Abhinav Birda’s research while affiliated with University of California, Irvine and other places

Hypertrophic scars and keloids represent abnormal wound healing, manifesting as raised scars confined to or extending beyond the wound margin, respectively. Understanding the risk factors associated with these scarring types is crucial for prevention and management. Utilizing the TriNetX global health research network database, we analyzed the data of 6,249 patients with hypertrophic scars or keloids. We employed the ICD-10 code L91.0 for identification, generating a control cohort matched by age, sex, and race. Associations between scarring and race, ethnicity, and various comorbidities were quantified. The analysis revealed that hypertrophic scars and keloids were more commonly associated with Black/African American individuals (OR=1.74, P<0.01) and less so with White races and Hispanic ethnicity. Significant comorbidities associated with increased risk included scarring alopecia, rosacea, atopic dermatitis, and acne. Inadequate sample size limited analysis for conditions like vitiligo. The findings suggest a higher prevalence of these scars in Black/African American races, potentially linked to melanocyte-mediated fibroblast and extracellular matrix activities. A notable correlation with inflammatory conditions suggests shared cytokine pathways, highlighting IL-4 and IL-13 as therapeutic targets. The strong association between scarring alopecia and skin cancers may implicate chronic inflammation and treatment-related scarring. Limitations of the study include its retrospective design, possible misdiagnosis, and small sample sizes for certain comorbidities. J Drugs Dermatol. 2025;24(2):212-215. doi:10.36849/JDD.8401R1.

Introduction: Cutaneous infections pose ongoing challenges to standard treatments due to resistance and limited efficacy. Photodynamic therapy (PDT) emerges as a promising supplement or an alternative to address complicated cases. In this review, we comprehensively review PDT's safety and efficacy in treating cutaneous infections. Evidence acquisition: A PubMed systematic review with search terms for PDT treatment, hair, skin, and nail infections. Evidence synthesis: There were a total of 43 studies on the use of PDT in cutaneous infections which discussed the treatment of viral (N.=20), bacterial (N.=11), fungal (N.=9), and protozoal (N.=3) infections. There is evidence for using PDT, mostly 5-aminolevulinic acid (5-ALA) and methyl aminolevulinate (MAL), in the treatment of cutaneous infections. Most evidence for viral infections involved treatment with 5-ALA PDT in condyloma acuminatum (CoAc), verruca vulgaris, and molluscum contagiosum. In bacterial infections, 5-ALA and MB PDT have been used to achieve complete remission in refractory Pseudomonas and atypical mycobacteria infections without recurrence. In onychomycosis, MAL PDT achieved a 40.9% cure rate and MB PDT showed a 77.8-100% cure rate with no reports of recurrence. Parasitic infections, such as leishmaniasis have also been successfully treated with both 5-ALA and MAL PDT. Conclusions: PDT is a promising treatment option for cutaneous infections, with growing evidence for its utility in treating cutaneous bacterial, viral, fungal, and parasitic infections, particularly those that fail standard treatments. Side effects were mostly limited to localized pain with good outcomes and low recurrence rates.

Background: The clean beauty market is projected to reach 39 billion USD by 2033, reflecting the growing demand from consumers who are increasingly conscious of the ingredients in their personal care products. As this trend continues, it has become more crucial to examine the composition of clean beauty products to better assess their safety, efficacy, and impact on consumer health and behavior. However, the lack of a universal consensus on the definition of “clean” has led to varied interpretations within the cosmeceutical and skincare industry. In some cases, the clean beauty movement’s vilification of certain ingredients, such as preservatives, has led to their replacement with potentially more allergenic alternatives, like isothiazolinones. These unintended consequences and the ambiguity surrounding the term “clean” warrant further investigation. Objectives: The objective of this study is to determine the prevalence of allergenic ingredients in clean-labeled skincare products. Methods: The ingredient lists of 313 moisturizers, cleansers, and sunscreens in the “clean skincare” category of the leading online beauty store worldwide (sephora.com) were carefully assessed for the presence of potentially allergenic compounds, selected based on the American Contact Dermatitis Society (ACDS) and the US Food and Drug Administration (FDA) allergen listings. Results: Tocopherol, an antioxidant and preservative, was the most common allergen found in the moisturizer and sunscreen categories, present in 73.8% and 63.8% of these products, respectively. Alkyl glucosides were the most common allergens in cleansers, found in 46.7% of products. Preservatives such as phenoxyethanol and benzoate derivatives were consistently present across all three product categories. Conclusions: This study shows that clean-labeled skincare products often contain allergenic ingredients, underscoring the complexity and potential misinterpretation of the safety of these products.

Tofacitinib is a Janus kinase inhibitor (JAKi) that is used off-label for the treatment of alopecia areata (AA). Its boxed warning includes an increased risk of serious adverse events (SAEs) based on the results of a safety trial in rheumatoid arthritis (RA) patients taking the medication. The purpose of this study was to investigate the differences in patients’ characteristics and SAEs profiles between RA and AA populations taking tofacitinib. The cohorts were constructed using the TrinetX database to identify the patients who were prescribed tofacitinib for RA or AA between October 2012 and October 2023. A total of 22,873 patients were included in this analysis, with 21,080 individuals in the RA cohort and 1793 individuals in the AA cohort. After matching for age, sex, and race, each cohort had a sample size of 1482. Data on the patients’ sex, age, race, comorbidities, concomitant medications, and associated SAEs were collected. The cohorts were compared by calculating the odds ratios and tested for significance associations using Fisher’s Exact Tests. Both the RA and AA cohorts were predominantly female (RA 79%, AA 70%), with mean ages of 61 ± 14 years and 38 ± 19 years (p-value < 0.0001), respectively. Both the groups showed similar racial distributions. The RA cohort had increased rates of hypertension, obesity, type 2 diabetes mellitus, and nicotine dependence compared to those of the AA cohort (p-value < 0.0001). With the exception of cyclosporine and azathioprine, the percentage of concomitant medication use was higher in all the categories in the RA cohort than those in the AA cohort (p-value < 0.0001). Higher rates of adverse events were seen in the RA cohort across all the categories, except myocardial infarction, stroke, and lymphomas/hematopoietic malignancies. Our findings show that the SAEs on the boxed warning of tofacitinib should be strongly considered when being used off-label for the treatment of AA. Clinicians must carefully assess the individual patient factors when determining the appropriateness of tofacitinib use.