DermHelpCentral

Aspirin and Melanoma Risk in Women

NY Times Article: "Researchers report that a woman’s regular use of aspirin may decrease her risk for melanoma, the most serious kind of skin cancer.

The study, published online in the journal Cancer, included 59,806 women ages 50 to 79. Researchers gathered health and lifestyle data at the start of the study, and the women reported their health in yearly questionnaires over an average 12 years of follow-up. The women brought in their medicine bottles for the researchers to examine and record.

There were 548 incidents of melanoma during the period. After controlling for sun exposure, sunscreen use, a history of skin cancer and many other factors, the researchers found that women who reported using aspirin had an average 21 percent lower risk of melanoma compared with nonusers, and the longer they used aspirin, the lower their risk.

The reasons for the effect are unclear, but the authors suggest that aspirin’s known effect in promoting cell death and activating tumor suppressor genes may be factors.

The senior author, Dr. Jean Y. Tang, an assistant professor of dermatology at Stanford, pointed out that the study was observational and not a clinical trial, and correlation does not equal causation. “It’s an important finding for high-risk women to discuss with their doctors,” she said, “but it’s way too early to recommend that everyone go take aspirin to prevent melanoma.”

Comment: It is discouraging that the Cancer (Journal) article is not free open access, considering that federal funds were probably used for the study.  The question is whether the relative risk reduction outweighs aspirin's known side-effects.

Reference:
Aspirin is associated with lower melanoma risk among postmenopausal Caucasian women: The Women's Health Initiative. Gamba CA, et. al. Cancer. 2013 Mar 11. doi: 10.1002/cncr.27817.
Source: Stanford University School of Medicine and Cancer Institute, Stanford, California.

One needs to understand the difference between Relative Risk and Absolute Risk to judge the value of this finding.  See:  RR vs. AR article.

 

Difficult Diaper Dermatitis

Dr. Julianne Mann, a pediatric dermatologist at the Oregon Health Sciences University, has the following recommendations for recalcitrant diaper dermatitis.

KEEP IT SUPER SIMPLE!

1. Absolutely NO diaper wipes at all.  Have mom get a large pack of rectangular cotton makeup remover pads.  Have her apply mineral oil to the cotton pad and use this to clean the baby's bottom.  When she is away from home OK to have her use a damp cotton cloth (I tell parents to pack several damp soft cotton washcloths in a ziplock in their travel diaper bag).

2. With every diaper change, have mom liberally apply a thick barrier paste after cleaning the baby's bottom.  We have had the best luck with a compounded butt paste that our local pharmacy mixes up because we suspect that preservatives in OTC diaper pastes may also play a role with the dermatitis.  They compound 25% corn starch, 25% zinc oxide, and 50% petrolatum and dispense as a one pound jar.

3. I emphasize the importance of stopping everything else that they've been using.  Most parents whose baby's butt looks like this have been desperately trying everything, including doing things like vinegar or baking soda soaks and trying a different cream almost daily.  I tell them the goal is to simplify.  KEEP IT SUPER SIMPLE!

Before and after photos of an infant with erosive diaper dermatitis (Jacquet’s Disease).  Improvement started within the first week of treatment.

 

 

The Food Allergy Buster

Dr. Kari Nadeau and her patients

Here is an important article which addresses oral desensitization of food allergies.  It's a great introduction to this area.  Oral desensitization is not new, and the lab discussed is not the only one which is working on this topic, but the basic facgts are well presented here and anyone with an interest in this topic will benefit from spending time with this piece.

See The Allergy Buster, NY Times Magazine, March 10, 2013.

To put this into perspective, read Nicholas Christakis' 2008 article in the British Medical Journal, "This Allergies Hysteria Is Just Nuts."   He uses this prescient quote, “A peanut was seen on the floor of a school bus, whereupon the bus was evacuated and cleaned, even though it was full of 10 year olds who, unlike 2 year olds, could actually be told not to eat food off the floor.”