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Journal of Drugs in Dermatology: JDD

Hugh M Gloster
The following is a response to the Letter to the Editor by Konda, Francis, and Patel regarding the article "Mohs and Close" Technique (MCT) for selected cases to increase the efficiency of Mohs micrographic surgery.1,2 The letter raises questions about our utilization of MCT that require clarification.
March 1, 2018: Journal of Drugs in Dermatology: JDD
Stephanie Donaldson, Theresa Canavan, Peter G Pavlidakey, Wendy C Cantrell, Boni E Elewski
Local adverse reactions to vaccination are typically mild and often quickly resolve. Vaccine adjuvants such as aluminum salts in combination with improper vaccination technique may result in severe local adverse reactions. As far as we know, there is only one prior case of frankly necrotic rapidly progressing vaccine site necrosis, which occurred in a pediatric patient.1 To our knowledge, this is the first adult case of vaccine site necrosis to be reported. The presumed etiology has been aluminum salt adjuvants and improper vaccination technique...
March 1, 2018: Journal of Drugs in Dermatology: JDD
Liza Brown, Jennifer David, Stanley Skopit
Basal cell carcinoma (BCC) is a common skin malignancy comprising 80% of non-melanoma skin cancers.1 Over 2.8 million cases are estimated to be diagnosed in the United States alone each year. Advanced BCCs are comprised of BCCs that have metastasized to local or distant lymph nodes or organs, or locally invasive BCCs that are extensive and infiltrate vital structures such as eyes, nose, or brain. Advanced BCC tumors represent roughly 1-10% of BCCs today. Two severe case presentations and treatment options will be discussed in this case report series and review...
March 1, 2018: Journal of Drugs in Dermatology: JDD
Gillian K Weston, Jette Hooper, Bruce E Strober
Dupilumab (Dupixent, Regeneron Pharmaceuticals and Sanofi Genzyme) is a novel biologic medication recently approved by the FDA for the treatment of moderate-to-severe atopic dermatitis in adults who have not achieved adequate control with topical medications. Dyshidrotic eczema is a distinct entity, often considered on the spectrum of atopic dermatitis, that primarily effects the palms and soles; it is often associated with considerable morbidity yet is frequently challenging to treat. We report two cases of recalcitrant dyshidrotic eczema treated successfully with dupilumab at standard dosing...
March 1, 2018: Journal of Drugs in Dermatology: JDD
Raza Aly, Tate Winter, Steve Hall, Tracey Vlahovic
Dermatophytoma is a little-known, difficult to treat fungal infection that complicates onychomycosis. First described by Roberts and Evans in the late 1990's, dermatophytoma presents as a dense concentration of fungal hyphae within or under the nail plate and is generally white or yellow/brown in color, and linear (streaks) or round (patches) in shape; primary etiologic organisms are dermatophytes. Oral antifungals have limited success in treating dermatophytoma owing to difficulties accessing and penetrating what is hypothesized to be a fungal biofilm...
March 1, 2018: Journal of Drugs in Dermatology: JDD
Neal Bhatia, Leon Kircik
Optimizing combinations for psoriasis means asking patients to take control of their disease. It means balancing potency of steroids for the short-run to put out the fire and bring relief and maintaining the clearance for the long-run to reduce recurrence potential. Successful combinations are built on tolerability, ease of application, and the efficacy demonstrated by the synergy of the sum of the parts over being used separately. <p><em>J Drugs Dermatol. 2018;17(3):342-346.</em></p>...
March 1, 2018: Journal of Drugs in Dermatology: JDD
James J Leyden, Vilma Sniukiene, David R Berk, Alexandre Kaoukhov
BACKGROUND: There is a need for new oral antibiotics for acne with improved safety profiles and targeted antibacterial spectra. Sarecycline is a novel, tetracycline-class antibiotic specifically designed for acne, offering a narrow spectrum of activity compared with currently available tetracyclines, including less activity against enteric Gram-negative bacteria. This phase 2 study evaluated the efficacy and safety of three doses of sarecycline for moderate to severe facial acne vulgaris...
March 1, 2018: Journal of Drugs in Dermatology: JDD
Logan W Thomas, Ashley Elsensohn, Terese Bergheim, Jessica Shiu, Anand Ganesan
IMPORTANCE: Intramuscular (IM) steroids can be used to treat a wide variety of dermatologic diseases. Although seemingly effective and safe, this form of corticosteroid therapy may be underused amongst dermatologists. OBJECTIVE: The objective of this review is to determine the evidence regarding the efficacy and side effect profile of intramuscular triamcinolone in the treatment of dermatologic disease. EVIDENCE REVIEW: A PubMed search engine was used for this study...
March 1, 2018: Journal of Drugs in Dermatology: JDD
Janet DuBois, Jeffrey S Dover, Terry M Jones, Robert A Weiss, David R Berk, Gurpreet Ahluwalia
BACKGROUND: Rosacea is a chronic dermatologic condition with limited treatment options. OBJECTIVE: This phase 2 study evaluated the optimal oxymetazoline dosing regimen in patients with moderate to severe persistent facial erythema of rosacea. METHODS: Patients were randomly assigned to oxymetazoline cream, 0.5%, 1.0%, or 1.5%, or vehicle, administered once daily (QD) or twice daily (BID) for 28 consecutive days. The primary efficacy endpoint was the proportion of patients with ≥2-grade improvement from baseline on the Clinician Erythema Assessment (CEA) and the Subject Self-Assessment of erythema (SSA-1) on day 28...
March 1, 2018: Journal of Drugs in Dermatology: JDD
Elizabeth T Makino, Lily I Jiang, Priscilla Tan, Tsing Cheng, Rahul C Mehta
The growing male skincare market reflects the increased interest of men in addressing facial aging concerns and maintaining a healthy youthful appearance. Because of differences in skin structure and aging as well as in lifestyle and behavior, male facial skin presents unique challenges that may result in different priorities or treatment strategies compared to female skin. A clinical study was conducted to assess clinical efficacy and tolerability of a topical skincare treatment product that was developed to address several male facial skin concerns related to skin quality, skin aging, and shaving...
March 1, 2018: Journal of Drugs in Dermatology: JDD
Leslie Baumann, David J Goldberg, Linda Stein Gold, Emil A Tanghetti, Edward Lain, Joely Kaufman, Emily Weng, David R Berk, Gurpreet Ahluwalia
Rosacea is a chronic dermatologic condition with limited treatment options, particularly for persistent erythema. This pivotal phase 3 study evaluated oxymetazoline, an a1A-adrenoceptor agonist, for the treatment of moderate to severe persistent erythema of rosacea. Eligible patients were randomly assigned 1:1 to receive oxymetazoline cream 1.0% or vehicle applied topically to the face once daily for 29 days. The primary efficacy outcome was ≥2-grade improvement from baseline on both Clinician Erythema Assessment (CEA) and Subject Self-Assessment for rosacea facial redness (SSA) (composite success) at 3, 6, 9, and 12 hours postdose on day 29...
March 1, 2018: Journal of Drugs in Dermatology: JDD
Nicole Y Lee, Omer Ibrahim, Shilpi Khetarpal, Mariya Gaber, Spiros Jamas, Ioannis Gryllos, Jeffrey S Dover
Keratosis pilaris (KP) is a common skin finding that presents as follicular hyperkeratotic papules on the proximal extremities in patients with a propensity for atopy. Although often asymptomatic, the stippled appearance is cosmetically disturbing to patients and difficult to treat as current therapies are limited in availability and efficacy. Nitric oxide (NO) has been found to be essential in basic systemic and cutaneous physiologic function, specifically in terms of its anti-microbial and anti-inflammatory properties, which evolutionarily was maintained by ammonia-oxidizing bacteria (AOB)...
March 1, 2018: Journal of Drugs in Dermatology: JDD
Garrett T Prince, Michael C Cameron, Ramin Fathi, Theodore Alkousakis
INTRODUCTION: 5-fluorouracil has proven to be an effective therapy in the treatment of a variety of dermatologic conditions. Approved by the United States Food and Drug Administration for the topical treatment of actinic keratoses and superficial basal cell carcinoma, 5-fluorouracil has also demonstrated efficacy in the treatment of a variety of other dermatologic diseases. While best known for its use as a topical medication, 5-fluorouracil can also be delivered intralesionally for the treatment of dermatologic disease...
March 1, 2018: Journal of Drugs in Dermatology: JDD
James Q Del Rosso, Linda Stein Gold, Sandra Marchese Johnson, Maria Jose Rueda, Hilary Baldwin, Edward L Lain, Megan Landis, Marta Rendon, Emil Tanghetti, Jonathan Weiss
INTRODUCTION: Acne treatment guidelines suggest a combination approach with topical therapy including a topical retinoid, benzoyl peroxide and an oral antibiotic, or oral isotretinoin (OI), as first-line treatment options for severe acne vulgaris (AV). This study evaluated the efficacy and safety of a daily regimen of 0.3% adapalene and 2.5% benzoyl peroxide (0.3% A/BPO) gel and oral doxycycline 100 mg twice daily in severe (nonnodulocystic, non-conglobate) inflammatory AV. METHODS: This was a phase 4, 12-week, single-arm, openlabel, multi-center investigational study...
March 1, 2018: Journal of Drugs in Dermatology: JDD
Sam Hanna, Anneke Andriessen, Jennifer Beecker, Martin Gilbert, Eric Goldstein, Sunil Kalia, Aaron King, John Kraft, Carrie Lynde, Davindra Singh, Irina Turchin, Catherine Zip
BACKGROUND: Recently, experience and knowledge have been gained using effective topical treatment for onychomycosis, a difficult-to-treat infection. METHODS: This project aims to help understand and improve patient-focused quality of care for fungal nail infections. A panel of dermatologists who treat onychomycosis convened on several occasions to review and discuss recent learnings in the treatment of onychomycosis. The panel developed and conducted a survey on diagnosis, treatment and prevention, discussed the results, and provided recommendations...
March 1, 2018: Journal of Drugs in Dermatology: JDD
Peter W Hashim, John K Nia, David Terrano, Gary Goldenberg, Leon H Kircik
February 1, 2018: Journal of Drugs in Dermatology: JDD
Stephanie Kao, Ramsin Yadgar, Thomas Enelow, Adam Friedman
Blastomycosis-like pyoderma (BLP) is a rare reactive skin disease that is most commonly caused by bacterial infection. Herein we present a case of BLP arising in lichen planus, a chronic inflammatory disease. We propose Wolf's isotopic response, or the appearance of a new skin disease at the site of an existing and unrelated disease, as the underlying molecular mechanism responsible for this unusual physical presentation. It is important that clinicians recognize atypical morphologies such as BLP, which mimics squamous cell carcinoma both clinically and pathologically...
February 1, 2018: Journal of Drugs in Dermatology: JDD
Lauren K Hoffman, Isabelle Raymond, Leon Kircik
BACKGROUND: Tinea pedis is the most common dermatophyte infection. Treatment is critical to alleviate pruritic symptoms, to reduce the risk for secondary bacterial infection, and to limit the spread of infection to other body sites or other individuals. The objective of this study was to compare the abilities of econazole nitrate topical foam, 1% and ketoconazole cream (2%) to reduce pruritus, thus improving quality of life, and to determine patient preference for the foam product versus the cream product in patients with interdigital tinea pedis...
February 1, 2018: Journal of Drugs in Dermatology: JDD
Linda Stein Gold, Jerry Bagel, Mark Lebwohl, J Mark Jackson, Rongdean Chen, Joana Goncalves, Eugenia Levi, Kristina Callis Duffin
<p>BACKGROUND: Many patients with moderate plaque psoriasis are undertreated despite broadening treatment options. In the phase IV UNVEIL study, oral apremilast demonstrated efficacy and safety in systemic-naive patients with chronic moderate plaque psoriasis with lower psoriasis-involved body surface area (BSA; 5%-10%) during the 16-week, double-blind, placebo-controlled phase. We describe efficacy and safety of apremilast in this population through week 52 in UNVEIL.</p> <p>METHODS: Patients with moderate plaque psoriasis (BSA 5%-10%; static Physician's Global Assessment [sPGA] score of 3 [moderate]) and naive to systemic therapies for psoriasis were randomized (2:1) to receive apremilast 30 mg twice daily or placebo for 16 weeks...
February 1, 2018: Journal of Drugs in Dermatology: JDD
Amy W Kuang, Janet DuBois, Mayssa Attar, Gurpreet Ahluwalia
BACKGROUND: Oxymetazoline cream 1.0% is FDA-approved for the topical treatment of persistent facial erythema associated with rosacea in adults. This phase 2, multicenter, randomized, double-blind, parallel-group study assessed the pharmacokinetics, safety, and tolerability of oxymetazoline in patients with moderate to severe erythema associated with rosacea. METHODS: Eligible patients were randomized to 1 of 8 treatment groups (oxymetazoline cream 0.5%, 1.0%, or 1...
February 1, 2018: Journal of Drugs in Dermatology: JDD
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