Second Primary Melanomas: Increased Risk and Decreased Time to Presentation in Patients exposed to Tanning Beds
Melanoma incidence has increased; the primary modifiable risk factor is ultraviolet radiation (UVR) from the sun or artificial (arUVR) from tanning beds. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 15, 2018 Category: Dermatology Authors: Yang Li, Mukti Kulkarni, Kathryn Trinkaus, Lynn A. Cornelius Source Type: research

Sun protection behaviour after diagnosis of high-risk primary melanoma and risk of a subsequent primary
Melanoma survivors are at high risk of further primary melanomas. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 15, 2018 Category: Dermatology Authors: Lena A. von Schuckmann, Louise F. Wilson, Maria Celia B. Hughes, Vanessa L. Beesley, Monika Janda, Jolieke C. van der Pols, B Mark Smithers, Kiarash Khosrotehrani, Adele C. Green Source Type: research

The Role of Sunscreen in the Prevention of Cutaneous Melanoma and Non-Melanoma Skin Cancer
(Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 15, 2018 Category: Dermatology Authors: Reid A. Waldman, Jane M. Grant-Kels Source Type: research

Fat reduction
The objective of this continuing medical education series, which is intended for the novice or experienced dermatologist, is to provide an update of the pathophysiology and anatomic considerations of adipose tissue, and detail the liposuction procedure, from patient selection/management to the latest developments in liposuction devices. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 14, 2018 Category: Dermatology Authors: Zeena Al Dujaili, Cheryl Karcher, Michelle Henry, Neil Sadick Tags: Continuing medical education Source Type: research

Fat reduction
Despite the favorable safety profile of liposuction, complications occur that need to be appropriately managed. In the second article in this continuing medical education series, the range of complications that may arise from liposuction are described, and the latest best practices to manage them are discussed. Specific technical strategies to prevent and minimize the risk of complications are also presented. Early recognition, accurate diagnosis, and proper clinical management can ensure an optimal outcome and patient satisfaction in individuals who are investing in fat reduction procedures. (Source: Journal of the Americ...
Source: Journal of the American Academy of Dermatology - July 14, 2018 Category: Dermatology Authors: Zeena Al Dujaili, Cheryl Karcher, Michelle Henry, Neil Sadick Tags: Continuing medical education Source Type: research

CME examination
(Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 14, 2018 Category: Dermatology Tags: Continuing medical education Source Type: research

Answers to CME examination
(Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 14, 2018 Category: Dermatology Tags: Continuing medical education Source Type: research

CME examination
(Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 14, 2018 Category: Dermatology Tags: Continuing medical education Source Type: research

Answers to CME examination
(Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 14, 2018 Category: Dermatology Tags: Continuing medical education Source Type: research

August iotaderma (#294)
(Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 14, 2018 Category: Dermatology Authors: Robert I. Rudolph Tags: JAAD Online Source Type: research

July iotaderma (#293)
(Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 14, 2018 Category: Dermatology Authors: Robert I. Rudolph Tags: JAAD Online Source Type: research

Comment on: “When does atopic dermatitis warrant systemic therapy? Recommendations from an expert panel of the International Eczema Council”
To the Editor: We read with interest the recent expert panel recommendations by Simpson et  al on when systemic therapies may be indicated in the management of atopic dermatitis (AD).1 The authors rightly highlight the importance of identifying and addressing potential biologic exacerbating factors such as infection or contact allergy, as well as the role of patient education in improvi ng adherence to topical therapy. However, we believe that the recommendations offered are narrow in scope. AD, like so many other chronic skin diseases, is a condition in which a holistic biopsychosocial approach must be used...
Source: Journal of the American Academy of Dermatology - July 14, 2018 Category: Dermatology Authors: Adam Daunton, Jonathan M.R. Goulding Tags: JAAD Online Source Type: research

Response to “Comment on: ‘When does atopic dermatitis warrant systemic therapy? Recommendations from an expert panel of the International Eczema Council’”
To the Editor: We thank Drs Daunton and Goulding1 for their interest in our article2 and for their comments. Naturally, we agree that “a holistic assessment is needed” in patients with atopic dermatitis, including consideration of “existent comorbidities,” as stated in our article. It was beyond the scope of our recommendation to discuss in detail the many comorbidities of AD, including the associated neuropsychiatric issu es that the International Eczema Council recently reviewed.3 (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 14, 2018 Category: Dermatology Authors: Eric L. Simpson, Nick J. Reynolds, Carsten Flohr, Amy S. Paller, Jonathan I. Silverberg, Michel J. Cork, Emma Guttman-Yassky, Alan D. Irvine Tags: JAAD Online Source Type: research

Bullous pemphigoid and diabetes mellitus: Are we missing the larger picture?
To the Editor: We read with interest the study by Benzaquen et  al1 reporting an increased risk for development of bullous pemphigoid (BP) in patients who are receiving a dipeptidyl peptidase-4 inhibitor (DPP4i). Their findings are supported by previous studies showing a significant signal of increased risk for development of BP during exposure to a DPP4i in t he European and French pharmacovigilance databases.1 (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 14, 2018 Category: Dermatology Authors: Shamir Geller, Noa Kremer, Tal Zeeli, Eli Sprecher Tags: JAAD Online Source Type: research

Reply to: “Bullous pemphigoid and diabetes mellitus: Are we missing the larger picture?”
To the Editor: We read with interest the letter titled “Bullous pemphigoid and diabetes mellitus—are we missing the larger picture?” by Geller et al1 and have several comments. The authors discuss the claimed association between diabetes mellitus (DM) and bullous pemphigoid (BP) and speculate about its underlying mechanisms. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 14, 2018 Category: Dermatology Authors: Michael Benzaquen, Luca Borradori, Simone Cazzaniga, Philippe Berbis, Laurence Feldmeyer Tags: JAAD Online Source Type: research

Reply to: “Re-evaluating pyoderma gangrenosum patients for Behçet disease before initiating any invasive procedures is essential”
To the Editor: We would like to thank Dr Aksoy1 for drawing attention to the unique challenges facing patients with Beh çet syndrome in the perioperative setting. Her comments serve as an important reminder for physicians who are translating research into the clinical setting: we must consider the representativeness of the study sample when we generalize results to other settings or populations. Our patients' diseas e was diagnosed by using the Su criteria, and the overall demographics of our cohort are consistent with the known epidemiology of the disease in the United States. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 14, 2018 Category: Dermatology Authors: Arash Mostaghimi, Cara Joyce Tags: JAAD Online Source Type: research

Re-evaluating pyoderma gangrenosum patients for Beh çet disease before initiating any invasive procedures is essential
To the Editor: I would kindly like to remind your readers that pyoderma gangrenosum –like lesions also occur in Behçet disease, as is stated in a comment on the study “Risk of developing pyoderma gangrenosum after procedures in patients with a known history of pyoderma gangrenosum—A retrospective analysis.”1 As the authors mentioned, the pathergy phenomenon is associated w ith pyoderma gangrenosum, but pathergy can also be seen in other conditions such as Behçet disease.2 Although very rare, pyoderma gangrenosum–like lesions are one of the clinical manifestations of Behçet...
Source: Journal of the American Academy of Dermatology - July 14, 2018 Category: Dermatology Authors: Luna Aksoy Tags: JAAD Online Source Type: research

Editorial Board
(Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 14, 2018 Category: Dermatology Source Type: research

Table of Contents
(Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 14, 2018 Category: Dermatology Source Type: research

Information for Readers
(Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 14, 2018 Category: Dermatology Source Type: research

JAAD Case Reports article List
(Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 14, 2018 Category: Dermatology Source Type: research

Journal Based CME Instructions and Information
(Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 14, 2018 Category: Dermatology Source Type: research

Dermatology Calendar
(Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 14, 2018 Category: Dermatology Source Type: research

CME Part II Psoriasis: Which Therapy for Which Patient Focus on special populations and chronic infections
Despite the availability of several new systemic agents for psoriasis treatment, it can be challenging to choose the right therapy in certain patient populations. There are few up-to-date reviews on systemic drugs for moderate to severe psoriasis in pregnant and pediatric patients and in patients with concomitant chronic infections such as hepatitis, HIV and latent tuberculosis. These groups are usually excluded from clinical trials and much of the available evidence is based on anecdotal case reports and case series. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 12, 2018 Category: Dermatology Authors: Shivani B. Kaushik, Mark G. Lebwohl Source Type: research

CME Part I Psoriasis: Which Therapy for Which Patient Psoriasis comorbidities and preferred systemic agents
Psoriasis is a systemic inflammatory disease associated with increased risk of comorbidities such as psoriatic arthritis, Crohn disease, malignancy, obesity and cardiovascular diseases. All these factors have a significant impact on the decision to use one therapy over another. The past decade has seen a paradigm shift in our understanding of the pathogenesis of psoriasis which has led to identification of new therapeutic targets. Several new drugs have gained FDA approval, expanding the psoriasis armamentarium but still a large number of patients continue to be untreated or undertreated. (Source: Journal of the American A...
Source: Journal of the American Academy of Dermatology - July 12, 2018 Category: Dermatology Authors: Shivani B. Kaushik, Mark G. Lebwohl Source Type: research

Mohs micrographic surgery (MMS) with MART-1 immunostaining for atypical intraepidermal melanocytic proliferation (AIMP)
Surgical outcomes for AIMP are unknown. Upstaging to unequivocal melanoma was identified in 18.8% of AIMP. No local recurrences occurred with a mean follow-up of 2.7 years. 23.8% of AIMP required greater than one stage of MMS. MMS may be an effective treatment option for AIMP. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 9, 2018 Category: Dermatology Authors: Jeremy R. Etzkorn, Olivia S. Jew, Thuzar M. Shin, Joseph F. Sobanko, Donald E. Neal, Christopher J. Miller Source Type: research

Pigmentation of basal cell carcinoma is inversely associated with tumor aggressiveness in Asian patients
(Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 9, 2018 Category: Dermatology Authors: Hye-Rim Moon, Tae Jun Park, Ki Woong Ro, Hwa Jung Ryu, Soo Hong Seo, Sang Wook Son, Il-Hwan Kim Source Type: research

“Comparing the eighth and the seventh editions of the ajcc staging system and the brigham and women’s hospital alternative staging system for cutaneous squamous cell carcinoma: implications for clinical practice”
The new 8th edition of the American Joint Committee on Cancer (AJCC) staging system incorporates changes regarding cutaneous squamous cell carcinoma (CSCC). (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 9, 2018 Category: Dermatology Authors: J. Ca ñueto, J. Burguillo, D. Moyano-Bueno, A. Viñolas-Cuadros, A. Conde-Ferreirós, Luis Antonio Corchete-Sánchez, J. Pérez-Losada, C. Román-Curto Source Type: research

Drug-Induced Phototoxicity: A Systematic Review
Numerous oral drugs are implicated in phototoxicity; however, the level of evidence for most has not been assessed. Vemurafenib, NSAIDs, and antibiotics (fluoroquinolones, tetracyclines) have strongest evidence for phototoxicity. Most associations are not supported by robust evidence. Improved documentation of phototoxicity testing is required before labelling oral drugs as phototoxic. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 9, 2018 Category: Dermatology Authors: Whan B. Kim, A.J. Shelley, K. Novice, J. Joo, H.W. Lim, S.J. Glassman Source Type: research

The ALT-70 Predictive Model Outperforms Thermal Imaging for the Diagnosis of Lower Extremity Cellulitis: A Prospective Evaluation
Point-of-care diagnostic tools may decrease misdiagnosis rates and unnecessary care associated with lower extremity cellulitis. In our prospective study, the ALT-70 predictive model for lower extremity cellulitis outperformed thermal imaging in diagnostic accuracy. The high negative predictive value of ALT-70 effectively allows clinicians to rule out lower extremity cellulitis. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 9, 2018 Category: Dermatology Authors: David G. Li, Anna K. Dewan, Fan Di Xia, Hasan Khosravi, Cara Joyce, Arash Mostaghimi Source Type: research

Antiandrogen therapy with spironolactone for the treatment of hidradenitis suppurativa
This study evaluated both physician and patient reported hidradenitis suppurativa severity outcomes for patients treated with spironolactone. Antiandrogen therapy with spironolactone may be a useful treatment option for reducing inflammatory lesions and pain for female patients with HS. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 9, 2018 Category: Dermatology Authors: Nicole M. Golbari, Martina L. Porter, Alexa B. Kimball Source Type: research

Methotrexate for alopecia areata: a systematic review and meta-analysis
There is lack of synthesised data regarding methotrexate in AA, Good response was observed in 63% of patients and complete response in 36% of patients, Initial regrowth is observed after 3 months of treatment and takes 6-12 months to achieve complete regrowth, The pooled recurrence rate of AA was 47.7% (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 9, 2018 Category: Dermatology Authors: Kevin Phan, Vignesh Ramachandran, Deshan Frank Sebaratnam Source Type: research

Topical Glycopyrronium Tosylate for the Treatment of Primary Axillary Hyperhidrosis: Results from the ATMOS-1 and ATMOS-2 Phase 3 Randomized Controlled Trials
Current treatment options for hyperhidrosis are limited. The topical anticholinergic, glycopyrronium tosylate, results in significant reductions in sweating severity/production and favorable tolerability in two phase 3, randomized, vehicle-controlled trials in primary axillary hyperhidrosis. These results suggest glycopyrronium tosylate may provide a non-invasive, once-daily, topical treatment option for primary axillary hyperhidrosis. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 9, 2018 Category: Dermatology Authors: Dee Anna Glaser, Adelaide A. Hebert, Alexander Nast, William P. Werschler, Lawrence Green, Richard Mamelok, Janice Drew, John Quiring, David M. Pariser Source Type: research

Ustekinumab treatment for neutrophilic dermatoses associated with Crohn ’s disease: a multicenter-retrospective study
(Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 9, 2018 Category: Dermatology Authors: Tullia de Risi-Pugliese, Philippe Seksik, Jean-David Bouaziz, Fran çois Chasset, Philippe Moguelet, Jean-Marc Gornet, Anne Bourrier, Aurélien Amiot, Laurent Beaugerie, Camille Francès, Sarah Guégan, Ustek-CDND study group Source Type: research

Intralesional Immunotherapy for the Treatment of Warts: A Network Meta-analysis
Although intralesional immunotherapy is commonly used for wart treatment, selection among existing immunotherapeutic modalities remains challenging. PPD and MMR are the most effective modalities for lesion clearance at primary and distant sites (along with autoinoculation), and also reduce recurrence. PPD and MMR may be considered as first-line treatments for warts. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 9, 2018 Category: Dermatology Authors: Samar Salman, Mohamed Shehata Ahmed, Ahmed Mohamed Ibrahim, Omar Mohamed Mattar, Hassan El-Shirbiny, Sameh Sarsik, Ahmed M. Afifi, Ruba Marwan Anis, Nadim Aiman Yakoub Agha, Abdelrahman Ibrahim Abushouk Source Type: research

Efficacy, Safety, and Comparison of Sonic Hedgehog Inhibitors in Basal Cell Carcinomas: A Systematic Review and Meta-Analysis
Sonic hedgehog inhibitors are systemic treatments for locally advanced and metastatic basal cell carcinomas. In locally advanced disease, overall response rate is similarly significant for sonidegib and vismodegib; complete response rate is significant for vismodegib only. Rates of major side effects do not differ between vismodegib and sonidegib. Patients should expect partial responses in locally advanced disease. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 9, 2018 Category: Dermatology Authors: Pingxing Xie, Philippe Lefran çois Source Type: research

Surgical Pearl: A Granny Sliding Knot for High Tension Closures
(Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 9, 2018 Category: Dermatology Authors: Jeffrey F. Scott, Mona Ascha, Whitney Pollard, Jeremy S. Bordeaux Source Type: research

Beyond JAAD - October 2018
(Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 9, 2018 Category: Dermatology Authors: Andrew Bronin, Robert Phelps, Robert Sidbury Source Type: research

Atypical Fibroxanthoma: Systematic Review and Meta-analysis of Treatment with Mohs Micrographic Surgery or Excision
The two treatment modalities most commonly used for AFX are wide local excision (WLE) and Mohs micrographic surgery (MMS). Mohs micrographic surgery (MMS) is associated with a lower local recurrence rate than WLE. MMS should be considered for treatment of AFX, especially in anatomically sensitive areas and in immunosuppressed patients. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 5, 2018 Category: Dermatology Authors: Stanislav N. Tolkachjov, Benjamin F. Kelley, Fares Alahdab, Patricia J. Erwin, Jerry D. Brewer Source Type: research

Comment on “Guidelines of care for the management of basal cell carcinoma”
(Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 5, 2018 Category: Dermatology Authors: Lieke C.J. van Delft, Maud H.E. Jansen, Klara Mosterd, Nicole W.J. Kelleners-Smeets Source Type: research

Reply to Comment on “Guidelines of Care for the Management of Basal Cell Carcinoma”
(Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 5, 2018 Category: Dermatology Authors: Christopher K. Bichakjian, Murad Alam Source Type: research

Skin Confident: A skin health and acne educational intervention to improve Acne Quality of Life measures in adolescents
(Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 5, 2018 Category: Dermatology Authors: Angela Burleigh, Masoud Yousefi, Shannon Humphrey Source Type: research

Review of environmental effects of oxybenzone and other sunscreen active ingredients
With increasing awareness regarding the risks of sunburn, photoaging and skin cancer, the use of sunscreens has increased. Organic and inorganic filters are used in sunscreen products worldwide. Concerns have been raised on commonly used organic UV filters including oxybenzone (benzophenone-3; BP-3), 4-methylbenzylidene camphor (4-MBC), octocrylene (OC), and octinoxate (ethylhexyl methoxycinnamate; EHMC) on their effects on the environment. Studies have identified UV filters such as oxybenzone, octocrylene, octinoxate and ethylhexyl salicylate (ES) in almost all water sources around the world and have commented that these ...
Source: Journal of the American Academy of Dermatology - July 5, 2018 Category: Dermatology Authors: Samantha L. Schneider, Henry W. Lim Source Type: research

Clinical Pearls: Fluorescent tattoos as anatomic markers to track trichologic responses
(Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 4, 2018 Category: Dermatology Authors: Kumar Sukhdeo Source Type: research

A survey-based study on nail examinations at an American Academy of Dermatology free skin cancer screening
(Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 4, 2018 Category: Dermatology Authors: Dayoung Ko, Shari R. Lipner Source Type: research

Drug Utilization Patterns and Adherence in Patients on Systemic Medications for the Treatment of Psoriasis: A Retrospective Comparative Cohort Study
There is limited data on adherence to systemic medications for psoriasis in real-world practice. Using a large US health insurance claims database, we found significantly increased odds of adherence to biologics compared to methotrexate. Dermatologists should consider adherence when choosing systemic treatments for psoriasis patients. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 4, 2018 Category: Dermatology Authors: Erica D. Dommasch, Moa P. Lee, Cara J. Joyce, Elizabeth M. Garry, Joshua J. Gagne Source Type: research

Chronic Non-Melanoma Skin Cancers and Health Related Impairment: A Case-Control Study
(Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 3, 2018 Category: Dermatology Authors: Adam Sutton, Ashley Crew, Shauna Higgins, Andrew Kwong, Ashley Wysong Source Type: research

A Comparison of Skin Cancer Screening and Treatment Costs at a Massachusetts Cancer Center, 2008 versus 2013
Temporal analyses of skin cancer costs are needed to examine how expenditure differences between diagnoses are changing. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 3, 2018 Category: Dermatology Authors: Frederick C. Morgan, Juanita Duran, Belen Fraile, Pritesh S. Karia, Jennifer Y. Lin, Patrick A. Ott, Emily Stamell Ruiz, David M. Wang, Yichen Zhang, Chrysalyne D. Schmults Source Type: research

Apremilast for moderate hidradenitis suppurativa: results of a randomized controlled trial
Effective anti-inflammatory treatments for hidradenitis suppurativa (HS) are limited. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 3, 2018 Category: Dermatology Authors: Allard R.J.V. Vossen, M.B.A. van Doorn, Hessel H. van der Zee, Errol P. Prens Source Type: research

A Phase 2, Randomized Dose-Finding Study of Tapinarof (GSK2894512 Cream) for the Treatment of Atopic Dermatitis
Safe and efficacious topical treatments are needed for atopic dermatitis (AD). (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - July 3, 2018 Category: Dermatology Authors: Johnny Peppers, Amy S. Paller, Tomoko Maeda-Chubachi, Sterling Wu, Kevin Robbins, Kelly Gallagher, John E. Kraus Source Type: research