The Psychosocial Burden of Skin Disease and Dermatology Care Insights Among Skin of Color Consumers.

BACKGROUND: Skin conditions are associated with psychological symptoms and may be particularly distressing for skin of color (SoC) individuals. SoC consumers' decisions to pursue dermatology care may be negatively impacted by the scarcity of skin tone diversity in dermatology. This survey explored SoC consumers' perspectives on dermatologic care to provide insight into the psychosocial burden of skin disease. METHODS: Beacon Science conducted an anonymous web-based survey in August 2022 among self-selected consumers. Demographics, bothersome skin condition effects on mental health, insights about skincare products, and dermatologists’ ability to address SoC were captured. Descriptive statistics were performed. RESULTS: 775 responded, 64.6% (n=501) with SoC. Among these, 94.2% (472/501) were female, 76.6% (384/501) Black/African American, and 48.9% (245/501) 18-24 years. 79.6% (399/501) reported a bothersome skin condition that was moderate to extremely bothersome (85.2%, 340/399). 57.4% (229/399) reported skin condition(s) affected mental health. Discoloration/acne-related post-inflammatory pigmentation changes (69.5%, 348/501), acne (58.5%, 293/501), and ingrown hairs (48.1%, 241/501) were most common. The face was most frequently affected (93.6%, 469/501). 40.9% (205/501) believed available skin products do not address their specific skin needs; 44.8% (179/399) have consulted a dermatologist; 46.4% (185/399) felt like the dermatologist did not know how to treat their skin; and 92.5% (369/399) did not believe most dermatologists or aestheticians are trained to treat darker skin tones. The survey was not validated and may not be generalizable. CONCLUSIONS: SoC consumers experience skin-condition psychosocial distress and may hesitate to seek dermatology care. Dermatology products, services, and education tailored to SoC consumers is needed. J Drugs Dermatol. 2023;22(10):1027-1033 doi:10.36849/JDD.7713.

The Role of Medical Nutrition Therapy in Dermatology and Skin Aesthetics: A Review

The field of nutritional sciences has advanced beyond research of the role of individual nutrients, supplements, and diet in disease to the multi-disciplinary practice of adjuvant medical nutrition therapy (MNT). Nutrition research is often that of association rather than cause and effect, yet there are compellingly strong relationships between diet and disease severity and incidence of a number of dermatological conditions. MNT is a tailored, evidence-based, comprehensive nutrition intervention strategy delivered by a physician and registered dietitian to a subset of dermatology patients who may benefit from nutrition intervention. With shorter clinical interaction times and patients requesting nutrition information, a collaborative approach may spur clinically meaningful nutritional changes with advice beyond the often quoted "eat better, lose weight, and exercise." This review provides a comprehensive overview of the latest Dermatology Medical Nutrition Therapy (D-MNT) recommendations and advocates an evidence-based, collaborative approach to dermatological patient care. J Drugs Dermatol. 2020;19(1):12-18. doi:10.36849/JDD.2020.4745

Toxigenic and metabolic causes of ketosis and ketoacidotic syndromes.

Ketoacidotic syndromes are frequently encountered in acute care medicine. This article focuses on ketosis and ketoacidotic syndromes associated with intoxications, alcohol abuse, starvation, and certain dietary supplements as well as inborn errors of metabolism. Although all of these various processes are characterized by the accumulation of ketone bodies and metabolic acidosis, there are differences in the mechanisms, clinical presentations, and principles of therapy for these heterogeneous disorders. Pathophysiologic mechanisms that account for these disorders are presented, as well as guidance regarding identification and management.

The metabolic response to stress: a case of complex nutrition support management.

The ICU patient with burns, neurotrauma, sepsis, or major surgery typifies the classic hypermetabolic patient. These patients have increased energy and nutrient needs as a result of their injuries and require early nutrition support. Although these patients are likely to benefit from nutritional intervention, the complexity of the stress response to injury and subsequent changes in nutrient metabolism make the design and implementation of nutrition care challenging. This article reviews the pathophysiology of common hypermetabolic conditions and provides strategies to manage the complications associated with nutrition support.

Eating disorder emergencies: understanding the medical complexities of the hospitalized eating disordered patient.

Eating disorders are maladaptive eating behaviors that typically develop in adolescence and early adulthood. Psychiatric maladies and comorbid conditions, especially insulin-dependent diabetes mellitus, frequently co-exist with eating disorders. Serious medical complications affecting all organs and tissues can develop and result in numerous emergent hospitalizations. This article reviews the pathophysiologies of anorexia nervosa, bulimia nervosa, and orthorexia nervosa and discusses the complexities associated with the treatment of medical complications seen in these patients.