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Journal of Drugs in Dermatology: JDD

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https://www.readbyqxmd.com/read/30124737/what-lies-beneath-the-face-value-of-a-box-warning-a-deeper-look-at-brodalumab
#1
Peter W Hashim, Tinley Chen, Mark G Lebwohl, Lauren B Marangell, Leon H Kircik
Brodalumab, a fully human antibody of the interleukin-17 receptor, is highly effective in the treatment of moderate-to-severe plaque psoriasis. However, based on safety signals identified in clinical trials, brodalumab carries a boxed warning regarding possible risks of suicidal ideation and behavior (SIB). The validity of this link remains controversial, especially in the context of the psoriasis population as well as clinical trial data from other recently approved treatments. Herein, we critically examine the association between brodalumab and SIB...
August 1, 2018: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/30124736/depression-it-s-the-disease-not-the-drug
#2
Leon H Kircik
Research into the immunopathological mechanisms of plaque psoriasis has produced increasingly targeted biologic therapies. The specificity of these agents allows for high rates of efficacy and decreased adverse events, most notably reduced immune system suppression. In recent years, the recognition of interleukin (IL)-17 as an important component in the pathogenesis of psoriasis has led to the development of a new class of biologics.
August 1, 2018: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/30124735/treat-to-target-in-psoriasis-a-real-world-experience-with-biologics-and-adjunctive-topical-therapy
#3
https://www.readbyqxmd.com/read/30124734/an-excellent-response-to-tofacitinib-in-a-pediatric-alopecia-patient-a-case-report-and-review
#4
Liza Brown, Stanley Skopit
KD is an 8 year-old male patient who presented to our clinic in December 2016 with a history of patchy hair loss for many months duration that was worsening. KD's past medical history was notable for atopic dermatitis, and a positive family history of autoimmune thyroid disease. Upon examination he had well circumscribed areas of hair loss throughout his scalp, with exclamation mark hairs seen on dermoscopy. Eyebrows and eyelashes were intact, no epidermal changes of scale or erythema were noted on the scalp and no palpable lymph nodes were present...
August 1, 2018: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/30124733/evaluation-of-the-performance-of-a-nature-based-sensitive-skin-regimen-in-subjects-with-clinically-diagnosed-sensitive-skin
#5
Zoe Diana Draelos, Stanley B Levy, Celeste Lutrario, Hemali Gunt
BACKGROUND: Unique whole formula nature-based sensitive skin products are formulated to minimize irritation while providing conditioning and soothing benefits to clinically diagnosed sensitive skin. OBJECTIVE: To evaluate and compare the efficacy and tolerability of a regimen of cleanser containing natural oils, beeswax, and witch hazel, and day & night creams containing natural oils, glycerin, and botanical anti-inflammatories (NR); and a synthetic dermatologist-recommended regimen of cetyl alcohol, sodium lauryl sulphate-containing cleanser and glycerin, polyisobutene-containing lotion (CR) in clinically diagnosed sensitive skin resulting from eczema/atopic dermatitis, rosacea, or cosmetic intolerance...
August 1, 2018: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/30124732/uv-protection-by-natural-products-c-myrrha-oil-versus-sunscreen
#6
Nikhil Chakravarty, Caitlyn Kellogg, Jason Alvarez, Ozlem Equils, Margie Morgan
Exposure to various types of ultraviolet (UV) radiation from the sun has been linked to skin cancer. Use of sunscreen can reduce the damaging and carcinogenic effects of UV radiation. However, multiple chemicals in sunscreen can trigger allergic responses, making people less inclined to use sunscreen. Thus, finding natural, plant-based alternatives to sunscreen with similar efficacy has become an important area of research. Myrrh oil, extracted from the shrub Commiphora myrrha, has been used in the treatment of topical wounds and studies have shown that it may provide protection against solar radiation...
August 1, 2018: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/30124731/cosmetic-versus-medicine-how-does-your-country-define-sunscreen
#7
Elissa Tong, Gayle Fischer, Saxon D Smith
Skin cancer (melanoma and non-melanoma) is the most commonly diagnosed cancer in the United States of America, and non-melanoma skin cancer is the most common cause of Australian hospitalisations with cancer as the principle diagnosis, having a huge cost to the country's health care system. Primary and secondary skin cancer prevention is globally inadequate, with only 3 in 10 American adults using sun protection routinely. Evidence suggests that regular sunscreen use in Australians prevents both melanoma and non-melanoma skin cancers, and American research has found that daily sunscreen use reduced the incidence of melanoma - the most skin cancer deaths - by half...
August 1, 2018: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/30124730/a-novel-optimized-method-to-accelerate-the-preparation-of-injectable-poly-l-lactic-acid-by-sonication
#8
Chien-Nien Li, Chao-Chin Wang, Cheng-Chieh Huang, Hsiao-Han Wang, Nia-Jen Hsu
Current consensus for preparing injectable poly-L-lactic acid (PLLA) suggests adequate hydration (less than equal to 2-24 hours of reconstitution) of the lyophilized particles before injection, but the volume of reconstitution and the duration of hydration time varies. This study established a method to evaluate the distribution of PLLA particles after hydration and found that longer hydration time increased the effective portion (particles less than 60 μm) of PLLA products. Further investigation of the feasibility of reconstitution with sonication revealed that 2-hour hydration of PLLA powders with additional 5-minute-sonication could yield a comparable particle distribution with 48-hour-hydration of PLLA...
August 1, 2018: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/30124729/a-phase-2-controlled-dose-ranging-study-of-sb208-an-investigational-topical-nitric-oxide-releasing-drug-for-the-treatment-of-tinea-pedis
#9
Boni E Elewski, Leon H Kircik, Nathan Stasko, Emily De Leon, Carolyn Enloe, Todd Durham, Tomoko Maeda-Chubachi
BACKGROUND: Tinea pedis, or athlete's foot, is a superficial, skin infection caused by dermatophytes. It is usually topically treated. Nitric oxide is endogenously produced in humans and has a variety of physiologic and antimicrobial properties. SB208 is a novel topical treatment comprising berdazimer sodium (a nitric oxide-storing macromolecule) and a hydrogel. Admixing these two components releases nitric oxide to the application site. METHODS: A phase 2, double-blind, randomized trial evaluated the safety and efficacy of 3 doses of SB208 (2%, 4%, and 16%) vs matching vehicle, administered once daily for 14 days, in subjects with culture-confirmed interdigital tinea pedis...
August 1, 2018: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/30124728/discordance-between-patient-reported-motivations-to-seek-treatment-for-psoriasis-compared-to-television-advertisements
#10
Nicole M Golbari, Martina L Porter, Alexa B Kimball
INTRODUCTION: Despite a growing arsenal of therapies for psoriasis and, consequently, an increasing number of advertisements for these treatments, many psoriasis patients still remain untreated. While the primary treatment seeking motivations for these patients have been identified, it is unknown if the commercials for the medications designed to encourage patient engagement in treatment are relevant to these concerns. METHODS: Online databases for national television advertisements were searched for psoriasis treatment commercials broadcast between 2000 and 2018...
August 1, 2018: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/30124727/patient-reported-satisfaction-with-the-fixed-combination-calcipotriene-betamethasone-dipropionate-foam-for-plaque-psoriasis
#11
Joe Gorelick, Wendy Cantrell, Kristine Kucera, Karen A Veverka, Kara Gooding
Psoriasis is a chronic, immune-mediated inflammatory disease characterized by localized scaling and plaques associated with itching and pain. In some cases, topical therapies are effective to treat mild to moderate psoriasis. Topical agents can be used concomitantly with other treatments for moderate and severe or treatment-resistant psoriasis. Patient adherence to medication regimens remains a major challenge in therapy, especially with topical agents, for which adherence can be affected by the amount of time needed for application, the treatment formulation, cost, and cosmetic characteristics...
August 1, 2018: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/30124726/efficacy-and-safety-of-toreforant-a-selective-histamine-h4-receptor-antagonist-for-the-treatment-of-moderate-to-severe-plaque-psoriasis-results-from-a-phase-2-multicenter-randomized-double-blind-placebo-controlled-trial
#12
Ellen Frankel, Michael Song, Shu Li, Jingzhi Jiang, Robin L Thurmond, Bruce Randazzo
BACKGROUND: Toreforant is a selective histamine H4 receptor antagonist. H4 receptor activation may play a role in immune-mediated inflammation in psoriasis. OBJECTIVE: To evaluate Toreforant efficacy and safety in patients with moderate-to-severe psoriasis. METHODS: Biologic-naïve patients were to be treated (30, 60, or 3 mg Toreforant or placebo) for 12 weeks and followed through week 16. In this adaptive-design study, assignments were guided by interim analyses...
August 1, 2018: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/30124725/rapid-onset-of-action-in-patients-with-moderate-to-severe-plaque-psoriasis-with-halobetasol-0-01-tazarotene-0-045-fixed-combination
#13
Linda Stein Gold, Leon H Kircik, David Pariser, Jeffrey L Sugarman, Tina Lin, Robert Kang, Radhakrishnan Pillai
BACKGROUND: Psoriasis is a chronic condition often managed with topical therapy. Patients have high expectations about the speed at which improvement is achieved, which then can have a marked impact on the patient's adherence to treatment. Recently, clinical data on a new fixed combination of halobetasol and tazarotene (HP/TAZ) have been presented. HP/TAZ lotion was statistically more effective than individual active ingredients or its vehicle, with a predictable safety profile. OBJECTIVES: Here we review the efficacy and tolerability data with a specific focus on the first two weeks of therapy...
August 1, 2018: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/30124724/safety-and-efficacy-of-a-fixed-combination-halobetasol-and-tazarotene-lotion-in-the-treatment-of-moderate-to-severe-plaque-psoriasis-a-pooled-analysis-of-two-phase-3-studies
#14
Jeffrey L Sugarman, Jonathan Weiss, Emil A Tanghetti, Jerry Bagel, Paul S Yamauchi, Linda Stein Gold, Tina Lin, Gina Martin, Radhakrishnan Pillai, Robert Israel
BACKGROUND: Topical corticosteroids (TCS) are the mainstay of psoriasis treatment. Safety concerns may limit use. Combination with tazarotene may optimize efficacy and minimize safety and tolerability concerns. OBJECTIVE: Investigate safety and efficacy of halobetasol propionate 0.01%/tazarotene 0.045% (HP/TAZ) lotion in moderate-to-severe plaque psoriasis. METHODS: Two multicenter, randomized, double-blind, vehicle-controlled phase 3 studies (N=418)...
August 1, 2018: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/30124723/a-prospective-open-label-study-evaluating-adjunctive-calcipotriene-0-005-betamethasone-dipropionate-0-064-foam-in-psoriasis-patients-with-inadequate-response-to-biologic-therapy
#15
Jerry Bagel, James Zapata, Elise Nelson
OBJECTIVE: To assess the effectiveness and safety of combining calcipotriene 0.005%/betamethasone dipropionate 0.064% (Cal/BD) foam with biologic therapies for patients with plaque psoriasis who have not obtained an adequate response with biologic therapy. METHODS: This was a prospective, open-label, single-arm study of patients with chronic plaque-type psoriasis (body surface area [BSA] ≤5%) who were being treated with biologic agents for ≥24 weeks. All patients received once-daily Cal/BD foam for 4 weeks, followed by twice-weekly use on consecutive days for 12 weeks (maintenance regimen)...
August 1, 2018: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/30124722/mechanisms-underlying-the-clinical-effects-of-apremilast-for-psoriasis
#16
Carlo Pincelli, Peter H Schafer, Lars E French, Matthias Augustin, James G Krueger
Psoriasis is a chronic, systemic, inflammatory disease with manifestations resulting from a dysregulated immune response. In psoriatic skin, expression of all phosphodiesterase 4 (PDE4) isoforms (A-D), part of a family of enzymes known to regulate cyclic adenosine monophosphate levels and immune homeostasis, is elevated compared with healthy controls. Agents that inhibit the enzymatic activity of PDE4, the predominant PDE in most immune cells, exert well-recognized anti-inflammatory effects. Apremilast is a selective PDE4 inhibitor approved for the treatment of adults with moderate to severe plaque psoriasis and/or psoriatic arthritis...
August 1, 2018: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/30124721/long-term-efficacy-of-guselkumab-for-the-treatment-of-moderate-to-severe-psoriasis-results-from-the-phase-3-voyage-1-trial-through-two-years
#17
Christopher E M Griffiths, Kim A Papp, Alexa B Kimball, Bruce Randazzo, Michael Song, Shu Li, Yaung-Kaung Shen, Andrew Blauvelt
BACKGROUND: Due to the chronic nature of psoriasis, it is important to assess the sustained response of treatments over time. OBJECTIVE: To assess the efficacy of continuous treatment with guselkumab (an interleukin-23 blocker) through two years in the phase 3 VOYAGE 1 trial. METHODS: Patients were randomized to placebo, guselkumab, or adalimumab at baseline. Placebo-randomized patients crossed over to guselkumab at week 16 (placebo→guselkumab) and adalimumab-randomized patients crossed over to guselkumab at week 52 (adalimumab→guselkumab); all patients received open-label guselkumab beyond week 52...
August 1, 2018: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/30005109/the-practice-of-compounding-associated-compounding-regulations-and-the-impact-on-dermatologists
#18
James Quertermous, Seemal Desai, Julie Harper, Mark Lebwohl, Abel Torres, Leon H Kircik
Medication compounding gained national attention in the fall of 2012 after contaminated compounded medications produced in the New England Compounding Center infected 800 people with fungal meningitis and led to several fatalities. This prompted Congress to pass regulations on compounding through the Drug Quality and Security Act (DQSA) in 2013. The act increased oversight of patient-specific drug compounding taking place in compounding pharmacies, created 503(b) outsourcing facilities to obtain compounded drugs, and added regulations for obtaining compounded drugs from traditional 503(a) pharmacies...
July 1, 2018: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/30005108/yes-to-appropriate-compounding-no-to-illegal-compounding
#19
Leon H Kircik
Dermatology is often described as a "visual" specialty. While it is true that many of our diagnoses can be made based on a relatively quick recognition of morphology, such a characterization of our profession overlooks the reality that dermatologists are "doers" in the clinic. From aesthetic injections to biopsies and cryosurgery, much of our patient care time is spent performing minor and major procedures. We are well known for our in-office efficiency and cost saving practices.
July 1, 2018: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/30005107/margin-assessment-for-punch-and-shave-biopsies-of-dysplastic-nevi
#20
George A Zakhem, Vitaly Terushkin, Euphemia W Mu, David Polsky, Shane A Meehan
INTRODUCTION: Biopsies of atypical melanocytic nevi are among the most commonly performed procedures by dermatologists. Margin assessment is often used to guide re-excision, but can be a point of confusion as negative margins reported in the planes of sections examined do not always reflect complete removal of a lesion. This study investigates the rates of false negative margins after both punch and shave biopsies. METHODS: We performed a retrospective analysis of 50 consecutive punch and shave biopsy specimens (1) diagnosed as DN, and (2) reported as having clear margins in the planes of section examined...
July 1, 2018: Journal of Drugs in Dermatology: JDD
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