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https://www.readbyqxmd.com/read/28453645/medicare-part-d-payments-for-topical-steroids-rising-costs-and-potential-savings
#1
Hannah Song, Adewole Adamson, Arash Mostaghimi
Importance: Rising pharmaceutical costs in the United States are an increasing source of financial burden for payers and patients. Although topical steroids are among the most commonly prescribed medications in dermatology, there are limited data on steroid-related spending and utilization. Objective: To characterize Medicare and patient out-of-pocket costs for topical steroids, and to model potential savings that could result from substitution of the cheapest topical steroid from the corresponding potency class...
April 28, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28448778/economic-impact-of-above-label-dosing-with-etanercept-adalimumab-or-ustekinumab-in-patients-with-psoriasis
#2
Steven R Feldman, Yang Zhao, Huanxue Zhou, Vivian Herrera, Haijun Tian, Yunfeng Li
BACKGROUND: Patients with moderate-to-severe psoriasis may be treated with above-label doses of biologics in an attempt to optimize outcomes. Dose escalation will have an effect on the cost of treatment. OBJECTIVE: To examine costs related to above-label use of etanercept, adalimumab, and ustekinumab among patients with moderate-to-severe psoriasis. METHODS: A retrospective study was performed using a large U.S. claims database. Patients were included in the study if they were aged ≥ 18 years with a diagnosis of psoriasis (excluding psoriatic arthritis) and had at least 1 medication fill for etanercept, adalimumab, or ustekinumab between January 1, 2011, and June 30, 2012...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28435762/laboratory-diagnosis-of-scabies-using-a-simple-saline-mount-a-clinical-microbiologist-s-report
#3
Venkataramana Kandi
Scabies is a skin condition caused by infestation of the mite Sarcoptes scabiei. Sarcoptes scabiei var. hominis is an arthropod member belonging to the order Acarina. Scabies is present throughout the world and is prevalent in all age groups, mostly involving people frequently in contact with animals, children, women, and elderly people. Predisposing factors for scabies include individuals with immunosuppressive conditions and people residing under low socioeconomic conditions. Skin lesions that occur during mite infestation closely resemble dermatological disorders caused by microbes, including fungi, parasites, and viruses...
March 19, 2017: Curēus
https://www.readbyqxmd.com/read/28427793/contribution-of-health-care-factors-to-the-burden-of-skin-disease-in-the-united-states
#4
Henry W Lim, Scott A B Collins, Jack S Resneck, Jean L Bolognia, Julie A Hodge, Thomas A Rohrer, Marta J Van Beek, David J Margolis, Arthur J Sober, Martin A Weinstock, David R Nerenz, Wendy Smith Begolka, Jose V Moyano
The American Academy of Dermatology has developed an up-to-date national Burden of Skin Disease Report on the impact of skin disease on patients and on the US population. In this second of 3 manuscripts, data are presented on specific health care dimensions that contribute to the overall burden of skin disease. Through the use of data derived from medical claims in 2013 for 24 skin disease categories, these results indicate that skin disease health care is delivered most frequently to the aging US population, who are afflicted with more skin diseases than other age groups...
April 17, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28421610/use-of-vegetable-oils-in-dermatology-an-overview
#5
REVIEW
Rashmi Sarkar, Indrashis Podder, Narendra Gokhale, Soumya Jagadeesan, Vijay K Garg
Vegetable oils have been used for a wide variety of purposes since time immemorial; however, their principle use remains as skin moisturizers, especially in neonates and children. Because of their considerable efficacy and a low side effect profile and bearable cost, these oils are hugely popular as moisturizers among the common people in countries such as India. A wide variety of oils have been used, and newer ones are coming up with each passing day. This article focuses on the different types of vegetable oils and their varied uses in dermatology...
April 19, 2017: International Journal of Dermatology
https://www.readbyqxmd.com/read/28414370/semi-automated-localization-of-dermal-epidermal-junction-in-optical-coherence-tomography-images-of-skin
#6
Adeleh Taghavikhalilbad, Saba Adabi, Anne Clayton, Hadi Soltanizadeh, Darius Mehregan, Mohammad R N Avanaki
Identifying the location of the dermal epidermal junction (DEJ) in skin images is essential in several clinical applications of dermatology such as epidermal thickness determination in healthy versus unhealthy skins, such as basal cell carcinoma. Optical coherence tomography (OCT) facilitates the visual detection of DEJ in vivo. However, due to the granular texture of speckle and a low contrast between dermis and epidermis, a skin border detection method is required for DEJ localization. Current DEJ algorithms work well for skins with a visible differentiable epidermal layer but not for the skins of different body sites...
April 10, 2017: Applied Optics
https://www.readbyqxmd.com/read/28406394/a-randomised-controlled-trial-to-compare-the-safety-effectiveness-and-cost-effectiveness-of-doxycycline-200%C3%A2-mg-day-with-that-of-oral-prednisolone-0-5%C3%A2-mg-kg-day-for-initial-treatment-of-bullous-pemphigoid-the-bullous-pemphigoid-steroids-and-tetracyclines-blister
#7
Joanne R Chalmers, Fenella Wojnarowska, Gudula Kirtschig, James Mason, Margaret Childs, Diane Whitham, Karen Harman, Anna Chapman, Shernaz Walton, Enno Schmidt, Thomas R Godec, Andrew J Nunn, Hywel C Williams
BACKGROUND: Bullous pemphigoid (BP) is an autoimmune blistering skin disorder with increased morbidity and mortality in the elderly. OBJECTIVES: To evaluate the effectiveness, safety and cost-effectiveness of a strategy of initiating BP treatment with oral doxycycline or oral prednisolone. We hypothesised that starting treatment with doxycycline gives acceptable short-term blister control while conferring long-term safety advantages over starting treatment with oral prednisolone...
March 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28403263/microneedling-in-all-skin-types-a-review
#8
Lauren Meshkov Bonati, Gorana Kuka Epstein, Tamara Lazic Strugar
<p>INTRODUCTION: Microneedling procedures are growing in popularity for a wide variety of skin conditions. This paper comprehensively reviews the medical literature regarding skin needling efficacy and safety in all skin types and in multiple dermatologic conditions.</p> <p>METHODS: A PubMed literature search was conducted in all languages without restriction and bibliographies of relevant articles reviewed. Search terms included: "microneedling," "percutaneous collagen induction," "needling," "skin needling," and "dermaroller...
April 1, 2017: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/28399154/silk-garments-plus-standard-care-compared-with-standard-care-for-treating-eczema-in-children-a-randomised-controlled-observer-blind-pragmatic-trial-clothes-trial
#9
Kim S Thomas, Lucy E Bradshaw, Tracey H Sach, Jonathan M Batchelor, Sandra Lawton, Eleanor F Harrison, Rachel H Haines, Amina Ahmed, Hywel C Williams, Taraneh Dean, Nigel P Burrows, Ian Pollock, Joanne Llewellyn, Clare Crang, Jane D Grundy, Juliet Guiness, Andrew Gribbin, Eleanor J Mitchell, Fiona Cowdell, Sara J Brown, Alan A Montgomery
BACKGROUND: The role of clothing in the management of eczema (also called atopic dermatitis or atopic eczema) is poorly understood. This trial evaluated the effectiveness and cost-effectiveness of silk garments (in addition to standard care) for the management of eczema in children with moderate to severe disease. METHODS AND FINDINGS: This was a parallel-group, randomised, controlled, observer-blind trial. Children aged 1 to 15 y with moderate to severe eczema were recruited from secondary care and the community at five UK medical centres...
April 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28394864/safety-of-cochlear-implants-in-electrosurgery-a-systematic-review-of-the-literature
#10
James Behan, Shauna Higgins, Ashley Wysong
BACKGROUND: The implications of electrosurgical instrument use in patients with cochlear implants (CIs) are becoming increasingly relevant for dermatologic surgeons as the number of implanted CI devices continues to grow. The literature, however, fails to provide clear recommendations for appropriate treatment of these patients. OBJECTIVE: To systematically consolidate and critique the current literature regarding electrosurgical instrument use in patients with CI, to determine implications of various electrosurgical devices and settings on CI function and health of cochlear tissues, and to devise recommendations for appropriate use...
April 6, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28392648/efficacy-of-punch-reduction-prior-to-cryotherapy-in-patients-with-viral-warts-a-case-control-study-in-a-single-tertiary-center
#11
Ju Yeon Choi, Ji-Hye Park, Seung Hwan Oh, Jong Hee Lee, Joo-Heung Lee, Dong-Youn Lee, Jun-Mo Yang
BACKGROUND: Cutaneous warts are a common complaint to visit dermatologic clinic and its course is variable, ranging from spontaneous resolution to a chronic condition refractory to treatment. OBJECTIVE: To evaluate the efficacy and safety of punch biopsy for cutaneous warts. METHODS: Thirty-nine patients who received punch biopsy for warts were reviewed through charts and photos. Among them, 15 were matched with cryotherapy-only controls in terms of size and location of the wart...
April 2017: Annals of Dermatology
https://www.readbyqxmd.com/read/28391619/ciclosporin-compared-to-prednisolone-therapy-for-patients-with-pyoderma-gangrenosum-cost-effectiveness-analysis-of-the-stop-gap-trial
#12
J M Mason, K S Thomas, A D Ormerod, F E Craig, E Mitchell, J Norrie, H C Williams
BACKGROUND: Pyoderma gangrenosum (PG) is a painful, ulcerating skin disease with poor evidence for management. Prednisolone and ciclosporin are the most commonly used treatments, although not previously compared within a randomised controlled trial (RCT) OBJECTIVES: To compare the cost-effectiveness of ciclosporin and prednisolone-initiated treatment for patients with PG. METHODS: Quality-of-life (EuroQoL EQ-5D-3L) and resource data were collected as part of the STOP-GAP trial: a multicentre, parallel-group, observer-blind RCT...
April 9, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28391127/the-role-of-spatially-derived-access-to-care-characteristics-in-melanoma-prevention-and-control-in-los-angeles-county
#13
Loraine A Escobedo, Ashley Crew, Ariana Eginli, David Peng, Michael R Cousineau, Myles Cockburn
Among 10,068 incident cases of invasive melanoma, we examined the effects of patient characteristics and access-to-care on the risk of advanced melanoma. Access-to-care was defined in terms of census tract-level sociodemographics, health insurance, cost of dermatological services and appointment wait-times, clinic density and travel distance. Public health insurance and education level were the strongest predictors of advanced melanomas but were modified by race/ethnicity and poverty: Hispanic whites and high-poverty neighborhoods were worse off than non-Hispanic whites and low-poverty neighborhoods...
April 5, 2017: Health & Place
https://www.readbyqxmd.com/read/28365038/future-considerations-for-clinical-dermatology-in-the-setting-of-21st-century-american-policy-reform-the-medicare-access-and-children-s-health-insurance-program-reauthorization-act-and-the-merit-based-incentive-payment-system
#14
John S Barbieri, Jeffrey J Miller, Harrison P Nguyen, Howard P Forman, Jean L Bolognia, Marta J VanBeek
As the implementation of the Medicare Access and Children's Health Insurance Program Reauthorization Act begins, many dermatologists who provide Medicare Part B services will be subject to the reporting requirements of the Merit-based Incentive Payment System (MIPS). Clinicians subject to MIPS will receive a composite score based on performance across 4 categories: quality, advancing care information, improvement activities, and cost. Depending on their overall MIPS score, clinicians will be eligible for a positive or negative payment adjustment...
March 30, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28328635/a-systematic-review-of-the-use-of-telemedicine-in-plastic-and-reconstructive-surgery-and-dermatology
#15
Krishna S Vyas, H Rhodes Hambrick, Afaaf Shakir, Shane D Morrison, Duy C Tran, Keon Pearson, Henry C Vasconez, Samir Mardini, Amanda A Gosman, Marek Dobke, Mark S Granick
BACKGROUND: Telemedicine, the use of information technology and telecommunication to provide healthcare at a distance, is a burgeoning field with applications throughout medicine. Given the visual nature of plastic surgery and dermatology, telemedicine has a myriad of potential applications within the field. METHODS: A comprehensive literature review of articles published on telemedicine since January 2010 was performed. Articles were selected for their relevance to plastic and reconstructive surgery and dermatology, and then reviewed for their discussion of the applications, benefits, and limitations of telemedicine in practice...
March 21, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28296992/association-of-dermatology-consultations-with-patient-care-outcomes-in-hospitalized-patients-with-inflammatory-skin-diseases
#16
Nima Milani-Nejad, Myron Zhang, Benjamin H Kaffenberger
Importance: The value of inpatient dermatology consultations has traditionally been demonstrated with frequency in changes of diagnosis and management; however, the impact of dermatology consultations on metrics such as hospital length of stay and readmission rates remains unknown. Objective: To determine the association of dermatology consultations with patient care in hospitalized patients using objective values. Design, Setting, and Participants: We retrospectively queried the deidentified database of patients hospitalized between January 1, 2012, and December 31, 2014, at a single university medical center...
March 15, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28295530/the-fanny-pack-no-ifs-ands-or-buts
#17
Kaiane Habeshian, Anna Yasmine Kirkorian, Kalyani Marathe
Although the white coat is central to the practice of adult medicine, pediatricians often shed it to avoid creating negative associations and provoking fear in children. In our pediatric dermatology practice, the fanny pack (FP) has replaced many of the functional elements of the white coat. The FP is a kid-friendly way to readily carry key medical supplies from one patient encounter to the next. It is more hygienic, light weight, and affordable than traditional doctor's bags and white coats. In this article we outline the benefits of the FP, which include storage, ergonomics, efficiency, cleanliness, kid-friendliness, and cost-effectiveness...
March 10, 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/28281329/addiction-an-underestimated-problem-in-psoriasis-health-care
#18
A Zink, M Herrmann, T Fischer, F Lauffer, N Garzorz-Stark, A Böhner, C D Spinner, T Biedermann, K Eyerich
BACKGROUND: Psoriasis is a disease of enormous socio-economic impact. Despite approval of numerous highly efficient and costly therapies, a minor proportion of severely affected patients actually receives sufficient treatment. OBJECTIVE: To investigate whether addictions are associated with psoriasis and to develop evidence-based recommendations for dermatologists in their daily clinical practice in order to improve medical assessment of psoriasis and patients' quality of life...
March 9, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28270072/topical-ingenol-mebutate-a-new-treatment-modality-for-multiple-actinic-keratoses-and-field-cancerization
#19
Kresimir Kostovic, Sandra Jerkovic Gulin, Zrinka Bukvic Mokos, Romana Ceovic
BACKGROUND: Ingenol mebutate gel is a recent stirring weapon recommended for the treatment of multiple actinic keratoses (AKs) and field cancerization. This review brings a summary of recent data on the treatment of AKs with ingenol mebutate (IM) providing critical commentary with regard to drug&#039;s characteristics, drug&#039;s safety profile, treatment regimen, treatment outcome, patient compliance, AK recurrence, cost-effectiveness and cost-utility, as well as guidelines for the management of the treatment of AK...
February 13, 2017: Anti-cancer Agents in Medicinal Chemistry
https://www.readbyqxmd.com/read/28264791/more-than-5000-patients-with-metastatic-melanoma-in-europe-per-year-do-not-have-access-to-recommended-first-line-innovative-treatments
#20
L Kandolf Sekulovic, K Peris, A Hauschild, A Stratigos, J-J Grob, P Nathan, R Dummer, A-M Forsea, C Hoeller, H Gogas, L Demidov, C Lebbe, C Blank, J Olah, L Bastholt, D Herceg, B Neyns, R Vieira, J Hansson, P Rutkowski, I Krajsova, M Bylaite-Bucinskiene, I Zalaudek, J Maric-Brozic, N Babovic, M Banjin, K Putnik, G Weinlich, V Todorovic, K Kirov, J Ocvirk, A Zhukavets, M Kukushkina, L De La Cruz Merino, A Ymeri, M Risteski, C Garbe
BACKGROUND: Despite the efficacy of innovative treatments for metastatic melanoma, their high costs has led to disparities in cancer care among different European countries. We analysed the availability of these innovative therapies in Europe and estimated the number of patients without access to first-line recommended treatment per current guidelines of professional entities such as the European Society for Medical Oncology (ESMO), the European Organisation for Research and Treatment of Cancer (EORTC), the European Association of Dermato-Oncology (EADO), and European Dermatology Forum (EDF)...
March 2, 2017: European Journal of Cancer
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