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Skin Therapy Letter

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https://www.readbyqxmd.com/read/27825175/update-on-efinaconazole-10-topical-solution-for-the-treatment-of-onychomycosis
#1
A K Gupta, C Studholme
Efinaconazole 10% nail solution is a novel topical antifungal drug for the treatment of onychomycosis. Two Phase III trials were completed using efinaconazole 10% nail solution, where 17.8% and 15.2% of patients achieved complete cure, and 55.2% and 53.4% achieved mycological cure. Several post hoc analyses were carried out using data from Phase III trials to determine the efficacy of efinaconazole with respect to disease duration, disease progression, and comorbidities of diabetes or tinea pedis with onychomycosis...
November 2016: Skin Therapy Letter
https://www.readbyqxmd.com/read/27825174/a-review-of-ixekizumab-an-anti-interleukin-17a-monoclonal-antibody-for-moderate-to-severe-plaque-psoriasis
#2
A J Peranteau, A E Turkeltaub, Y Tong, Z Nawas, S K Tyring
Psoriasis is a multifactorial chronic skin disease that can have significant detrimental effects on patients' physical, mental, antibodypsychosocial wellbeing. Patients often suffer from a decreased quality of life along with numerous comorbidities. Recent advances in our understanding of the innate and adaptive immune systems have led to the identification of interleukin (IL)-17 as a key pro-inflammatory mediator in psoriasis. This knowledge has in turn led to the development of newer biologic agents that have been shown to be more effective than traditional therapies...
November 2016: Skin Therapy Letter
https://www.readbyqxmd.com/read/27603326/rituximab-uses-in-dermatology
#3
K Gleghorn, J Wilson, M Wilkerson
Rituximab is an anti-CD20 monoclonal antibody with considerable potential in dermatology due to an increase in off-label indications. Chronic graft-versus-host disease and pemphigus vulgaris are two of the most promising indications for off-label use of rituximab. It is a generally safe alternative that should be considered when traditional therapy with corticosteroids or immunosuppressants has failed or caused significant intolerance. Currently, rituximab is only FDA-approved for treatment of follicular and diffuse large B-cell non-Hodgkin's lymphoma, rheumatoid arthritis, chronic lymphocytic leukemia, granulomatosis with polyangiitis (formerly Wegener's granulomatosis) and microscopic polyangiitis...
September 2016: Skin Therapy Letter
https://www.readbyqxmd.com/read/27603325/sodium-deoxycholate-for-submental-contouring
#4
S Humphrey, K Beleznay, J D A Beleznay
The chin and jaw line are integral parts of an individual's aesthetic profile, and the presence of submental fat detracts from this and can lead to displeasure with one's facial appearance. While liposuction and cosmetic surgery are regarded as the gold standard in treating submental fat, surgical intervention is not appealing to all patients and has potential surgical complications including longer recovery, and contour irregularities. Despite ample advances in aesthetic medicine to enhance the appearance of the face, very little is available in non-invasive options to reduce submental fat that has been supported by robust evidence...
September 2016: Skin Therapy Letter
https://www.readbyqxmd.com/read/27388531/frontal-fibrosing-alopecia
#5
S Holmes
Frontal fibrosing alopecia, described just over 20 years ago, has become one of the most frequently seen causes of scarring alopecia at many specialist hair clinics. Considered a clinical variant of lichen planopilaris (LPP), it has distinctive features and associations which distinguish it from LPP. Although largely affecting postmenopausal women, a small but increasing number of men and premenopausal women are affected. The spectrum of the disease has expanded from involvement of the frontal hairline and eyebrows, to potentially affecting the entire hairline, facial and body hair...
July 2016: Skin Therapy Letter
https://www.readbyqxmd.com/read/27388530/adalimumab-humira-for-the-treatment-of-hidradenitis-suppurativa
#6
A K Gupta, C Studholme
Adalimumab (Humira®) is a novel therapy approved by the US Food and Drug Administration, Health Canada, and the European Commission for the treatment of hidradenitis suppurativa (HS). Results of two Phase III trials of adalimumab demonstrate significantly higher efficacies compared to placebo. Primary efficacy outcome of 50% reduction in abscess and inflammatory nodule count was seen in 41.8% and 58.9% of participants receiving adalimumab in PIONEER I and PIONEER II studies, respectively, showing substantial improvement compared with placebo groups in both trials (26...
July 2016: Skin Therapy Letter
https://www.readbyqxmd.com/read/27223249/dsm-5-update-in-psychodermatology
#7
D A Nowak, S M Wong
Up to a third of dermatology outpatients have a significant psychiatric issue complicating their skin complaint. Although the ideal would frequently involve psychiatric assessment, those with comorbid mental illness often refuse psychiatric referral. As a result, it is imperative that dermatologists be mindful of psychiatric comorbidity in their patients and comfortable with the fundamentals of psychodermatologic diagnosis and therapy. This update summarizes current concepts, relevance, and therapeutics in psychodermatology, including aspects pertinent to depression, anxiety, obsessive-compulsive, impulse-control, and delusional disorders as described in the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5, published in 2013 by the American Psychiatric Association)...
May 2016: Skin Therapy Letter
https://www.readbyqxmd.com/read/27223248/actikerall%C3%A2-5-fluorouracil-0-5-and-salicylic-acid-10-topical-solution-for-patient-directed-treatment-of-actinic-keratoses
#8
H P Nguyen, J K Rivers
Actinic keratosis (AK), a common cutaneous lesion with the potential to transform into squamous cell carcinoma, has traditionally been treated with ablative and/or surgical procedures. Recently, a topical formulation combining 0.5% 5-fluorouracil with 10% salicylic acid (5-FU-SA) was introduced in Europe under the trade name Actikerall™ for the treatment of grade I/II AKs. In a single randomized phase III trial, 5-FU-SA was shown to be superior to diclofenac 3% gel in hyaluronic acid, as measured by the histological clearance of one defined lesion (72% vs...
May 2016: Skin Therapy Letter
https://www.readbyqxmd.com/read/27223114/nivolumab-for-metastatic-melanoma
#9
A K Gupta, D Daigle
Melanoma is an aggressive skin cancer with a generally poor prognosis at Stage III-IV disease. Traditionally, metastatic melanoma was treated by surgical resection, when possible, and with systemic chemotherapy. New developments in molecular biology have led to the identification of immune checkpoints which are exploited by malignant cells, allowing them to go undetected by the immune system. Nivolumab (Opdivo®) is a human monoclonal antibody which prevents immune inhibition by interacting with PD-1 on tumor cells; thus, increasing tumor-specific T cell proliferation...
March 2016: Skin Therapy Letter
https://www.readbyqxmd.com/read/27223113/dupilumab-a-monoclonal-antibody-for-atopic-dermatitis-a-review-of-current-literature
#10
K Blakely, M Gooderham, K Papp
Atopic dermatitis results when aberrant barrier function and immune activation occur within the skin. Standard therapies for atopic dermatitis have fallen short, prompting efforts to discover novel therapeutics for this disease. Of these, dupilumab, a fully human monoclonal antibody that inhibits the actions of both IL-4 and IL-13, has shown the greatest promise. Clinical trials of systemic dupilumab in moderate-to-severe atopic dermatitis have demonstrated marked improvement in patient symptoms, including pruritus and clinically visible disease...
March 2016: Skin Therapy Letter
https://www.readbyqxmd.com/read/27224898/off-label-uses-of-topical-calcineurin-inhibitors
#11
E Wong, A Kurian
Topical calcineurin inhibitors (TCIs) have been proposed as an alternative, long-term treatment option to topical corticosteroids, without the side effects commonly associated with steroid use. Currently, TCIs are only approved for treatment of atopic dermatitis in patients 2 years of age or older. This article reviews the off-label uses of TCIs and their efficacy in the treatment of cutaneous diseases. Studies show that TCIs may be effective in treating/managing a variety of skin conditions. The strongest evidence based support on clinical outcomes has been reported for allergic contact dermatitis, lichen planus, psoriasis, seborrheic dermatitis and vitiligo...
January 2016: Skin Therapy Letter
https://www.readbyqxmd.com/read/27224897/melasma-and-post-inflammatory-hyperpigmentation-management-update-and-expert-opinion
#12
B Sofen, G Prado, J Emer
Dyschromia is a leading cause for cosmetic consultation, especially in those with diverse skin types (mixture of ethnicities) and with the rise of non-core and untrained physicians performing cosmetic procedures. Melasma and post-inflammatory hyperpigmentation (PIH) account for the majority of cases and are characterized by pigmented macules and patches distributed symmetrically in sun-exposed areas of the forehead, cheeks, and chin in melasma, and irregularly in areas of inflammation or an inciting traumatic event with PIH...
January 2016: Skin Therapy Letter
https://www.readbyqxmd.com/read/27224843/tavaborole-5-solution-a-novel-topical-treatment-for-toenail-onychomycosis
#13
G Gupta, K A Foley, A K Gupta
Onychomycosis is a stubborn fungal infection of the nails that can be difficult to effectively manage. One of the challenges with topical therapies is penetrating the nail plate to reach the site of infection. As the first antifungal in a boron-containing class of drugs with a novel mechanism of action, tavaborole is able to penetrate the nail plate more effectively than ciclopirox and amorolfine lacquers. In Phase II/III clinical trials, tavaborole was shown to be safe and clinically effective. Tavaborole 5% solution was approved by the US FDA for the treatment of toenail onychomycosis in July 2014 and is an important addition to the topical treatment arsenal against this stubborn infection...
November 2015: Skin Therapy Letter
https://www.readbyqxmd.com/read/27224842/sugar-sag-glycation-and-the-role-of-diet-in-aging-skin
#14
H P Nguyen, R Katta
First described in the context of diabetes, advanced glycation end products (AGEs) are formed through a type of non-enzymatic reaction called glycation. Increased accumulation of AGEs in human tissue has now been associated with end stage renal disease, chronic obstructive pulmonary disease, and, recently, skin aging. Characteristic findings of aging skin, including decreased resistance to mechanical stress, impaired wound healing, and distorted dermal vasculature, can be in part attributable to glycation. Multiple factors mediate cutaneous senescence, and these factors are generally characterized as endogenous (e...
November 2015: Skin Therapy Letter
https://www.readbyqxmd.com/read/26382907/new-antibiotics-in-the-management-of-acute-bacterial-skin-and-skin-structure-infections
#15
REVIEW
K Gleghorn, E Grimshaw, E K Kelly
Acute bacterial skin and skin-structure infections (ABSSSIs), often caused by aerobic gram-positive cocci, are most often mild-tomoderate infections that can easily be treated in an outpatient setting. With the rates of these infections substantially increasing in the past decade, owing in part to the emergence of community acquired methicillin-resistant Staphylococcus aureus (CA-MRSA), alternative options for the treatment of ABSSSIs are necessary. This editorial reviews the mechanism of action, efficacy, bacterial coverage, and potential side effect profiles for dalbavancin and oritavancin, both semisynthetic lipoglycopeptide antibiotics, and tedizolid, an oxazolidinone...
September 2015: Skin Therapy Letter
https://www.readbyqxmd.com/read/26382906/apremilast-in-the-treatment-of-psoriasis-and-psoriatic-arthritis
#16
REVIEW
M Gooderham, K Papp
Phosphodiesterase 4 (PDE4) is a key enzyme in the regulation of immune responses of inflammatory diseases through degradation of the second messenger, cyclic adenosine 3',5'-monophosphate (cAMP). Apremilast, a selective PDE4 inhibitor, has been shown to reduce the production of pro-inflammatory cytokines by increasing intracellular levels of cAMP and promoting the production of anti-inflammatory cytokines. The efficacy and safety of apremilast in the treatment of psoriasis and psoriatic arthritis has been demonstrated in phase 2 and 3 studies and will be reviewed here...
September 2015: Skin Therapy Letter
https://www.readbyqxmd.com/read/26382711/ivermectin-1-cream-for-rosacea
#17
REVIEW
G Gupta, D Daigle, A K Gupta, L S Gold
The etiology of papulopustular rosacea (PPR) is not well understood yet appears to involve both the innate and adaptive immune response in addition to possible infestation with Demodex mites. Current treatments for PPR consist mainly of antibiotics. Ivermectin cream 1%, a new topical treatment for PPR, possesses both anti-inflammatory and anti-parasitic properties. After 12 weeks of treatment, subjects treated with ivermectin cream 1% had significantly greater reductions in PPR symptoms and enhanced diseaserelated quality of life improvements compared to subjects who received vehicle...
July 2015: Skin Therapy Letter
https://www.readbyqxmd.com/read/26382710/hidradenitis-suppurativa-a-review-with-a-focus-on-treatment-data
#18
REVIEW
D Barlev, D B Eisen, A Alikhan
Hidradenitis suppurativa (HS) is a chronic disease of the follicular unit that often leads to marked impairment of quality of life and usually affects the axillary, perineum and inframammary regions resulting in tender subcutaneous nodules, abscesses, fibrosis and sinus tract formation. New updates on HS underscores the role of various genes as well as the innate and adaptive immune response in its pathogenesis. Although every patient requires an individualized approach to treatment, topical therapy and antibiotics are mainly used for mild to moderate disease, whereas various systemic immune modulators and/or surgical approaches play a pivotal role in moderate to severe disease...
July 2015: Skin Therapy Letter
https://www.readbyqxmd.com/read/26382557/current-management-of-scalp-psoriasis
#19
L Guenther
The scalp is involved in up to 80% of individuals with psoriasis. Eighty percent of those with scalp psoriasis experience a negative impact on quality of life. Topical treatment with corticosteroids with or without vitamin D3 analogues is the mainstay of treatment. Topical therapy most suitable for the scalp is formulated as a solution, lotion, gel, foam, spray, oil, or shampoo. Twice weekly maintenance in frequent relapsers may decrease the time to first relapse. Intralesional steroids, phototherapy and the excimer laser are occasionally used for resistant cases...
May 2015: Skin Therapy Letter
https://www.readbyqxmd.com/read/26382556/regulating-off-label-promotion-of-medications-has-the-pendulum-swung-too-far
#20
M B Hoffman, B A Yentzer, S R Feldman
Prescribing medications off-label is commonplace in dermatology. Recent policy changes on the regulatory abilities of the US FDA and legal precedents regarding this topic have led to intense debate on free speech about off-label drug use by physicians and drug manufacturers. Here, we summarize and discuss the risks and benefits of off-label promotion and how this relates to quality patient care in dermatology.
May 2015: Skin Therapy Letter
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