Biologic drugs have proven to be of benefit for diseases where there is no indicated treatment, such as for immunobullous diseases. "Pemphigus vulgaris with rituximab (Rituxan, Genentech) has been a major advance, although this is not a formally approved indication for the drug," says Alan Menter, M.D., chief, dermatology, and chairman, residency program, Baylor University Medical Center, Dallas.
The cutaneous symptoms of lymphoma and atopic dermatitis (AD) can mimic one another, particularly when AD is severe. An accurate evaluation and assessment of the presenting clinical symptoms is crucial in avoiding a potential misdiagnosis of either disease.
Politicians on Capitol Hill once again have dermatologists - and all physicians who serve Medicare patients - wondering what in the name of common sense they are going to do. Just before Christmas, Congress delayed a 27.4 percent Medicare fee cut from its original Jan. 1 implementation date. The cut is now scheduled, barring any further congressional action, to take effect Feb. 29.
Even though botulinum toxin type A is one of the most potent neurotoxins known, its injection into muscles for the reduction of hyperfunctional lines is one of the safest procedures being performed in cosmetic dermatology. And the favorable risk-to-benefit profile of the toxin is fueling its use in an expanding number of off-label applications, says Thomas E. Rohrer, M.D.
Biologic therapies can help patients with dermatologic conditions, providing anti-inflammatory benefits without significant effects on other organ systems, says Steven R. Feldman, M.D., Ph.D., professor of dermatology, pathology and public health sciences, Wake Forest Baptist Medical Center, Winston-Salem, N.C.
In 2009, the federal government launched its Electronic Prescribing (eRx) Incentive Program. Although this program (which was authorized in the Medicare Improvements for Patients and Providers Act of 2008/MIPPA) is now three years old, physicians remain confused about the details. Fortunately, the eRx Incentive Program is straightforward.
Stopping of a type of regulated cell death called necroptosis in keratinocytes is critical for the prevention of skin inflammation, according to new research from Germany.
Analyzing 18th and 19th century (Victorian-era) paintings can help dermatologists think beyond their established habits and preconceptions in the search for visual and other diagnostic clues, says Irwin Braverman, M.D., professor of dermatology, Yale School of Medicine.
Implementation of the final regulations from the Food and Drug Administration for sunscreen testing and labeling should enable consumer selection of effective sunscreen products. More work is still needed, however, to better educate the public about the damaging effects of UV exposure and to motivate appropriate sunscreen use, says Vincent A. DeLeo, M.D.
New safety profile data continues to emerge on biologics used in psoriasis. Among the findings: Today's biologics do not appear to increase serious infection risk; the drugs' short-term cancer risk profile is promising; but concerns remain about long-term cancer risk with all biologics and cardiovascular risk with interleukin-12/23, ustekinumab (Stelara, Janssen Biotech).
Drugs, by definition, are not safe. Exactly how safe a drug must be is a topic of much controversy. However, it is hard to determine the safety of many drugs because the inclusion/exclusion criteria for study protocols requires that the drug be studied in persons who are not pregnant or lactating and who are usually above the age of 12, and in those who have normal test results and normal physical exams.
Biologics may provide excellent relief from psoriasis, but that relief comes with the potential for serious side effects, mainly associated with an altered immune system. As a result, Kevin Cooper, M.D., emphasizes the importance of making sure patients are physically and mentally prepared for undergoing biologic therapies.
A naturally secreted, embryonic-like human cell conditioned media (hCCM) used as a follicle holding solution (FHS) holds promise for improving outcomes of hair transplantation surgery, according to clinical trial findings reported by Neil S. Sadick, M.D., at the 2011 annual meeting of the American Society for Dermatologic Surgery.
Dermatologists are increasingly turning to "extenders" - physician assistants and nurse practitioners - to combat a shortage of doctors in the specialty. These mid-level providers and the physicians who hire them say teamwork and training are among the keys for successful collaborations.
Body contouring is the next aesthetic frontier, and thanks to advances in noninvasive lipolysis, the future is very bright, says Mark S. Nestor, M.D., Ph.D.
Beginning in 2003, with approval of human collagen and in the following years the introduction of products containing hyaluronic acid, calcium hydroxylapatite, poly-L-lactic acid and more, it's no surprise that fillers have taken on an ever-increasing role in aesthetic dermatology. On Call wondered whether dermatologists' treatment techniques have changed as a result of the growing array of product options, and if so, how.
The p53 gene is very important in dermatology for the prevention of skin cancer. P53 is the gene that is activated when viable epidermal skin cells are damaged by UV radiation. UV radiation strikes the skin and is first transformed to heat by an organic sunscreen and possibly reflected by an inorganic sunscreen. If the sunscreen fails to diffuse all of the damaging UV radiation, keratinocytes function to reflect and scatter the radiation.
Born into an accomplished dermatology family, Ethan Lerner, M.D., has had to ask himself if he had any choice but to join the specialty. His father, the late Aaron B. Lerner, M.D., former professor and chairman of the Yale University dermatology department, discovered melatonin and developed transplantation therapy for vitiligo.
The unique needs of infants with severe atopic dermatitis require special attention. As such, says Mary Wu Chang, M.D., associate clinical professor of dermatology and pediatrics, University of Connecticut School of Medicine, "This is not something you can handle in a 15-minute visit."
Future management of actinic keratosis (AK) and nonmelanoma skin cancer (NMSC) will involve creative uses of conventional therapies, particularly in multimodal regimens, and it will be expanded by recent advances in chemotherapy, according to Theodore Rosen, M.D., who spoke at the 30th annual Fall Clinical Dermatology Conference.
Biosimilars are designed to mimic biologic agents, but they are not precise duplicates of these drugs. Biosimilars may prove useful for treating skin conditions such as psoriasis, but clinicians are waiting for guidance on the drugs from the Food and Drug Administration, which was still pending at press time.
Dr. Doe has practiced dermatology for more than three decades and has seen many of his patients become quite elderly. He is saddened by the senility of some of these patients, and he is worried about their ability to consent to various office-provided procedures. One of his patients with dementia has a brother who holds a power of attorney that becomes effective when the described patient is no longer able to make decisions for himself.
Photodynamic therapy (PDT) using a topically applied liposomal eosin hydrogel is an effective treatment for primary axillary hyperhidrosis, according to a study reported at the 31st annual meeting of the American Society for Laser Medicine and Surgery.
Neodymium is a crystal that is used as a lasing medium for some solid-state lasers. The 1,064 nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser emits monochromatic light in the near-infrared spectrum. Near-infrared lasers include other devices emitting wavelengths between 750 nm and 1,400 nm.
Clinical trial results suggest that natural supplement Pycnogenol (Horphag Research), an antioxidant plant extract from the bark of the French maritime pine tree, improves skin hydration and elasticity in women.
The Food and Drug Administration has approved Picato gel (ingenol mebutate, Leo Pharma) as a treatment for actinic keratoses on the face, scalp, trunk and extremities.
The Food and Drug Administration has approved the groundbreaking, first-in-class drug Erivedge (vismodegib, Genentech) to treat adult patients with advanced and metastatic basal cell cancers.
Results of a randomized, sham-controlled clinical trial including objective and subjective efficacy endpoints have established noninvasive high-intensity focused ultrasound (HIFU; LipoSonix/Solta Medical, cleared in September 2011 by the Food and Drug Administration for noninvasive waist circumference reduction) as an effective and well-tolerated option for body contouring.
Use of interactive teledermatology consultations leads to improved clinical outcomes for patients, according to a new study from the University of California, Davis, School of Medicine.
Supply & Demand : ‘Chronic’ shortage of derms leaves some areas underserved Good Morning : Afternoon sun exposure carries greater risk of skin cancer in humans Special Report : Naturopathic therapies