 60-minute interview of 30 adults with acne scars informed and contextualized the development of a cross-sectional survey of 723 adults with atrophic acne scars. Results The main themes identified in the qualitative interviews included acceptability to self and others, social functioning, and emotional well-being. In the cross-sectional survey, 31.6%, 49.6%, and 18.8% of the participants had mild, moderate, and severe/very severe acne scarring. The survey revealed that 25.7% of the participants felt less attractive, 27.5% were embarrassed or self-conscious because of their scars, 8.3% reported being verbally and/or physically abused because of their scars on a regular basis, and 15.9% felt that they were unfairly dismissed from work. In addition, 37.5% of the participants believed that their scars affected people's perceptions about them, and 19.7% of the participants were very bothered about hiding their scars daily. Moreover, 35.5% of the participants avoided public appearances, and 43.2% felt that their scars had negatively impacted their relationships. Limitations The temporal evaluation of the impact was not estimated. Conclusion Even mild atrophic acne scarring can evoke substantial emotional, social, and functional concerns.

18277 Development of a patient decision aid for hidradenitis suppurativa: Facilitating informed shared decision making

Journal of the American Academy of Dermatology, 2020

Angioscopy enables macroscopic pathological diagnosis of cardiovascular diseases from the inside.... more Angioscopy enables macroscopic pathological diagnosis of cardiovascular diseases from the inside. This imaging modality has been intensively directed to characterizing vulnerable coronary plaques. Scoring of plaque color was developed, and based on prospective studies; dark yellow or glistening yellow plaques were proposed as vulnerable ones. Colorimetry apparatus was developed to assess the yellow color of the plaques quantitatively. The effects of lipid-lowering therapies on coronary plaques were confirmed by angioscopy. However, since observation is limited to surface color and morphology, pitfalls of this imaging technology became evident. Dye-staining angioscopy and near-infrared fluorescence angioscopy were developed for molecular imaging, and the latter method was successfully applied to patients. Color fluorescence angioscopy was also established for molecular and chemical basis characterization of vulnerable coronary plaques in both in vitro and in vivo. Drug-eluting stents (DES) reduce coronary restenosis significantly, however, late stent thrombosis (LST) occurs, which requires long-term antiplatelet therapy. Angioscopic grading of neointimal coverage of coronary stent struts was established, and it was revealed that neointimal formation is incomplete and prevalence of LST is higher in DES when compared to bare-metal stent. Many new stents were devised and they are now under experimental or clinical investigations to overcome the shortcomings of the stents that have been employed clinically. Endothelial cells are highly antithrombotic. Neoendothelial cell damage is considered to be caused by friction between the cells and stent struts due to the thin neointima between them that might act as a cushion. Therefore, development of a DES that causes an appropriate thickness (around 100 m) of the neointima is a potential option with which to prevent neoendothelial cell damage and consequent LST while preventing restenosis.

Beyond the Face: The Hidden Burden of Truncal Acne

Acta Dermato Venereologica, 2021

Identifying and appraising patient‐reported outcome measures on treatment satisfaction in acne: a systematic review*

British Journal of Dermatology, 2020

BACKGROUND After dermatitis, acne is the second skin disease most contributing to the burden of s... more BACKGROUND After dermatitis, acne is the second skin disease most contributing to the burden of skin diseases worldwide. Recently, seven core outcome domains have been identified that together form an Acne Core Outcome Set (ACORN project). One of these was satisfaction with acne treatment. OBJECTIVE Our aim was to identify studies that described the development of patient-reported outcome measures (PROMS), evaluated one or more measurement properties of a PROM, or evaluated the interpretability of a PROM in patients with acne regarding treatment satisfaction. METHODS The COSMIN search strategy for identifying PROMS on acne treatment satisfaction was used. We searched Pubmed, MEDLINE, Embase, LILACS, Web of Science, Cochrane Library, Emcare, PsychINFO and Academic Search premier (June 2020). Study selection, data extraction, and assessment of methodological quality according to COSMIN guidance were carried out independently by two authors. RESULTS Only one study could be included, describing the development of a treatment satisfaction measure in patients with acne. The development was assessed as inadequate, and data on measurement properties were lacking. Additionally, we found 188 studies reporting treatment satisfaction solely as an outcome, using a wide variety of methods, none of them standardised nor validated. CONCLUSIONS We could not find a PROM on treatment satisfaction to recommend for a core outcome set in acne. There is an unmet need for a PROM measuring treatment satisfaction in acne that is robustly developed, designed and validated.

A Split-Face Study Assessing the Clinical Benefit, Tolerability and Subject Satisfaction of a Dermocosmetic in Subjects with Rosacea Associated with Erythema and Sensitive Skin

Clinical, Cosmetic and Investigational Dermatology, 2020

This study was conducted to evaluate effects of somatic embryos (SEs) induction with different ki... more This study was conducted to evaluate effects of somatic embryos (SEs) induction with different kinds and concentrations of osmoticum, with gelrite and SEs germination with different abscisic acid (ABA) and embryogenic tissue lines (ETLs) in Japanese red pine (Pinus densiflora). In comparison of somatic embryos induction with different kinds and concentrations of osmoticum, the highest record (45/90 mg FW) was obtained from the treatment of 0.1 M maltose+3.75% PEG 4000. In addition, the higher one was also recorded from 0.2 M maltose (41 SEs), it turned out this treatment was also effective in induction of SEs with previous one. In effects of various gelrite concentrations for SEs production, no SEs were occurred in the treatment of 0.4 or 0.6% gelrite, however, the highest no. of SEs shown in 1.0% gellrite (41 SEs), and some comparable results were also marked with 0.8 (37.3 SEs) or 1.2% (39.7 SEs) gelrite. Therefore, SEs can be produced from above 0.8% concentration of gelrite. Finally, in comparison of SEs germination with different concentrations of ABA, ETLs, and AC, the best germination rates (45%) were obtained from the SEs derived from both concentrations of 150 and 200 μM ABA in 06-6 ETL and when cultured on germination supplemented with 0.2% AC. When SEs were cultured on germination medium without AC, best germination rate (28.9%) came from the SEs which cultured on 250 μM ABA in 06-6 ETL

Evaluating patients' unmet needs in hidradenitis suppurativa: Results from the Global Survey Of Impact and Healthcare Needs (VOICE) Project

Journal of the American Academy of Dermatology, 2019

Background: A needs assessment for patients with hidradenitis suppurativa (HS) will support advan... more

Evidence‐based treatments for rosacea based on phenotype approach

British Journal of Dermatology, 2019

Rosacea is a common, chronic skin condition causing flushing, redness, red pimples and pus-filled... more Rosacea is a common, chronic skin condition causing flushing, redness, red pimples and pus-filled spots (pustules) on the face. It affects about 1-20% of people worldwide. Rosacea can also cause inflammation of the eyes/eyelids (ocular rosacea) and thickening of the skin, especially the nose (rhinophyma). Although the cause of rosacea is unclear, treatments are available for this distressing disease. This review from the Netherlands, U.K. and Canada aimed to find out which treatments are effective for rosacea. The authors included data from 152 studies. For reducing redness, brimonidine and oxymetazoline worked from three up to 12 hours after being applied. For reducing pimples and pustules with topical (applied to the skin) treatments, azelaic acid, ivermectin and metronidazole were effective and safe. Ivermectin was slightly more effective than metronidazole. Minocycline foam also showed a large reduction in pimples and pustules. With oral (taken by mouth) antibiotics, tetracycline, doxycycline 40 mg or minocycline 45 mg reduced the number of pimples and pustules. Doxycycline 40 mg was likely as effective as 100 mg, with fewer side effects like diarrhoea and nausea. Oral minocycline 100 mg was as effective as doxycycline 40 mg. Azithromycin may be as effective as 100 mg doxycycline. Isotretinoin 0.25 mg/kg decreased pimples and pustules by 90%, and increased quality of life and patients' satisfaction. Isotretinoin 0.3 mg/kg appeared to be slightly more effective than 50-100 mg doxycycline. However, isotretinoin is known to cause serious birth defects, so pregnancy must be avoided when using it. For treating dilated blood vessels, laser therapy and intense pulsed light therapy were both effective, but these studies had limited data. In ocular rosacea, ciclosporin 0.05% ophthalmic emulsion increased quality of life and improved the amount/quality of tears, and was slightly more effective than oral doxycycline. Omega-3 fatty acids likely improve dry eyes and tear gland function.

Putting the Patient in Patient-Centred Care: Pilot Testing an Updated Patient Decision Aid for Plaque Psoriasis

Journal of Cutaneous Medicine and Surgery, 2019

Proceeding report of the Second Symposium on Hidradenitis Suppurativa Advances (SHSA) 2017

Experimental Dermatology, 2018

The 2nd Annual Symposium on Hidradenitis Suppurativa Advances (SHSA) took place on 03‐05 November... more The 2nd Annual Symposium on Hidradenitis Suppurativa Advances (SHSA) took place on 03‐05 November 2017 in Detroit, Michigan, USA. This symposium was a joint meeting of the Hidradenitis Suppurativa Foundation (HSF Inc.) founded in the USA, and the Canadian Hidradenitis Suppurativa Foundation (CHSF). This was the second annual meeting of the SHSA with experts from different disciplines arriving from North America, Europe and Australia, in a joint aim to discuss most recent innovations, practical challenges and potential solutions to issues related in the management and care of Hidradenitis Suppurativa patients. The last session involved clinicians, patients and their families in an effort to educate them more about the disease.

Defining treatment success in rosacea as 'clear' may provide multiple patient benefits: Results of a pooled analysis

The Journal of dermatological treatment, Jan 15, 2017

Background Rosacea treatment success is usually defined as a score of 1 ("almost clear"... more Background Rosacea treatment success is usually defined as a score of 1 ("almost clear") or 0 ("clear") on the 5-point Investigator Global Assessment (IGA) scale. Objective To evaluate whether after successful treatment, "clear" subjects had better outcomes than "almost clear" subjects. Methods A pooled analysis was performed on 1366 rosacea subjects from 4 randomized controlled trials with IGA before and after treatment (ivermectin, metronidazole or vehicle). Assessments included the Dermatology Life Quality Index (DLQI) questionnaire and subject assessment of rosacea improvement. In one trial, patients were followed after the treatment period to measure time to relapse (IGA score ≥ 2). Results At end of treatment, more "clear" than "almost clear" subjects had a clinically meaningful difference in DLQI (59% vs. 44%; P<0.001) and a final DLQI score of 0-1 indicating no effect on quality of life (84% vs. 66%; P<0.001)....

Oral isotretinoin: ensuring safe use while not limiting access to those who need it

CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, Apr 3, 2017

Olumacostat glasaretil, a novel topical sebum inhibitor, in the treatment of acne vulgaris: A phase IIa, multicenter, randomized, vehicle-controlled study

Journal of the American Academy of Dermatology, 2017

Background: Olumacostat glasaretil (OG) inhibits acetyl-coenzyme A carboxylase, the enzyme respon... more Background: Olumacostat glasaretil (OG) inhibits acetyl-coenzyme A carboxylase, the enzyme responsible for the first, rate-limiting step in de novo fatty acid synthesis. OG inhibited in vitro human sebocyte lipid production and reduced in vivo sebaceous gland size in hamster ears. Objectives: Safety and efficacy of OG 7.5% gel were evaluated in patients with moderate to severe facial acne vulgaris. Methods: Patients were randomized (1:1) to twice-daily application of OG or vehicle for 12 weeks. Efficacy was measured through changes in lesion counts and improvement in acne severity scores. Results: A total of 108 patients received OG (n = 53) or vehicle (n = 55); these groups had mean baseline counts of 29.7 and 28.6 inflammatory and 40.9 and 38.8 noninflammatory lesions, respectively. At week 12, OG treatment showed greater reductions from baseline in inflammatory lesions (À63.9% vs À45.9%; P = .0006) and noninflammatory lesions (À48.1% vs À28.8%; P = .0025), and more patients with greater than or equal to 2-grade improvement in investigator global assessment score (24.5% vs 7.3%; P = .0070) than vehicle. Application-site adverse events (typically mild or moderate intensity) were more common with OG. Limitations: Larger trials are needed to optimize OG dosing and confirm the current results. Conclusion: OG was well tolerated and showed evidence of efficacy, suggesting further development is warranted.

Canadian Clinical Practice Guidelines for Rosacea

Journal of cutaneous medicine and surgery, Jan 17, 2016

Rosacea is a chronic facial inflammatory dermatosis characterized by background facial erythema a... more Rosacea is a chronic facial inflammatory dermatosis characterized by background facial erythema and flushing and may be accompanied by inflammatory papules and pustules, cutaneous fibrosis and hyperplasia known as phyma, and ocular involvement. These features can have adverse impact on quality of life, and ocular involvement can lead to visual dysfunction. The past decade has witnessed increased research into pathogenic pathways involved in rosacea and the introduction of novel treatment innovations. The objective of these guidelines is to offer evidence-based recommendations to assist Canadian health care providers in the diagnosis and management of rosacea. These guidelines were developed by an expert panel of Canadian dermatologists taking into consideration the balance of desirable and undesirable outcomes, the quality of supporting evidence, the values and preferences of patients, and the costs of treatment. The 2015 Cochrane review "Interventions in Rosacea" was used...

How People with Facial Acne Scars are Perceived in Society: an Online Survey

Dermatology and therapy, Jan 18, 2016

Atrophic scarring occurs throughout the course of inflammatory acne and across the spectrum of se... more Atrophic scarring occurs throughout the course of inflammatory acne and across the spectrum of severity. This study evaluates perceptions of the general population toward individuals with clear skin and acne scars. An online survey administered in the USA, UK, Japan, Germany, France and Brazil to respondents 18 years and over presented three facial pictures of clear skin or digitally superimposed acne scars (but no active acne lesions) in a random fashion. At least one clear and one scar picture were presented to each participant. Among the 4618 responders, 33% themselves had facial acne scars. The skin was the first thing noticed about the face by 41% when viewing pictures with scars vs 8% viewing clear skin (p < 0.05). Those with scars were less likely to be considered attractive (17% vs 25%), confident (25% vs 33%), happy (23% vs 30%), healthy (21% vs 31%) and successful (17% vs 24%), and more likely to be perceived as insecure (15% vs 8%) and shy (23% vs 14%) compared with th...

Development and Evaluation of a Rosacea Screening Instrument (Rosascreen)

Journal of cutaneous medicine and surgery, 2016

There are no current instruments to facilitate population screening for rosacea. To develop and e... more There are no current instruments to facilitate population screening for rosacea. To develop and evaluate a screening instrument for rosacea applicable for population surveys. A rosacea-specific screening instrument (Rosascreen), consisting of a subject-completed questionnaire and screening algorithm, was developed based on current diagnostic criteria for rosacea. Three iterations were pilot tested and refined for clarity and sensitivity in adult outpatients with and without rosacea. Three subject groups were consecutively evaluated with iterations of the questionnaire at each centre (overall N = 121). The final version had a sensitivity of 93% to 100% for key diagnostic criteria, and use of the algorithm had a sensitivity of 100% for detection of rosacea and specificity of 63% to 71%. Most subjects found the questionnaire easy to understand and complete. Rosascreen, a subject-completed questionnaire and diagnostic algorithm, is a highly sensitive screening instrument that may facili...

New Patient-Oriented Tools for Assessing Atrophic Acne Scarring

Dermatology and Therapy, 2016

Introduction: Scarring on visible areas such as the face is associated with negative psychologica... more Introduction: Scarring on visible areas such as the face is associated with negative psychological impact. Many patients with acne have clinically relevant scarring for which they seek treatment, implying that there is an impact on their lives. Currently there are no validated tools to assess the burden of atrophic acne scarring from the patient's perspective or to assess treatment benefit. Methods: Two patient-reported outcome measures, the self-assessment of clinical acne-related scars (SCARS) and the facial acne scar quality of life (FASQoL) tools, both specific to facial atrophic acne scarring, were developed according to Food and Drug Administration guidance methodology. Patient interviews were conducted first to elicit patient-important concepts about scarring, then to validate patients' understanding of wording in the On behalf of the Global Alliance to Improve Outcomes in Acne.

Oral contraceptives in the treatment of acne

Skin therapy letter

Oral contraceptives (OCs) can reduce acne by lowering the production of adrenal and ovarian andro... more Oral contraceptives (OCs) can reduce acne by lowering the production of adrenal and ovarian androgens, by inhibiting 5-alpha-reductase, which in turn, reduces the levels of dihydrotestosterone, and by stimulating sex hormone binding globulin (SHBG), thus reducing the levels of free testosterone. In newer OCs, such as Tricyclen and Diane-35, the progestin component is minimally androgenic and anti-androgenic respectively, thereby enhancing the favorable profile of these products in the treatment of hyperandrogenic disorders, including acne. The efficacy of these agents and their long-term safety profile supports their use in various grades of acne in females: * As adjunctive therapy to topical agents for women with mild non-scarring acne desiring oral contraception * As primary therapy for patients with moderate non-scarring acne in combination with topical therapy and systemic antibiotics * As one of two preferred methods of contraception in patients with scarring and severe inflamm...

Perceptions on the Psychological Impact of Facial Erythema Associated with Rosacea: Results of International Survey

Dermatology and therapy, 2015

Rosacea (including facial erythema) has a negative impact on psychological and emotional health. ... more Rosacea (including facial erythema) has a negative impact on psychological and emotional health. This survey aimed to assess the impact of facial erythema on subconscious perceptions and the initial reactions of others and how this affects attitudes in different settings. The survey also measured the impact of facial erythema on a person's emotional and psychological wellbeing. A total of 6831 participants from eight countries completed online computer-assisted web interviewing psychological assessments based on the implicit association test. Traditional questionnaires provided data on the impact of facial erythema and perceptions of people with rosacea from other participants. Facial erythema was strongly associated with poor health and negative personality traits with participants reporting negative impacts of rosacea emotionally, socially and in the workplace. Nearly 80% reported difficulty in controlling facial erythema but those with physician-diagnosed rosacea had signific...

Psychosocial impact of acne vulgaris: evaluating the evidence

Skin therapy letter

This paper reviews current evidence presented by recent studies on the impact of acne on psychoso... more This paper reviews current evidence presented by recent studies on the impact of acne on psychosocial health. Study methodologies, including case-control and cross-sectional surveys, have demonstrated psychological abnormalities including depression, suicidal ideation, anxiety, psychosomatic symptoms, including pain and discomfort, embarrassment and social inhibition. Effective treatment of acne was accompanied by improvement in self-esteem, affect, obsessive-compulsiveness, shame, embarrassment, body image, social assertiveness and self-confidence. Acne is associated with a greater psychological burden than a variety of other disparate chronic disorders. Future studies with a longitudinal cohort design may provide further validation of the causal inference between acne and psychosocial disability provided by the current literature.