Highlights d Cities possess a consistent ''core'' set of non-human microbes d Urban microbiomes echo important features of cities and city-life d Antimicrobial resistance genes are widespread in cities d Cities contain many novel bacterial and viral species
Background
Adalimumab is the only FDA‐approved biologic for hidradenitis suppurativa (HS). In the setting of increasing obesity rates worldwide, the relationship between adalimumab efficacy for HS and BMI is essential to understand. We assessed this relationship through markers of disease severity and inflammation.
Methods
Institutional review board‐approved retrospective chart review of Montefiore/Einstein HS Center (HSC) patients (n = 57) treated with adalimumab. The relationship between BMI and adalimumab efficacy was assessed through disease severity (HS‐Physician Global Assessment [HS‐PGA] 0 and Numerical Rating Scale Pain [NRS‐Pain]) and inflammatory markers (erythrocyte sedimentation rate [ESR], C‐reactive protein [CRP], and interleukin‐6 [IL‐6]). A BMI ≥ 30 is defined as obese; BMI < 30 is defined as non‐obese.
Results
The mean age was 35.8 ± 13.0 years. After adalimumab therapy, those with BMI < 30 experienced significant reductions in HS‐PGA (−1.5 ± 0.9; P < 0.0001) and NRS‐Pain (−1.6 ± 2.1; P < 0.0001), as well as mean decreases in inflammatory markers ESR, CRP, and IL‐6 (−17.90 ± 23.6, −0.71 ± 1.4, −5.88 ± 7.9, respectively; P > 0.05). Obese patients (BMI ≥ 30) experienced mean increases in HS‐PGA (+0.22 ± 0.8; P > 0.05) and NRS‐Pain scores (+1.41 ± 3.5; P > 0.05) as well as mean increases in ESR, CRP, and IL‐6 (+2.62 ± 28.3, +0.44 ± 3.0, +2.35 ± 6.9, respectively; P > 0.05). Comparing the cohorts, differences in changes in HS‐PGA, NRS‐Pain, ESR, and IL‐6 after therapy are significantly different (P < 0.05).
Conclusions
We identified significantly lower efficacy of adalimumab in HS patients with BMI ≥ 30 compared to those with BMI < 30. Those with BMI ≥ 30 demonstrated signs of both clinical and physiological deterioration while on adalimumab. Future studies are needed to examine adalimumab dosing for HS patients with high BMI, as well as a critical reconsideration of weight‐based therapies.
Rhododendrol (RD) is a skin whitening ingredient that was developed in Japan. Among the 800,000 users of RD-containing cosmetics, 20,000 patients developed localized leukoderma (RD-induced leukoderma). Forty-two % of those users showed perilesional hyperpigmentation (leukomelanoderma), and 14% of them were associated with vitiligo vulgaris afterwards. The aim of this study is to investigate the risk factors affecting the severity of RD-induced leukoderma, the occurrence of leukomelanoderma, and the association with vitiligo vulgaris. For this retrospective cohort study, we abstracted data from our dermatology medical records of 101 patients who developed leukoderma after using the cosmetics containing RD from July 2013 to December 2014. Age, BMI, the number of RD-containing products they used, smoking history and depigmentation scores at their baseline visit as well as blood test data for anti-nuclear and/or anti-thyroid antibodies were analyzed. Multivariable logistic regression and linear regression were used for analyses of leukomelanoderma, vitiligo vulgaris and characteristics at the baseline visit. Age, the number of RD-containing products used, BMI, anti-nuclear and anti-thyroid antibodies were not significantly correlated with the presence of leukomelanoderma, but it appeared that leukomelanoderma was more likely to occur in patients who had a smoking history (p¼0.006). In addition, smokers showed a significant increase in their depigmentation score at the baseline visit (p¼0.03). Our study demonstrates that smoking is associated with the severity of RD-induced leukoderma and the occurrence of leukomelanoderma.
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