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result(s) for
"Podwojniak, Alicia"
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Racial Differences in Perceived Risk and Sunscreen Usage
by
Podwojniak, Alicia
,
Fliorent, Rebecca
,
Adolphe, Lianne
in
Attitudes
,
Black people
,
Dermatology
2023
Background Although White individuals have higher incidence of melanoma, clinical outcomes are worse among patients with skin of color. This disparity arises from delayed diagnoses and treatment that are largely due to clinical and sociodemographic factors. Investigating this discrepancy is crucial to decrease melanoma-related mortality rates in minority communities. A survey was used to investigate the presence of racial disparities in perceived sun exposure risks and behaviors. Methods A survey consisting of 16 questions was deployed via social media to assess skin health knowledge. Over 350 responses were recorded, and the extracted data were analyzed using statistical software. Results Of the respondents, White patients were significantly more likely to have higher perceived risk of developing skin cancer, highest levels of sunscreen usage, and higher reported frequency of skin checks performed by primary care providers (PCPs). There was no difference between racial groups in the amount of education provided by PCPs related to sun exposure risks. Conclusion The survey findings suggest inadequate dermatologic health literacy as a result of other factors such as public health and sunscreen product marketing rather than as a consequence of inadequate dermatologic education provided in healthcare settings. Factors such as racial stereotypes in communities, implicit biases in marketing companies, and public health campaigns should be considered. Further studies should be conducted to determine these biases and improve education in communities of color.
Journal Article
Cutaneous Adverse Effects From Diabetes Devices in Pediatric Patients With Type 1 Diabetes Mellitus: Systematic Review
by
Podwojniak, Alicia
,
Jones, Anne
,
Tan, Isabella J
in
Adolescent
,
Apps, Mobile, Wearables for Diabetes
,
Blood Glucose Self-Monitoring - adverse effects
2024
Continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusions (CSIIs) are the current standard treatment devices for type 1 diabetes (T1D) management. With a high prevalence of T1D beginning in pediatrics and carrying into adulthood, insufficient glycemic control leads to poor patient outcomes. Dermatologic complications such as contact dermatitis, lipodystrophies, and inflammatory lesions are among those associated with CGM and CSII, which reduce glycemic control and patient compliance.
This systematic review aims to explore the current literature surrounding dermatologic complications of CGM and CSII as well as the impact on patient outcomes.
A systematic review of the literature was carried out using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines using 5 online databases. Included articles were those containing primary data relevant to human participants and adverse reactions to CGM and CSII devices in pediatric populations, of which greater than 50% of the sample size were aged 0-21 years. Qualitative analysis was chosen due to the heterogeneity of outcomes.
Following the application of exclusion criteria, 25 studies were analyzed and discussed. An additional 5 studies were identified after the initial search and inclusion. The most common complication covered is contact dermatitis, with 13 identified studies. Further, 7 studies concerned lipodystrophies, 5 covered nonspecific cutaneous changes, 3 covered unique cutaneous findings such as granulomatous reactions and panniculitis, and 2 discussed user acceptability.
The dermatologic complications of CGM and CSII pose a potential risk to long-term glycemic control in T1D, especially in young patients where skin lesions can lead to discontinuation. Increased manufacturer transparency is critical and further studies are needed to expand upon the current preventative measures such as device site rotation and steroid creams, which lack consistent effectiveness.
Journal Article
Cutaneous presentations of systemic sclerosis in skin of colour: A systematic review
by
Podwojniak, Alicia
,
Cohen, Bernard A.
,
Leiter, Aliza
in
African Americans
,
Antibodies
,
autoimmune
2024
Systemic sclerosis (SSc), a rheumatologic autoimmune disease, can present diversely, especially in patients with skin of colour (SOC). Differences in clinical manifestations among SOC individuals compared to predominantly White populations require a comprehensive examination to optimize diagnosis and treatment. This systematic review aims to explore the differences in SSc manifestations among individuals with SOC, identifying variations in disease severity, clinical features and psychosocial impacts. A systematic review of the literature was conducted following PRISMA guidelines. Databases searched included PubMed, SCOPUS, Cochrane and Web of Science, focusing on studies published within the last 10 years. Nine studies were selected and qualitatively analysed due to the heterogeneity of study types. Key findings highlight significant variations in disease severity and cutaneous clinical features among SOC cohorts compared to predominantly White populations. Raynaud's phenomenon was prevalent across all ethnicities; however, SOC groups exhibited fewer hallmark features of scleroderma, such as telangiectasias, calcinosis and digital swelling, which complicates diagnosis. SOC individuals showed a higher propensity for severe pulmonary complications and increased mortality rates. Atypical cutaneous presentations in SOC were associated with disease progression. Psychosocial impacts were more pronounced in SOC individuals, with greater awareness and dissatisfaction over cutaneous symptoms. Recognizing the atypical presentations of SSc in SOC is critical for early diagnosis and optimizing patient outcomes. The study underscores the need for further research to determine if observed differences are due to variations in prevalence, genetic factors or insufficient training in recognizing cutaneous manifestations in SOC. Enhanced awareness and targeted training for healthcare providers are essential to address these diagnostic challenges and improve care for SOC patients with SSc. This systematic review investigates systemic sclerosis in individuals with skin of color (SOC), highlighting key differences in disease manifestations compared to predominantly White populations. SOC patients often exhibit fewer hallmark features, such as telangiectasias and calcinosis, complicating diagnosis. They also experience higher rates of severe pulmonary complications and increased mortality, alongside pronounced psychosocial challenges. The review underscores the need for greater awareness and targeted training among healthcare providers to enhance early diagnosis and treatment outcomes for SOC patients with systemic sclerosis.
Journal Article
The Efficacy of Glucagon-like Peptide-1 (GLP-1) Receptor Agonists for Insufficient Weight Loss or Regain After Metabolic/Bariatric Surgery: A Systematic Review and Meta-analysis
by
Soliman, Sara S.
,
Goodwin, Brandon
,
Kumar, Gaurav
in
Bariatric Surgery
,
Body mass index
,
Diabetes
2025
Metabolic and bariatric surgery (MBS) is a successful surgical option for obesity. However, many patients can experience insufficient weight loss and weight regain post-operatively. Glucagon-like peptide-1 (GLP-1) receptor agonists have become available for effective weight loss treatment due to their effects of suppressing appetite, slowing gastric emptying, and promoting fat loss. This systematic review aims to evaluate the efficacy of using GLP-1 agonists to treat insufficient weight loss or regain after metabolic/bariatric surgery. Pooled analysis demonstrated that GLP-1 agonists have a moderate effect on weight loss after failed weight loss or weight regain following MBS, with a Cohen’s
d
-score of 0.470 (
p
≤ 0.001). GLP-1 agonists show promise and deserve additional research as part of the standard of care following MBS with insufficient weight loss.
Journal Article
A comparison of the safety and efficacy of tapinarof and roflumilast topical therapies in the management of mild‐to‐moderate plaque psoriasis
by
Podwojniak, Alicia
,
Sanabria, Bianca
,
Tan, Isabella J.
in
Administration, Cutaneous
,
Administration, Topical
,
adverse effects
2024
Introduction Psoriasis is an immune‐mediated inflammatory skin disease. First‐line topical treatments include steroids, calcineurin inhibitors, vitamin D analogs, and anthralin. Recently, novel topical therapeutics like tapinarof and roflumilast have emerged with unique anti‐inflammatory mechanisms and promising efficacy profiles. Materials and methods This review utilized PubMed, SCOPUS, and Web of Science databases to identify recent studies on tapinarof and roflumilast. Criteria focused on efficacy, safety profiles, and therapeutic roles in psoriasis treatment. Results Four primary literature articles were identified for tapinarof and five for roflumilast. Both drugs demonstrated strong efficacy with minimal adverse events in treating mild‐to‐moderate plaque psoriasis. Tapinarof showed more frequent but mild adverse effects, while roflumilast had less frequent but more severe side effects. Discussion Tapinarof and roflumilast offer once‐daily dosing and successful treatment in restricted areas, potentially enhancing patient adherence. Cost remains a limiting factor, necessitating future comparative studies to evaluate the efficacy, safety, and cost‐effectiveness between the two drugs. Conclusion Tapinarof and roflumilast present promising topical treatments for psoriasis, showing efficacy and manageable safety profiles. Further research is crucial to fully elucidate their comparative benefits and drawbacks in clinical practice.
Journal Article
Updates on Topical Dyad and Triple Combination Therapies Approved for Acne Vulgaris
by
Podwojniak, Alicia
,
Sauer, John
,
Tan, Isabella J
in
Dermatology
,
Family/General Practice
,
Therapeutics
2024
Acne vulgaris is a multifaceted disease characterized by inflammatory and noninflammatory lesions. Topical combination therapies offer a multifaceted approach to acne treatment, with synergistic effects and a broad spectrum of action against multiple factors in acne pathogenesis in one single formulation. Clindamycin phosphate/benzoyl peroxide/adapalene, a combination therapy consisting of clindamycin phosphate 1.2%, benzoyl peroxide (BPO) 3.1%, and adapalene 0.15%, is a novel treatment, the only FDA-approved triple combination drug that offers effective treatment of acne vulgaris. This review aims to provide information on clindamycin phosphate/benzoyl peroxide/adapalene and review the literature on combination topical acne medications approved in the United States. This search was conducted on topical combination therapies for acne, their efficacy, adverse effects, and impacts on quality of life with a specific focus on the newly approved clindamycin phosphate/benzoyl peroxide/adapalene and its sub-component dyads, along with other combinations. PubMed, SCOPUS, Embase, Cochrane, and Web of Science databases were searched for publications in 2018-2023. Primary sources were given priority, and secondary sources such as other reviews were considered to supplement any missing information. It was found that various topical dyad and triad combinations exist for acne vulgaris, including adapalene/BPO, tazarotene/clindamycin, clindamycin/BPO, adapalene/clindamycin, topical tretinoin/azelaic acid, topical tretinoin/BPO, and clindamycin phosphate/benzoyl peroxide/adapalene. Dyad and triple combinations represent a promising, convenient solution for acne management, potentially improving patient adherence due to its single formulation. Clindamycin phosphate/benzoyl peroxide/adapalene exhibited significantly high efficacy in treating both inflammatory and noninflammatory lesions, a minimal side effect profile, although no significant changes in quality-of-life measures. Further research is indicated to assess its long-term efficacy and impact on other acne metrics such as cost, scarring, psychosocial implications, and impact on diverse patient populations.
Journal Article