Platelet-Rich Plasma (PRP): Current Applications in Dermatology
Abstract Platelet-rich plasma (PRP) is an autologous serum containing high concentrations of platelets and growth factors. PRP continues to evolve as an important treatment modality with many applications in dermatology, particularly in the areas of hair restoration, skin rejuvenation, acne scars, dermal augmentation, and striae distensae. Furthermore, combining PRP with laser therapies, microneedling, dermal fillers, and autologous fat grafting produces synergistic effects, leading to improved aesthetic results. Future studies should standardize PRP treatment protocols for specific indications. PRP holds consider...
Source: Skin Therapy Letter - September 1, 2019 Category: Dermatology Authors: Emer J Tags: Skin Therapy Lett Source Type: research

Skin, Hair and Nail Supplements: An Evidence-Based Approach
This article outlines an evidence-based approach to assess dermatology supplements. As a starting point, all supplements should be evaluated for PPIES: purity, potency, interactions, efficacy, and safety. PMID: 31584785 [PubMed - as supplied by publisher] (Source: Skin Therapy Letter)
Source: Skin Therapy Letter - September 1, 2019 Category: Dermatology Authors: Katta R, Huang S Tags: Skin Therapy Lett Source Type: research

A Closer Look at the Data Regarding Suicidal Ideation and Behavior in Psoriasis Patients: The Case of Brodalumab
Abstract The interleukin (IL)-17 inhibitors have proven to be highly effective in the treatment of psoriasis. The most recently approved agent, brodalumab, had few cases of suicidal behavior, including completed suicide, in the phase 3 clinical program leading both the US FDA and Health Canada to add a boxed warning to its label. This raises the importance of identifying the psychiatric comorbidities associated with psoriasis. It is also necessary to critically examine the data from the brodalumab clinical trial program to determine whether there is enough information to establish causality and whether other facto...
Source: Skin Therapy Letter - July 1, 2019 Category: Dermatology Authors: Rodriguez-Bolanos F, Gooderham M, Papp K Tags: Skin Therapy Lett Source Type: research

Shingrix for Herpes Zoster: A Review
Abstract Herpes zoster (HZ), also known as shingles, results from reactivation of the latent varicella-zoster virus (VZV), which commonly causes chickenpox in childhood. Greater than 90% of adults are infected with this virus, putting them at risk for reactivation. HZ presents as a painful, vesicular rash distributed in a unilateral and dermatomal pattern along dorsal root or cranial nerve ganglia. The rash often presents with prodromal symptoms and progresses to include clear vesicular clusters, evolving through stages of pustulation, ulceration, and crusting. HZ therapy currently involves the use of antiviral ag...
Source: Skin Therapy Letter - July 1, 2019 Category: Dermatology Authors: Shah RA, Limmer AL, Nwannunu CE, Patel RR, Mui UN, Tyring SK Tags: Skin Therapy Lett Source Type: research

Update on the Management of Vitiligo
Abstract Vitiligo is an acquired, autoimmune disease characterized by depigmented macules and patches on the skin, which occur secondary to melanocyte destruction. Available therapeutic options are broadly divided into medical, surgical and phototherapy, though treatment of vitiligo can be challenging. Early diagnosis and management can maximize treatment efficacy. The purpose of this discussion is to review updates in the management of vitiligo, including existing and emerging therapies. PMID: 31095346 [PubMed - in process] (Source: Skin Therapy Letter)
Source: Skin Therapy Letter - May 1, 2019 Category: Dermatology Authors: Nahhas AF, Braunberger TL, Hamzavi IH Tags: Skin Therapy Lett Source Type: research

Glycopyrronium Tosylate (Qbrexza) for Hyperhidrosis
Abstract Hyperhidrosis is a condition characterized by excessive sweat production beyond which is physiologically necessary for thermal regulation. Affecting over 4.8% of the United States population, studies have shown that severe primary hyperhidrosis interferes with daily activities and can be considered intolerable, negatively impacting a patient’s quality of life. Glycopyrronium tosylate is a topical anticholinergic agent that reduces sweat production by blocking the activation of acetylcholine receptors in peripheral sweat glands. In clinical trials, topical glycopyrronium tosylate, a pre-moistened clo...
Source: Skin Therapy Letter - March 1, 2019 Category: Dermatology Authors: Nwannunu CE, Limmer AL, Coleman K, Shah R, Patel RR, Mui UN, Tyring SK Tags: Skin Therapy Lett Source Type: research

Crisaborole 2% Ointment (Eucrisa) for Atopic Dermatitis
Abstract Atopic dermatitis is a common cutaneous disease with significant morbidity affecting children and adults. The mainstay of atopic dermatitis therapy has typically included emollients, topical corticosteroids, and topical calcineurin inhibitors. Among the newer advances recently introduced is crisaborole (Eucrisa™), a phosphodiesterase type-4 inhibitor (PDE-4) for the treatment of mild moderate atopic dermatitis. Evidence from phase 3 trials demonstrates crisaborole as an efficacious topical agent with a favorable safety profile and limited systemic exposure. While the efficacy of crisaborole compared...
Source: Skin Therapy Letter - March 1, 2019 Category: Dermatology Authors: Woo TE, Kuzel P Tags: Skin Therapy Lett Source Type: research

Update on Immunotherapeutics in the Management of Metastatic Melanoma
r E Abstract Today, a number of treatment options are now available for metastatic melanoma. Within the last decade, the development of novel immunotherapies for cancer has significantly altered the course of the disease in patients with melanoma. With more patients receiving these potentially life-saving treatments, not only have we learned more about the interplay between the immune system and melanoma, but more importantly, which treatment options are most appropriate given the clinical picture. PMID: 30817881 [PubMed - in process] (Source: Skin Therapy Letter)
Source: Skin Therapy Letter - January 1, 2019 Category: Dermatology Authors: Bulir D, Liang S, O’Malley M, McWhirter E Tags: Skin Therapy Lett Source Type: research

Chronic Urticaria: Following Practice Guidelines.
Abstract Histamine is a key inflammatory player in the pathogenesis of urticaria, a mast-cell-driven disease characterized clinically by the development of wheals, angioedema, or both. Changes to the management of chronic spontaneous urticaria have recently been adopted due to increasing literature surrounding the efficacy and safety of up-dosing modern second-generation H1-antihistamines and the use of omalizamub, a biologic agent, as a third-line treatment. Given the prevalence of chronic urticaria and its impact on quality of life, this editorial aims to provide a summary of the proposed updated guidelines for ...
Source: Skin Therapy Letter - May 1, 2018 Category: Dermatology Authors: Westby EP, Lynde C, Sussman G Tags: Skin Therapy Lett Source Type: research

A Review of Fabry Disease.
Abstract The class of medications known as Janus kinase inhibitors block cytokine-mediated signaling via the Janus kinase-signal transducer and activator of transcription (JAK-STAT) pathway, which plays an important role in immunoregulation and normal cell growth. This class includes the drugs tofacitinib, approved for the treatment of rheumatoid arthritis, and ruxolitinib, approved for the treatment of myelofibrosis and polycythemia rubra vera. The most common adverse events (AEs) reported in patients taking tofacitinib are infections, whereas the most common AEs in patients taking ruxolitinib are anemia and thro...
Source: Skin Therapy Letter - May 1, 2018 Category: Dermatology Authors: Cinats A, Heck E Tags: Skin Therapy Lett Source Type: research

Vitamin B Derivative (Nicotinamide)Appears to Reduce Skin Cancer Risk.
Abstract Nicotinamide, an amide form of vitamin B3, has shown the potential to treat a variety of dermatological conditions, including acne, rosacea, and atopic dermatitis. Recent studies have demonstrated the role of nicotinamide, in both topical and oral forms, as a chemopreventive agent against skin cancer. Its anti-carcinogenic role may be due to its ability to enhance DNA repair and prevent ultraviolet (UV)-induced immunosuppression, which is known to contribute to the progression of pre-malignant lesions. Furthermore, nicotinamide is a precursor of essential coenzymes for many important reactions in the body...
Source: Skin Therapy Letter - September 1, 2017 Category: Dermatology Authors: Nazarali S, Kuzel P Tags: Skin Therapy Lett Source Type: research

Epidermal Growth Factor Receptor Inhibitors: Cutaneous Side Effects and Their Management.
Abstract Epidermal growth factor receptor (EGFR) inhibitors are part of an emerging class of anticancer medicines known as "targeted therapy," which target pathways more specific to neoplastic proliferation than traditional chemotherapeutic agents. Adverse effects of such treatments are thought to be less severe, but can still be significant. Because EGFR is preferentially expressed in epithelial tissues, including the skin and hair follicle, cutaneous side effects of these agents are quite common. Not only can these toxicities severely affect patients' quality of life, but in some specific instances, th...
Source: Skin Therapy Letter - September 1, 2017 Category: Dermatology Authors: Monjazeb S, Wilson J Tags: Skin Therapy Lett Source Type: research

Hepatitis B and C Viruses and Biologics.
Abstract Hepatitis B virus (HBV) and hepatitis C virus (HCV) are common, worldwide viral illnesses that potentially impact the clinician's ability to manage patients with immunosuppressive medications such as biological therapy. In light of recent literature reviews, patients with HBV and HCV should be referred to a hepatologist or infectious disease expert prior to initiation of biological therapy. PMID: 28732153 [PubMed - in process] (Source: Skin Therapy Letter)
Source: Skin Therapy Letter - July 1, 2017 Category: Dermatology Authors: Grewal P, Sanghera R Tags: Skin Therapy Lett Source Type: research

The Role of Skin Care in Optimizing Treatment of Acne and Rosacea.
Abstract A triad approach to the treatment of acne and rosacea has been recommended. This integrated management approach includes patient education, selection of therapeutic agents, and initiation of an appropriate skin care regime. Proper skin care in patients undergoing treatment of both acne and rosacea includes use of products formulated for sensitive skin that cleanse, moisturize and photoprotect the skin. Both acne and rosacea are associated with epidermal barrier dysfunction, which can be mitigated by suitable skin care practices. Appropriate skin care recommendations for patients with acne and rosacea will...
Source: Skin Therapy Letter - May 1, 2017 Category: Dermatology Authors: Zip C Tags: Skin Therapy Lett Source Type: research

Psoriasis, Depression, and Suicidality.
Abstract Psoriasis is a chronic condition that affects the well-being and quality of life of patients. The disease is associated with an increased risk of depression and suicidality, which may not be fully understood by the general population. It is crucial to understand the effect this disease has on mental health and determine risk factors that may help identify patients who are susceptible to depression and suicidality. Risk factors discussed in this article include age, gender, and severity of disease in psoriasis patients. Of these, age and severity of disease are significant with a clear association of incre...
Source: Skin Therapy Letter - May 1, 2017 Category: Dermatology Authors: Nicholas MN, Gooderham M Tags: Skin Therapy Lett Source Type: research

The Role of Skin Care in Optimizing Treatment of Acne and Rosacea.
Abstract A triad approach to the treatment of acne and rosacea has been recommended. This integrated management approach includes patient education, selection of therapeutic agents, and initiation of an appropriate skin care regime. Proper skin care in patients undergoing treatment of both acne and rosacea includes use of products formulated for sensitive skin that cleanse, moisturize and photoprotect the skin. Both acne and rosacea are associated with epidermal barrier dysfunction, which can be mitigated by suitable skin care practices. Appropriate skin care recommendations for patients with acne and rosacea will...
Source: Skin Therapy Letter - May 1, 2017 Category: Dermatology Authors: Zup C Tags: Skin Therapy Lett Source Type: research

Tofacitinib in the Treatment of Rheumatoid Arthritis and Chronic Plaque Psoriasis.
Abstract Tofacitinib is an oral immunosuppressant approved for the treatment of rheumatoid arthritis (RA) and is currently undergoing investigation (Phase III trials) for treating chronic plaque psoriasis. Tofacitinib inhibits Janus kinases (JAKs), which are essential for the signaling of multiple inflammatory pathways and have been implicated in the pathogenesis of RA and psoriasis. The efficacy and safety of tofacitinib in the treatment of RA and psoriasis have been demonstrated in Phase III trials. Across all studies, the efficacy of tofacitinib in alleviating symptoms of RA and psoriasis were superior to place...
Source: Skin Therapy Letter - March 1, 2017 Category: Dermatology Authors: Gupta AK, Cernea M, Lynde CW Tags: Skin Therapy Lett Source Type: research

A Review of Guselkumab, an IL-23 Inhibitor, for Moderate-to-Severe Plaque Psoriasis.
This article reviews the current status of guselkumab as a therapy for moderate-to-severe plaque psoriasis. PMID: 28329405 [PubMed - in process] (Source: Skin Therapy Letter)
Source: Skin Therapy Letter - March 1, 2017 Category: Dermatology Authors: Nawas Z, Hatch M, Ramos E, Liu M, Tong Y, Peranteau A, Tyring S Tags: Skin Therapy Lett Source Type: research

A Review of Brodalumab, an IL-17 Receptor Antagonist, for Moderate-to-Severe Plaque Psoriasis.
Abstract Psoriasis is a chronic immune-mediated inflammatory disease with epidermal hyperplasia that affects 2-3% of the population. Interleukin (IL)-17 signaling has a central role in its pathogenesis. Brodalumab is a monoclonal antibody that neutralizes IL-17 receptor type A. Brodalumab is highly effective in the reversal of psoriatic phenotype and gene expression patterns. PMID: 28122092 [PubMed - in process] (Source: Skin Therapy Letter)
Source: Skin Therapy Letter - January 1, 2017 Category: Dermatology Authors: Tong Y, Peranteau AJ, Nawas Z, Tyring SK Tags: Skin Therapy Lett Source Type: research

A Dermatologist's Guide to Infection Screening Prior to Initiating Immunosuppressive Therapy.
Abstract Dermatologists have within their armamentarium numerous immunosuppressant agents, both traditional and new, that are useful in the treatment of chronic cutaneous disorders such as autoimmune bullous diseases and psoriasis. It is imperative that users of these agents are aware of potential sequelae from therapy, particularly infections. In this review, we summarize the most common immunosuppressant medications currently used in dermatology, and provide recommendations for infection screening prior to initiating treatment. PMID: 28122093 [PubMed - in process] (Source: Skin Therapy Letter)
Source: Skin Therapy Letter - January 1, 2017 Category: Dermatology Authors: Ponzo MG, Hong CH Tags: Skin Therapy Lett Source Type: research

A Review of Ixekizumab, an Anti-Interleukin-17A Monoclonal Antibody, for Moderate-to-Severe Plaque Psoriasis.
Abstract 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. In this article, we review phase 1-...
Source: Skin Therapy Letter - November 1, 2016 Category: Dermatology Authors: Peranteau AJ, Turkeltaub AE, Tong Y, Nawas Z, Tyring SK Tags: Skin Therapy Lett Source Type: research

Update on Efinaconazole 10% Topical Solution for the Treatment of Onychomycosis.
Abstract 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. Efinaconazole produced higher efficacy rates with patients presenting onychomycosis in a s...
Source: Skin Therapy Letter - November 1, 2016 Category: Dermatology Authors: Gupta AK, Studholme C Tags: Skin Therapy Lett Source Type: research

Sodium Deoxycholate for Submental Contouring.
Abstract 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 ...
Source: Skin Therapy Letter - September 1, 2016 Category: Dermatology Authors: Humphrey S, Beleznay K, Beleznay JD Tags: Skin Therapy Lett Source Type: research

Rituximab: Uses in Dermatology.
Abstract 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, g...
Source: Skin Therapy Letter - September 1, 2016 Category: Dermatology Authors: Gleghorn K, Wilson J, Wilkerson M Tags: Skin Therapy Lett Source Type: research

Adalimumab (Humira) for the Treatment of Hidradenitis Suppurativa.
Abstract 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 (26.0% and 27.6%, respectively). Altho...
Source: Skin Therapy Letter - July 1, 2016 Category: Dermatology Authors: Gupta AK, Studholme C Tags: Skin Therapy Lett Source Type: research

Frontal Fibrosing Alopecia.
Abstract 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. Genetic and environmen...
Source: Skin Therapy Letter - July 1, 2016 Category: Dermatology Authors: Holmes S Tags: Skin Therapy Lett Source Type: research

Actikerall™ (5-Fluorouracil 0.5% and Salicylic Acid 10%) Topical Solution for Patient-directed Treatment of Actinic Keratoses.
Actikerall™ (5-Fluorouracil 0.5% and Salicylic Acid 10%) Topical Solution for Patient-directed Treatment of Actinic Keratoses. Skin Therapy Lett. 2016 May;21(3):1-3 Authors: Nguyen HP, Rivers JK Abstract 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 rand...
Source: Skin Therapy Letter - May 1, 2016 Category: Dermatology Authors: Nguyen HP, Rivers JK Tags: Skin Therapy Lett Source Type: research

DSM-5 Update in Psychodermatology.
Abstract 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...
Source: Skin Therapy Letter - May 1, 2016 Category: Dermatology Authors: Nowak DA, Wong SM Tags: Skin Therapy Lett Source Type: research

Dupilumab, A Monoclonal Antibody for Atopic Dermatitis: A Review of Current Literature.
Abstract 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. Importantly, dupilumab treatment has been correlated with c...
Source: Skin Therapy Letter - March 1, 2016 Category: Dermatology Authors: Blakely K, Gooderham M, Papp K Tags: Skin Therapy Lett Source Type: research

Nivolumab for Metastatic Melanoma.
Abstract 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. Nivolumab has demonstrated effica...
Source: Skin Therapy Letter - March 1, 2016 Category: Dermatology Authors: Gupta AK, Daigle D Tags: Skin Therapy Lett Source Type: research

Melasma and Post Inflammatory Hyperpigmentation: Management Update and Expert Opinion.
Abstract 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. Treatment is challenging and focused on a variety of mechanisms to stop, hinder, ...
Source: Skin Therapy Letter - January 1, 2016 Category: Dermatology Authors: Sofen B, Prado G, Emer J Tags: Skin Therapy Lett Source Type: research

Off-Label Uses of Topical Calcineurin Inhibitors.
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. PMID: 27224898 [PubMed - in process] (Source: Skin Therapy Letter)
Source: Skin Therapy Letter - January 1, 2016 Category: Dermatology Authors: Wong E, Kurian A Tags: Skin Therapy Lett Source Type: research

Sugar Sag: Glycation and the Role of Diet in Aging Skin.
Abstract 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 endo...
Source: Skin Therapy Letter - November 1, 2015 Category: Dermatology Authors: Nguyen HP, Katta R Tags: Skin Therapy Lett Source Type: research

Tavaborole 5% Solution: A Novel Topical Treatment for Toenail Onychomycosis.
Abstract 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 i...
Source: Skin Therapy Letter - November 1, 2015 Category: Dermatology Authors: Gupta G, Foley KA, Gupta AK Tags: Skin Therapy Lett Source Type: research

Apremilast in the Treatment of Psoriasis and Psoriatic Arthritis.
Abstract 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. Across all studies, treatment was ge...
Source: Skin Therapy Letter - September 1, 2015 Category: Dermatology Authors: Gooderham M, Papp K Tags: Skin Therapy Lett Source Type: research

New Antibiotics in the Management of Acute Bacterial Skin and Skin Structure Infections.
Abstract 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 semisyn...
Source: Skin Therapy Letter - September 1, 2015 Category: Dermatology Authors: Gleghorn K, Grimshaw E, Kelly EK Tags: Skin Therapy Lett Source Type: research

Hidradenitis Suppurativa: A Review with a Focus on Treatment Data.
Abstract 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 an...
Source: Skin Therapy Letter - August 1, 2015 Category: Dermatology Authors: Barlev D, Eisen DB, Alikhan A Tags: Skin Therapy Lett Source Type: research

Ivermectin 1% Cream for Rosacea.
Abstract 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. Furthermore, PPR sym...
Source: Skin Therapy Letter - August 1, 2015 Category: Dermatology Authors: Gupta G, Daigle D, Gupta AK, Gold LS Tags: Skin Therapy Lett Source Type: research

Regulating Off-label Promotion of Medications: Has the Pendulum Swung Too Far?
Abstract 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. PMID: 26382556 [PubMed - in process] (Source: Skin Therapy Letter)
Source: Skin Therapy Letter - June 1, 2015 Category: Dermatology Authors: Hoffman MB, Yentzer BA, Feldman SR Tags: Skin Therapy Lett Source Type: research

Current Management of Scalp Psoriasis.
Abstract 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. In patients with moderate-to-severe psori...
Source: Skin Therapy Letter - June 1, 2015 Category: Dermatology Authors: Guenther L Tags: Skin Therapy Lett Source Type: research

Interleukin-23 in the pathogenesis and treatment of psoriasis.
Abstract In the past three decades, major advances have been made in understanding the pathogenesis of psoriasis. The currently accepted theory is that T-cell mediated immune dysregulation triggers keratinocyte hyperproliferation in psoriasis. Recent research indicates that the Th17/interleukin (IL)-23 pathway plays a prominent role in the amplification phase of psoriasis. The discovery of the Th17/ IL-23 pathway provides targets for new drug development. This review focuses on the role of IL-23 in psoriasis pathogenesis and the current therapies targeting IL-23 that are in clinical trials. PMID: 25807335 [Pu...
Source: Skin Therapy Letter - March 28, 2015 Category: Dermatology Authors: Kollipara R, Downing C, Gordon R, Tyring S Tags: Skin Therapy Lett Source Type: research

Male aesthetics.
Abstract Men are a fast growing segment of the aesthetic industry. A review was performed for publications on gender differences in facial anatomy, behavior, and the use of minimally invasive aesthetic procedures in men. There are substantial facial anatomical differences between genders with men having a larger but unique cranial shape, increased skeletal muscle mass, unique subcutaneous fat distribution, and more severe facial rhytides. Men also exhibit poor behavior that can accelerate aging including poor utilization of preventive health care services, higher rates of smoking, and increased ultraviolet light e...
Source: Skin Therapy Letter - March 28, 2015 Category: Dermatology Authors: Keaney T Tags: Skin Therapy Lett Source Type: research

Interleukin-17 (IL-17) Inhibitors in the Treatment of Plaque Psoriasis: A Review.
Abstract Acting on keratinocytes to produce antimicrobial peptides and chemokines, which in turn attract neutrophils and other inflammatory cells, interleukin-17 (IL-17) is believed to be a potent driver of plaque psoriasis. Its proinflammatory characteristics make IL-17 an attractive therapeutic target for addressing immune dysregulation. This review examines the role of IL-17 in the pathogenesis of plaque psoriasis and the potential implications of its inhibition. The efficacy and safety results from Phase 2 and 3 trials with monoclonal antibodies targeting IL-17RA (brodalumab), and IL-17A (ixekizumab and secuki...
Source: Skin Therapy Letter - February 1, 2015 Category: Dermatology Authors: Gooderham M, Posso-De Los Rios CJ, Rubio-Gomez GA, Papp K Tags: Skin Therapy Lett Source Type: research

Sinecatechins 10% ointment: a green tea extract for the treatment of external genital warts.
Abstract External genital warts (EGWs) resulting from the human papilloma virus (HPV) are a common sexually transmitted infection and cause significant impairments in patient quality of life and sexual well-being. Therapeutic options for EGWs can be providerassisted, but many patients opt for treatment that can be applied at home. Sinecatechins 10% ointment is a new botanically based patient-administered therapy for EGWs. It is comprised of>85% catechins, green tea polyphenols that have been shown to possess antioxidant, antiproliferative, antiviral, and antitumor properties. Phase III trials of sinecatechins 1...
Source: Skin Therapy Letter - February 1, 2015 Category: Dermatology Authors: Gupta AK, Daigle D Tags: Skin Therapy Lett Source Type: research

Chronic idiopathic urticaria: treatment with omalizumab.
Abstract Chronic idiopathic urticaria (CIU) is a common autoimmune skin condition characterized by spontaneously recurring hives for 6 weeks or longer. The new terminology used for CIU in most countries including Canada is chronic spontaneous urticaria (CSU). CSU is associated with significant psychosocial morbidity with a markedly negative impact on overall quality of life. Conventional approaches with antihistamines, even at high doses, is effective in about 50% of patients suffering from CSU. A new treatment option, omalizumab, a humanized monoclonal antibody against the Fc domain of IgE, has undergone the scru...
Source: Skin Therapy Letter - December 1, 2014 Category: Dermatology Authors: Naaman S, Sussman G Tags: Skin Therapy Lett Source Type: research

5% minoxidil: treatment for female pattern hair loss.
Abstract Minoxidil is a Health Canada and US FDA-approved medication for hair loss in men and women. While 5% minoxidil foam has been approved for men since 2006, Health Canada and the FDA only approved 5% minoxidil foam for female pattern hair loss (FPHL) in 2014. Recent Phase III clinical trials demonstrated the efficacy of once daily 5% minoxidil foam for treatment of FPHL, where a significant change from baseline in the target area hair count was observed compared to placebo. Similar changes in hair count for 5% foam and twice daily 2% minoxidil solution established noninferiority of the 5% foam formulation. F...
Source: Skin Therapy Letter - December 1, 2014 Category: Dermatology Authors: Gupta AK, Foley KA Tags: Skin Therapy Lett Source Type: research

Updates on the Management of Autoimmune Blistering Diseases.
Abstract Autoimmune blistering diseases are rare, but potentially debilitating cutaneous disorders characterized by varying degrees of mucosal and cutaneous bullae formation. Topical therapy is appropriate for mild and even some moderate disease activity, but systemic treatment can be considered for more extensive involvement. Corticosteroids remain the first-line systemic therapy for patients with moderate to severe bullous pemphigoid and pemphigus vulgaris. While the use of systemic steroids has dramatically reduced mortality from these two autoimmune blistering disorders, treatment is also associated with multi...
Source: Skin Therapy Letter - October 1, 2014 Category: Dermatology Authors: Hooten JN, Hall RP, Cardones AR Tags: Skin Therapy Lett Source Type: research

Pregnancy-Specific Skin Disorders.
This article will discuss the skin disorders specific to pregnancy, with a focus on clinical presentation, potential for fetal complications, pathogenesis, diagnosis, and treatment. PMID: 25405676 [PubMed - as supplied by publisher] (Source: Skin Therapy Letter)
Source: Skin Therapy Letter - October 1, 2014 Category: Dermatology Authors: White S, Philips R, Neill MM, Kelly E Tags: Skin Therapy Lett Source Type: research

Sirolimus: a therapeutic advance for dermatologic disease.
Abstract Sirolimus, also known as rapamycin (SRL, Rapamune®), was approved in 1999 by the US Food and Drug Administration to prevent graft rejection in renal transplantation. As a member of the mammalian target of rapamycin (mTOR) inhibitor class, its potent immunosuppressant, anti-angiogenic and anti-proliferative properties are well recognized. When compared to other immunosuppressants, SRL has a lower risk of renal, neurologic and lymphoproliferative complications. It has become a promising treatment modality for angiofibromas, Kaposi's sarcoma and other inflammatory and malignant disorders of the skin. Wit...
Source: Skin Therapy Letter - August 1, 2014 Category: Dermatology Authors: Peters T, Traboulsi D, Tibbles LA, Mydlarski PR Tags: Skin Therapy Lett Source Type: research

Review of evidence for dietary influences on atopic dermatitis.
Abstract Atopic dermatitis (AD) is a chronic inflammatory skin disease affecting children and adolescents worldwide. The relationship of AD to diet has been a matter of curiosity for many years. Here we look at the evidence in the literature of the association between AD and diet, and the effectiveness of elimination diets and diet supplementation in the management of AD. Several studies have found an association between clinical food allergy and AD, and more recent investigations have also suggested that dietary elements may promote late AD exacerbations. Diet elimination trials in select patients who are clinica...
Source: Skin Therapy Letter - August 1, 2014 Category: Dermatology Authors: Mohajeri S, Newman SA Tags: Skin Therapy Lett Source Type: research