Climate Change, Skin Health, and Dermatologic Disease: A Guide for the Dermatologist

One health: a structured review and commentary on trends and themes

BACKGROUND

One Health (OH) is defined as a unifying approach aiming to sustainably balance and optimise the health of people, animals and the ecosystem. It recognises that the health of humans, animals (both domestic and wild), plants and the wider ecosystem are both interdependent and linked. As a concept, it aims to address complex problems requiring input from multiple disciplines. Suitable issues for OH approaches typically include global issues which can widely impact not only the health of humans and animals, but also have a significant environmental impact. Examples include emerging zoonotic diseases and antimicrobial resistance (AMR). Interpretations and use of the term OH differ in the literature and have the potential to dilute its impact. The meaning of OH among the research community has evolved over time. Here, we collate the OH relevant literature from the last two decades, identifying major themes and trends and considering how OH has been embraced differently across various geographical regions.

METHODS AND RESULTS

Bibliographic databases were searched using the term "One Health" AND ("Veterinary" OR "Animal") AND ("Medicine" OR "Human") AND ("Environment" OR "Ecosystem") during the period between 1980 and 2022. Data analysis and narrative synthesis identified themes, similarities, and differences within literature. Web of Science and PubMed returned 948 and 1250 results for the period mentioned above. The predominant literature focused on human health, with veterinary health second, although often to benefit human health. It was found that OH is often utilised as a public health approach, generally towards the end of disease surveillance and control. Interestingly, while authors from low- and middle-income countries were well-represented within studies using the term OH, they were less well-represented as corresponding authors.

CONCLUSIONS

The predominant focus of the literature was on human and veterinary health, implying OH approach is human-orientated, despite its suggestion that all domains share a common 'health'. Potential improvement to OH could be achieved through greater incorporation of the environmental and social sciences for a more encompassing approach.

Burden of atopic dermatitis in Europe: A population-centred approach leveraging web search data in 21 European countries

BACKGROUND

The complexity, high prevalence, and substantial personal and socioeconomic burden collectively render atopic dermatitis (AD) a major public health concern. Using crowdsourced Internet data has the potential to provide unique insights into this concern, as demonstrated by several previous studies. However, a comprehensive comparison across European countries remains lacking.

OBJECTIVES

The study aimed to investigate AD-related web searches across Europe to assess spatiotemporal variations and associations between disease-related and external factors.

METHODS

AD-related web search data were extracted for 21 European countries between February 2019 and January 2023. Descriptive analysis and autocorrelation functions were performed to examine spatiotemporal patterns. Correlations (r) were used to evaluate the associations between web searches and disease-related, socioeconomic and meteorological data.

RESULTS

Over 241 million AD-related web searches were identified, with search volume varying substantially among European countries (p < 0.001) and correlating with AD prevalence and disease burden (both r = 0.51, p = 0.019). Search volume increased between 2019 and 2023 in all countries and seasonally peaked in January and March. Negative correlations with median population age (r = -0.46, p = 0.039), number of general practitioners (r = -0.29, p = 0.226) and specialists (r = -0.27, p = 0.270) were observed. Moderate to strong correlations were found between search volume and cold, humid and windy weather with fewer sunshine hours, while higher online interest typically occurred 1-3 months after such weather conditions.

CONCLUSION

The study highlights the great potential of online crowdsourced data analysis, for example, to investigate the impact of climate change or to identify unmet needs at a population level. Furthermore, the growing online interest in AD and the corresponding seasonal peaks emphasize the necessity of adapting treatment plans, intensifying public health campaigns, and disseminating reliable online information by governments and healthcare providers, especially during these periods.

Vitis vinifera L. Leaf Extract, a Microbiota Green Ally against Infectious and Inflammatory Skin and Scalp Diseases: An In-Depth Update

The skin microbiota, with its millions of bacteria, fungi, and viruses, plays a key role in balancing the health of the skin and scalp. Its continuous exposure to potentially harmful stressors can lead to abnormalities such as local dysbiosis, altered barrier function, pathobiont overabundance, and infections often sustained by multidrug-resistant bacteria. These factors contribute to skin impairment, deregulation of immune response, and chronic inflammation, with local and systemic consequences. In this scenario, according to the needs of the bio-circular-green economy model, novel harmless strategies, both for regulating the diverse epidermal infectious and inflammatory processes and for preserving or restoring the host skin eubiosis and barrier selectivity, are requested. Vitis vinifera L. leaves and their derived extracts are rich in plant secondary metabolites, such as polyphenols, with antioxidant, anti-inflammatory, antimicrobial, and immunomodulatory properties that can be further exploited through microbe-driven fermentation processes. On this premise, this literature review aims to provide an informative summary of the most updated evidence on their interactions with skin commensals and pathogens and on their ability to manage inflammatory conditions and restore microbial biodiversity. The emerging research showcases the potential novel beneficial ingredients for addressing various skincare concerns and advancing the cosmeceutics field as well.

Global research trends on melasma: a bibliometric and visualized study from 2014 to 2023

Melasma, a prevalent pigmentary disorder, is characterized by its complex etiology, propensity for recurrence, and resistance to treatment. However, there is currently no research on melasma through bibliometrics and visualisation. This study analyses the hotspots and trends in the field based on 2,709 publications from the Web of Science Core Collection (WOSCC). We carried out bibliometric analyses using Citespace software for different countries/regions, institutions, authors, and keywords. References were also analysed using VoSviewer. The results indicate that overall, there has been an increase in publications related to melasma since 2014. According to the analysis of the collaborative network diagram, the United States, Egyptian Knowledge Bank, and Benjakul Soottawat are the most contributing countries, institutions, and authors, respectively. Reference and keyword analyses have identified the pathogenesis and treatment of melasma as a prevalent topic in recent years. And how to find new treatment options and more effective therapeutic drugs is a future research trend. This is the first bibliometric and visual analysis of melasma-related literature to explore research hotspots and trends.

Baicalin attenuates acute skin damage induced by ultraviolet B via inhibiting pyroptosis

As the outermost layer of the human body, the skin suffers from various external factors especially light damage, among which ultraviolet B (UVB) irradiation is common and possesses a relatively high biological damage capacity. Pyroptosis is a newly discovered type of programmed cell death, which can induce cell rupture and induce local inflammatory response. However, the molecular mechanisms of pyroptosis in photodamaged skin is poorly understood. Baicalin, a flavonoid extracted from the desiccated root of Scutellaria baicalensis Georgi (Huang Qin). Despite its antioxidant abilities, whether baicalin protects skin by attenuating UVB-induced pyroptosis remains unclear, which was the aim of this study. The UVB-induced acute skin damage model was established by using human immortalized keratinocytes (HaCaT cells) and Kunming (KM) strain mice. The protective dose selection for baicalin is 50 μM in vitro and 100 mg/kg in vivo. In in vitro study, UVB irradiation significantly decreased cell viability, increased cell death and oxidative stress in HaCaT cells, while pretreatment with baicalin improved these phenomena. Furthermore, the baicalin pretreatment notably suppressed nuclear factor kappa B (NF-κB) translocation, the NLRP3 inflammasome activation and gasdermin D (GSDMD) maturation, thus effectively attenuating UVB-induced pyroptosis. In in vivo study, the baicalin pretreatment mitigated epidermal hyperplasia, collagen fiber fragmentation, oxidative stress and pyroptosis in UVB-irradiated mouse skin. In a nutshell, this study suggests that baicalin could be a potential protective agent to attenuate acute skin damage induced by UVB irradiation through decreasing oxidative stress and suppressing NF-κB/NLRP3/GSDMD-involved pyroptosis.

The role of the environment in allergic skin disease

PURPOSE OF REVIEW

This paper explores how environmental factors influence allergic skin diseases, including atopic dermatitis (AD), contact dermatitis (CD), urticaria, angioedema, and reactions to drugs and insect bites.

RECENT FINDINGS

Research indicates a significant impact of environmental elements on allergic skin diseases. High air pollution levels exacerbate symptoms, while climate change contributes to increased skin barrier dysfunction, particularly affecting AD. Allergen prevalence is influenced by climate and pollution. Irritants, like those in detergents and cosmetics, play a major role in CD. Plants also contribute, causing various skin reactions. Understanding the interplay between environmental factors and allergic skin diseases is crucial for effective management. Physicians must address these factors to support patient well-being and promote skin health amidst environmental changes.

Global burden and prediction study of cutaneous squamous cell carcinoma from 1990 to 2030: A systematic analysis and comparison with China

Background

China has the highest number of new cancer cases and deaths globally. Due to particularly low scores in health care quality for cutaneous squamous cell carcinoma (cSCC), the country's cSCC burden requires greater awareness. Consequently, we aimed to evaluate and predict the trend of the cSCC burden globally and in China from 1990 to 2030.

Methods

We retrieved data from the Global Burden of Disease 2019 study, which provided estimates of the incidence, mortality, prevalence, and disability-adjusted life years (DALYs) of cSCC from 1990 to 2019. We set up joint-point analyses and Bayesian age-period-cohort (BAPC) models to predict the disease burden of cSCC up to 2030.

Results

In 2019, China reported age-standardised rates of cSCC prevalence, incidence, mortality, and DALYs of 2.54, 2.12, 0.88, and 16.76 per 100 000 population, respectively. The country's prevalence and incidence rates from 1990 to 2019 were lower than the global levels, but its mortality and DALY rates were higher. The age-standardised rates were higher for males, and the disease burden increased with each age group globally and in China. Moreover, the average annual percentage change showed all indicators were growing faster than the global levels. According to the BAPC model, there will be an upward trend in the prevalence and incidence globally and in China between 2020 and 2030, with a decrease in mortality and DALYs.

Conclusions

We observed an upward trend in the cSCC burden over the past 30 years in China. Prevalence and incidence are expected to continue at a higher rate than the global average in the next decade, while mortality and DALYs are predicted to decrease. As the Chinese population ages, efforts toward managing and preventing cSCC should be targeted towards the elderly population.

Exploring the potential of the nano-based sunscreens and antioxidants for preventing and treating skin photoaging

Excessive exposure to sunlight, especially UV irradiation, causes skin photodamage. Sunscreens, such as TiO2 and ZnO, can potentially prevent UV via scattering, reflection, and absorption. Topical antioxidants are another means of skin photoprotection. Developing nanoparticles for sunscreens and antioxidants is recommended for photoaging prevention and treatment as it can improve uncomfortable skin appearance, stability, penetration, and safety. This study reviewed the effects of nano-sized sunscreens and antioxidants on skin photoprevention by examining published studies and articles from PubMed, Scopus, and Google Scholar, which explore the topics of skin photoaging, skin senescence, UV radiation, keratinocyte, dermal fibroblast, sunscreen, antioxidant, and nanoparticle. The researchers of this study also summarized the nano-based UV filters and therapeutics for mitigating skin photoaging. The skin photodamage mechanisms are presented, followed by the introduction of current skin photoaging treatment. The different nanoparticle types used for topical delivery were also explored in this study. This is followed by the mechanisms of how nanoparticles improve the UV filters and antioxidant performance. Lastly, recent investigations were reviewed on nanoparticulate sunscreens and antioxidants in skin photoaging management. Sunscreens and antioxidants for topical application have different concepts. Topical antioxidants are ideal for permeating into the skin to exhibit free radical scavenging activity, while UV filters are prescribed to remain on the skin surface without absorption to exert the UV-blocking effect without causing toxicity. The nanoparticle design strategy for meeting the different needs of sunscreens and antioxidants is also explored in this study. Although the benefits of using nanoparticles for alleviating photodamage are well-established, more animal-based and clinical studies are necessary.

Topically Applied Magnetized Saline Water Improves Skin Biophysical Parameters Through Autophagy Activation: A Pilot Study

Background Water exposed to a magnetic field exhibits several changes in its properties, such as increased electrical conductivity, reduced density, and low surface tension. Additionally, it has reduced dissolved oxygen levels and becomes more alkaline. Previous experimental studies have demonstrated that exposure to saline alkaline water leads to a dose-dependent increase in the expression of autophagy-related genes. Here, we hypothesize that the topical application of magnetized alkaline water to the skin can activate autophagy and improve cutaneous biophysical parameters, making it a promising strategy for enhancing skin aesthetics. Methods Two distinct substudies were undertaken. Firstly, a 12-week, uncontrolled, open-label investigation was conducted with 20 females who desired to enhance the appearance of their facial and neck skin. Secondly, a molecular study was carried out on a subset of 10 females to investigate the serum's impact on two autophagy markers (Beclin-1 and mammalian/mechanistic target of rapamycin {mTOR}) in skin biopsies taken from the posterior neck area below the hair attachment line. Results After a period of 12 weeks, the application of the serum resulted in significant improvements in skin hydration within the stratum corneum (56 ± 14 arbitrary units {a.u.}) compared to the baseline measurement (47 ± 12 a.u.; p < 0.001). Moreover, the transepidermal water loss (TEWL) decreased from 14 ± 2 g/m2/hour to 11 ± 3 g/m2/hour (p < 0.001). The results also revealed a notable reduction in sebum content from 38 ± 7 µg/cm2 to 30 ± 4 µg/cm2 after the 12-week period of serum application (<0.001). Additionally, the melanin index (p < 0.01) and erythema index (p < 0.001) were both significantly lower at 12 weeks compared to baseline. The molecular study showed a 38% increase in Beclin-1 levels after 12 weeks of serum application on the posterior neck area, as measured from skin biopsies. In contrast, mTOR levels decreased by 24% from baseline to 12 weeks. Conclusion The application of magnetized saline water topically, within a serum formulation, shows potential in improving skin biophysical parameters for females seeking to enhance the appearance of their facial and neck skin. These beneficial effects are achieved through the activation of cutaneous autophagy, as evidenced by an increase in Beclin-1 expression and a decrease in mTOR content in the skin.