Alexander Salava

University of Helsinki | HY · Department of Dermatology

This research utilizes whole metagenomic shotgun sequencing to analyse the skin microbiome in patients with psoriasis, comparing lesional and nonlesional skin with those of healthy individuals. The study identifies significant differences in the microbial composition and functionality between psoriatic and healthy skin, revealing distinct microbial...

Background Psoriasis (Pso) is a chronic inflammatory skin disease that poses both physical and psychological challenges. Dysbiosis of the skin microbiome has been implicated in Pso, yet a comprehensive multi-omics analysis of host-microbe interactions is still lacking. To bridge this gap, we conducted an exploratory study by adopting the integrated...

Background Perceptual learning modules (PLMs) have been shown to significantly improve learning outcomes in teaching dermatology. Objectives We aimed to investigate the quantity and quality of diagnostic errors during undergraduate PLMs and their potential implications. Methods The study data was acquired during eight successive dermatology cours...

Artificial intelligence (AI) systems have been shown to help dermatologists diagnose melanoma more accurately, however they lack transparency, hindering user acceptance. Explainable AI (XAI) methods can help to increase transparency, yet often lack precise, domain-specific explanations. Moreover, the impact of XAI methods on dermatologists’ decisio...

Dear Editor, During a recent undergraduate dermatology course, we were surprised by an important educational topic we had previously been quite unaware of, congenital colour vision deficiency (CVD), more commonly known as, colour blindness. We realized that we may have underestimated its relevance and practical implications when teaching dermatolog...

Dear Editor, Topical tacrolimus (TAC) has been used off-label in young children, but long-term clinical safety data in atopic dermatitis (AD) are limited.¹ There have been concerns regarding immunosuppression and a possible increased incidence of infections and malignancies,² but no safety issues have been reported across a number of clinical studi...

Cutavirus (CuV) is associated with cutaneous T-cell lymphoma (CTCL), of which parapsoriasis is a precursor. Our study reveals a significantly higher CuV-DNA prevalence in skin-swabs of parapsoriasis patients (6/13, 46.2%), compared to those of healthy adults (1/51, 1.96%). Eight patients (8/12, 66.7%) had CuV-DNA in biopsied skin, and four develope...

Background: Microbiome-targeted treatments have been investigated in atopic dermatitis (AD). We aimed to investigate the use of probiotic Lactococcus lactis lysate cream in AD. Methods: 13 patients with mild-to-moderate AD were treated with differently concentrated probiotic creams (3%, 10% and 30%) or placebo cream for 4 weeks. Disease severity (E...

Early-onset, persistent atopic dermatitis (AD) is proposed as a distinct subgroup that may have specific genotypic features. FLG gene loss-of-function variants are the best known genetic factors contributing to epidermal barrier impairment and eczema severity. In a cohort of 140 Finnish children with early-onset moderate-to-severe AD, we investigat...

Background: Implicit visual skills play an important role in the recognition of skin-related conditions. Objectives: We aimed to evaluate effectiveness and practicability of digital perceptual learning modules (PLMs) during undergraduate teaching of dermatology. Methods: The study consisted of four subsequent dermatology courses including 105...

Background: Childhood atopic dermatitis (AD) is often followed by other atopic comorbidities like asthma. Objective: To compare effectiveness of topical tacrolimus (TAC) and topical corticosteroids (TCSs) and their impact on airway inflammation and bronchial hyperresponsiveness in pediatric AD. Methods: A three-year randomized open-label compa...

Melanoma is a highly metastatic tumour originating from neural crest-derived melanocytes. The aim of this study was to analyse the expression of neuron navigator 3 (NAV3) in relation to membrane type-1 matrix metalloproteinase MMP14, a major regulator of invasion, in 40 primary melanomas, 15 benign naevi and 2 melanoma cell lines. NAV3 copy number...

Clinical dermatology is primarily learned through example or model learning. The author describes a method of teaching dermatology by thinkin aloud which may improve learning outcomes and student motivation.

Background: Patients with atopic dermatitis have an increased risk of herpes simplex virus (HSV) infections. Objectives: We carried out a retrospective, cross-sectional study to investigate the association of disease severity, concomitant atopic diseases and filaggrin mutations with the risk of cutaneous HSV infections in 463 patients with atopi...

The burden of atopic dermatitis (AD) appears to be increasing in adult and elderly patients. The aim of this study was to analyse the nationwide database of the Finnish Institute for Health and Welfare regarding the number of patients with AD and of general practitioner consultations in Finland during 2018. The database comprised the main diagnoses...

Background: Severity associated factors in atopic dermatitis (AD) have focused on early onset, concomitant atopic diseases, markers of Th2-shifted inflammation and filaggrin mutations. Objectives: To investigate factors associated with severe AD in Finnish patients. Methods: We conducted a single-center, cross-sectional observational study wit...

Keratosis pilaris (KP) associates with epidermal barrier defects in atopic dermatitis (AD) but its role in disease severity and concomitant atopic diseases seems to vary between populations. We performed a cross‐sectional observational study with 502 randomly selected AD patients of a Finnish tertiary health care center. At a single clinical examin...

Background: Dermatologic diagnosis depends highly on visual skills and implicit non-analytical proficiency plays a key role. Objectives: To investigate the effectiveness of digital perceptual learning modules (PLMs) in undergraduate teaching. Methods: The study cohort included 39 students of an undergraduate dermatology course. Online PLMs des...

Background: Atopic dermatitis (AD) has a severe impact on quality of life (QoL). Objectives: To analyze the impact of AD on QoL of small children with moderate-to-severe AD in a tertiary health care hospital in Helsinki, Finland. Materials & methods: Based on interim analysis of this longitudinal follow-up study, we investigated treatment resp...

Background Topical tacrolimus is used off-label in young children, but data remains limited regarding children under 2 years of age and long-term treatment. Objectives To compare safety differences between tacrolimus 0.03% and 0.1% ointments with mild and moderate potency topical corticosteroids in young children with atopic dermatitis. Methods W...

Visual clinical examination forms the diagnostic basis in skin-related conditions and is an essential element in medical teaching. The author describes a symbol-based aid to explain the dichotomy of factual observed findings with the information based on medical history: The Eye with Ears. It represents the two most relevant aspects in clinical exa...

The curricular content in medical education needs continuous development and therefore must regularly undergo a critical evaluation. Here, the author describes an implemented shift in the teaching substance of an undergraduate dermatology course aimed to focus on relevance and practicability for general practitioners. The changes were based on a co...

Background The prevalence of atopic dermatitis (AD) has increased, but studies in adult or elderly populations are sparse. Methods We investigated 12-month and lifetime prevalences of AD in the Finnish adult population ≥30 years of age and analyzed living environment factors, socioeconomic factors, lifestyle-related factors, and serum vitamin D le...

Background Skin-related conditions are the frequent cause of doctors’ consultations in primary care. Methods Based on nationwide data bank information of the Finnish Institute for Health and Welfare, we analysed the 20 most frequent main diagnoses for each ICD-10 category of all general practitioners’ visits in the public health care in Finland ov...

A 10-year national program to improve prevention and management of allergic diseases and asthma was implemented in Finland (population 5.5. million) in 2008-2018. The main aim was to reduce the long-term burden of these conditions. The strategy was changed from traditional avoidance to tolerance and resilience of the population. Health was endorsed...

Abstract is missing (Short communication)

Hidradenitis suppurativa (HS) has been associated with metabolic syndrome [1‐3]. Three large population‐based studies showed a significant association of type 2 diabetes mellitus (T2DM) with HS [3‐5]. Two meta‐analyses found an increased 1.69 to 3 odds of diabetes [6‐7]. In the present study, we aimed to compare whether the phenotype and comorbidit...

Hidradenitis suppurativa (HS) has been associated with the occurrence of psychiatric disorders (PD) such as depression [1], anxiety [1], bipolar disorder [2] or schizophrenia [2]. A recent national register‐based case‐control study in Finland [2] showed that patients with HS had a higher risk of mental disorders than those with psoriasis. Women wit...

Migraine is the most common primary headache syndrome worldwide, affecting approximately 12% of the Caucasian population [1]. Migraine has been associated with various cardiovascular [2] and psychiatric co‐morbidities [3], more recently inflammatory disorders such as psoriasis [4] and inflammatory bowel disease [5]. As hidradenitis suppurativa (HS)...

review

Staphylococcal enterotoxins have been shown to promote lymphoma-associated immune dysregulation. This study examined changes in the skin microbiome of parapsoriasis compared with intact skin. Swab microbiome specimens were taken of the parapsoriasis lesions of 13 patients. Control samples were taken from contralateral healthy sides of the body. Mic...

Neonatal sepsis (NS) is a frequent problem in neonatal intensive care, especially in preterm and very low birth weight (VLBW) infants. The objective of the study was to characterize the cutaneous bacterial microbiome in VLBW infants treated in the neonatal intensive care unit (NICU). Non-invasive skin microbiome specimens were taken repeatedly from...

The cutaneous microbiome has been investigated broadly in recent years and some traditional perspectives are beginning to change. A diverse microbiome exists on human skin and has a potential to influence pathogenic microbes and modulate the course of skin disorders, e.g. atopic dermatitis. In addition to the known dysfunctions in barrier function...

Hyperhidrosis can be localized or generalized and may cause the patient significant discomfort. Localized hyperhidrosis is usually primary, often begins in adolescence and is partly based on genetic dispositions. As a rule it does not necessitate investigations for secondary causes (e.g. endocrine or neurologic conditions). Generalized hyperhidrosi...

Background: High-throughput DNA sequencing has shown that the cutaneous microbiome varies due to different exogenous and endogenous factors. Objectives: To characterize the microbiome of cutaneous melanomas and melanocytic nevi. Material and methods: Non-invasive swab specimens were taken from 15 cutaneous melanomas and 17 benign melanocytic n...

We present a case report of a patient with chronic gastrointestinal symptoms who was referred to the allergologist because of suspected food allergy. In this setting, irritable bowel syndrome, reflux disease, lactose

Atopic dermatitis (AD) is a common inflammatory skin disorder and characterized by abnormalities in both skin barrier structures and alternations of the immune response. Molecular genetics have dramatically changed our vision of the micro-organisms colonizing the human skin and recently well-documented changes in the skin microbiome in atopic derma...

The dysplastic melanocytic nevus remains an issue of controversy despite extensive investigations. On clinical grounds the term atypical melanocytic nevus should be used, while dysplastic melanocytic nevus describes histological characteristics. The association with melanoma is complex. With the clinical picture, dermatoscopy and molecular biologic...

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Peritoneal dialysis is limited by morphologic changes of the peritoneal membrane. Use of peritoneal dialysis fluids (PDF) that contain glucose degradation products (GDP) generates advanced glycation end-products (AGE) within the peritoneal cavity. It is unknown whether peritoneal damage is causally related to AGE-receptor for AGE (RAGE) interaction...