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

Rosacea: an update on medical therapies.
Abstract Rosacea is a common, chronic cutaneous condition that affects the face. Two topicals and one oral medication are currently approved for the treatment of rosacea, including azelaic acid, metronidazole, and sub-antimicrobial dose of doxycycline. Identification of subtypes can help guide treatment strategies. It is essential for psychosocial implications of rosacea to be considered and conservative management, such as nonpharmacologic routine skin care, must form an important part of the overall care. Recently, new insights into the pathophysiology of rosacea have led to the emergence of etiologically orient...
Source: Skin Therapy Letter - June 1, 2014 Category: Dermatology Authors: Chang BP, Kurian A, Barankin B Tags: Skin Therapy Lett Source Type: research

Recent approval of xerese in Canada: 5% acyclovir and 1% hydrocortisone topical cream in the treatment of herpes labialis.
Abstract Herpes labialis is a frequently occurring viral infection of the lips and oral mucosa. Recurring lesions are induced by viral reactivation and replication, but the symptoms leading to morbidity, such as pain and inflammation, are immune-mediated. The introduction of 5% acyclovir/1% hydrocortisone in a topical cream (Xerese™) represents a therapeutic strategy directed at both of these pathogenic processes. Applied at the onset of prodromal symptoms, this combination treatment has a good safety profile and is more effective in reducing healing time than antiviral or anti-inflammatory agents alone. Alt...
Source: Skin Therapy Letter - June 1, 2014 Category: Dermatology Authors: Nguyen HP, Stiegel KR, Downing C, Stiegel KR Tags: Skin Therapy Lett Source Type: research

Metastatic melanoma: optimizing outcomes by managing dermatologic toxicities associated with novel therapies.
Abstract The last couple of years have seen the beginning of a new era in the treatment of metastatic melanoma. This disease is typically characterized by its poor prognosis and limited choice of therapy. Two mechanistically diverse classes of agents - BRAF inhibitors and immune modulators - have demonstrated an overall survival benefit. Along with their significant clinical benefits, there are also unique adverse events (AEs) related to these agents. While most of the AEs are mild and easily managed with supportive treatment, others require more aggressive management strategies. Education of all members of the mu...
Source: Skin Therapy Letter - April 1, 2014 Category: Dermatology Authors: Claveau J, Ho V, Petrella T Tags: Skin Therapy Lett Source Type: research

An update on the clinical management of cutaneous molluscum contagiosum.
Abstract Molluscum contagiosum is a poxvirus infection of the skin that is commonly observed in children. The molluscum contagiosum virus (MCV) expresses several gene-products that are involved in its pathogenesis and evasion of the host immune system. MCV can be transmitted both to other sites of the body and to other individuals through direct physical contact as well as fomites. While diagnosis is generally straightforward clinically, management of molluscum contagiosum is controversial. Several treatment options are available for the destruction of individual lesions, but there is insufficient evidence for the...
Source: Skin Therapy Letter - April 1, 2014 Category: Dermatology Authors: Nguyen HP, Tyring SK Tags: Skin Therapy Lett Source Type: research

Efinaconazole: a new topical treatment for onychomycosis.
Abstract Efinaconazole is an emerging antifungal therapy for the topical treatment of onychomycosis. Efinaconazole is an inhibitor of sterol 14α-demethylase and is more effective in vitro than terbinafine, itraconazole, ciclopirox and amorolfine against dermatophytes, yeasts and non-dermatophyte molds. Phase II studies indicate that efinaconazole 10% nail solution is more effective than either the 5% strength or 10% solution with semi-occlusion. In duplicate Phase III clinical trials, complete cure rates of 17.8% and 15.2% were demonstrated. The mean mycological cure rate for efinaconazole is similar to the ...
Source: Skin Therapy Letter - February 1, 2014 Category: Dermatology Authors: Gupta AA, Simpson FC Tags: Skin Therapy Lett Source Type: research

Steroid-sparing properties of emollients in dermatology.
Abstract Topical corticosteroids (TCS) and topical calcineurin inhibitors (TCIs) are very effective treatments in inflammatory dermatoses, but carry risks with long-term use. TCS are associated with cutaneous atrophy and tachyphylaxis and TCIs can be irritating and contain a black box warning of an increased risk of cancers including lymphoma and non-melanomatous skin cancers. Nevertheless, they are appropriate treatments for inflammatory conditions such as psoriasis and atopic dermatitis (AD) and should be used more often with disease flares and less as maintenance therapy. Given the associated risks of long-term...
Source: Skin Therapy Letter - February 1, 2014 Category: Dermatology Authors: Harcharik S, Emer J Tags: Skin Therapy Lett Source Type: research

Small molecules: an overview of emerging therapeutic options in the treatment of psoriasis.
Abstract Psoriasis is a chronic condition which requires ongoing management with therapies that have demonstrated favorable safety and efficacy profiles in long-term use. While biologics changed the way psoriasis is treated by providing effective targeted therapy, they are not without limitations. However, small molecules are emerging therapeutic options for the treatment of psoriasis. Several oral and topical small molecules, spanning different therapeutic classes, are proving to be promising treatment options in psoriasis. While studies to date have yielded positive results, further investigation of these agents...
Source: Skin Therapy Letter - December 1, 2013 Category: Dermatology Authors: Gooderham M Tags: Skin Therapy Lett Source Type: research

Chronic urticaria and autoimmunity.
Abstract Chronic urticaria is defined as hives, typically occurring daily, for greater than 6 weeks duration. Chronic idiopathic urticaria, which has no discernable external cause, comprises the majority of cases of chronic urticaria. Over half of all cases of chronic idiopathic urticaria are thought to occur by an autoimmune mechanism, primarily autoantibodies against the high affinity immunoglobulin E (IgE) receptor (FcεRI). Chronic urticaria is hypothesized to occur because of a predilection in the patient to develop reactions to self. Supporting this hypothesis, a strong association has been found betw...
Source: Skin Therapy Letter - December 1, 2013 Category: Dermatology Authors: Fraser K, Robertson L Tags: Skin Therapy Lett Source Type: research

Improving bioavailability with a novel isotretinoin formulation (isotretinoin-lidose).
Abstract Current practice guidelines recommend administration of oral isotretinoin with high-fat meals, which may pose issues with patient compliance. Isotretinoin-Lidose (Epuris™), approved by Health Canada in November 2012 and scheduled for commercial release June 2013, is based on novel lipid encapsulation technology (Lidose®) to enclose isotretinoin, thereby increasing drug absorption during fasted states. An open label, single dose randomized crossover study demonstrated pharmacokinetic bioequivalence of isotretinoin-Lidose to standard isotretinoin formulations during fed states, with significantly ...
Source: Skin Therapy Letter - October 1, 2013 Category: Dermatology Authors: Tan J, Knezevic S Tags: Skin Therapy Lett Source Type: research

Treatment of infantile hemangiomas with Beta-blockers: a review.
Abstract Infantile hemangiomas (IH) are the most common tumors occurring in early childhood, with a prevalence of approximately 5-10% of infants. While the natural history of IH is to spontaneously involute, a significant minority of IH require therapy with the aim to prevent disfigurement, functional impairment, or ulceration. In 2008, propranolol, a non-selective beta (β)-blocker, was reported to be highly effective in treating IH. Since that time there have been more than 200 articles published regarding the efficacy and potential toxicity of β-blockers, both systemic and topical, for the treatment of...
Source: Skin Therapy Letter - October 1, 2013 Category: Dermatology Authors: Shah S, Frieden IJ Tags: Skin Therapy Lett Source Type: research

A controversial proposal: no more antibiotics for acne!
Abstract Administration of antibiotics, often for prolonged periods, has become the de facto standard of care for acne (and rosacea). However, the world is now facing a health crisis relating to widespread antibiotic resistance. The authors provide current evidence to suggest that dermatologists should consider a radical departure from standard operating procedure by severely curtailing, if not outright discontinuing, the routine and regular use of antibiotics for acne. PMID: 24305661 [PubMed - in process] (Source: Skin Therapy Letter)
Source: Skin Therapy Letter - August 1, 2013 Category: Dermatology Authors: Muhammad M, Rosen T Tags: Skin Therapy Lett Source Type: research

An overview of parabens and allergic contact dermatitis.
Abstract Esters of p-hydroxybenzoic acid (parabens) are the most widely used preservatives in cosmetic, pharmaceutical, and industrial products. However, since the 1960s, controversy has surrounded its use and safety as a potential cause of allergic contact dermatitis. Despite the cloud of suspicion that has hovered over parabens ever since, these ubiquitous compounds have withstood four decades of extensive skin testing conducted by a variety of organizations, both North American and European, and now, it seems parabens have shown to be one of the least sensitizing preservatives in commercial use. Of the very lim...
Source: Skin Therapy Letter - August 1, 2013 Category: Dermatology Authors: Hafeez F, Maibach H Tags: Skin Therapy Lett Source Type: research

Selected skin diseases with systemic involvement.
cki K Abstract The skin is often a window to systemic disease that is available to the trained eye of the dermatologist. Herein, we focus on four dermatoses with associated systemic conditions of interest: scleromyxedema and monoclonal gammopathy, nephrogenic systemic fibrosis in the setting of renal insufficiency, dermatitis herpetiformis and celiac disease, and psoriasis as a risk factor for cardiovascular disease. Dermatologists can play a crucial role in recognizing the cutaneous manifestations linked with these conditions. Identifying the related underlying disorder will contribute to appropriate diagnosis an...
Source: Skin Therapy Letter - June 1, 2013 Category: Dermatology Authors: Ruiz M, Valdés P, Tomecki K Tags: Skin Therapy Lett Source Type: research

Topical agents for hair growth promotion: what is out there?
Abstract Hair loss is a widespread complaint that carries a significant psychosocial burden for affected individuals. Androgenetic alopecia (AGA) is the predominant cause of hair loss seen in the dermatology clinic. Although a range of therapies are available, minoxidil remains the only approved topical treatment for AGA. Promising new topical agents are under current investigation. PMID: 24310642 [PubMed - in process] (Source: Skin Therapy Letter)
Source: Skin Therapy Letter - June 1, 2013 Category: Dermatology Authors: Shamsaldeen OS, Mubki TA, Shapiro J Tags: Skin Therapy Lett Source Type: research

Dermatitis herpetiformis.
This article will provide a comprehensive review of DH, including its epidemiology, clinical and pathological findings, diagnostic evaluation, and management. PMID: 23674144 [PubMed - in process] (Source: Skin Therapy Letter)
Source: Skin Therapy Letter - March 1, 2013 Category: Dermatology Authors: Plotnikova N, Miller JL Tags: Skin Therapy Lett Source Type: research

Methotrexate: role of treatment in skin disease.
Abstract Methotrexate has been used for over half a century to treat a wide spectrum of skin conditions. It is a valuable steroid sparing agent, preventing protracted steroid courses and their undesirable side effects. While many alternative therapies exist and continue to emerge to treat these dermatologic conditions, the long history, affordability, and relative safety associated with methotrexate ensure its enduring utility. Further, ongoing research focusing on the pharmacogenetic properties of the drug may allow for more effective and targeted therapeutic strategies. PMID: 23674145 [PubMed - in process] ...
Source: Skin Therapy Letter - March 1, 2013 Category: Dermatology Authors: Holliday AC, Moody MN, Berlingeri-Ramos A Tags: Skin Therapy Lett Source Type: research

The evolving role of biologics in the treatment of pediatric psoriasis.
This article will provide a summary of the cumulative pediatric safety and efficacy data for the anti-tumor necrosis factor-alpha (TNF-α) agents and interleukin (IL)-12 and IL-23 (IL12/23) pathway inhibitor and suggestions for a rational clinical approach to their use in children with psoriasis. PMID: 23508772 [PubMed - in process] (Source: Skin Therapy Letter)
Source: Skin Therapy Letter - February 1, 2013 Category: Dermatology Authors: Luu M, Cordoro KM Tags: Skin Therapy Lett Source Type: research

The health controversies of parabens.
Abstract Parabens are preservatives used in a variety of personal care, cosmetic, pharmaceutical and food products. Studies have confirmed the ubiquitous presence of parabens, with levels detected in wastewater, rivers, soil and house dust. Parabens have also been detected in human tissues and bodily fluids, but it is the discovery of these chemical compounds in the breast tissue of patients with breast cancer that has raised public concern over their use. It is hypothesized that the estrogenic properties of parabens may play a role in breast cancer development. However, studies investigating the health effects of...
Source: Skin Therapy Letter - February 1, 2013 Category: Dermatology Authors: Kirchhof MG, de Gannes GC Tags: Skin Therapy Lett Source Type: research

Reducing skin malignancy risk in organ transplant recipients.
Abstract Skin cancer in organ transplant recipients is a serious problem that manifests as increased squamous cell carcinoma in longterm patients. In these patients, a combination of cumulative sun exposure as well as the immunosuppressive effects of transplant medications can cause cutaneous malignancy. Skin cancer can affect transplant patients in multiple ways. It can decrease quality of life by causing various separate skin cancers that require frequent and sometimes painful treatment, as well as possibly result in disfigurement. The more aggressive tumors pose a risk of metastasis and death. Clinical efforts ...
Source: Skin Therapy Letter - January 1, 2013 Category: Dermatology Authors: Francis S, Berg D Tags: Skin Therapy Lett Source Type: research

Urticaria & angioedema: a rational approach to diagnosis and therapy.
Urticaria & angioedema: a rational approach to diagnosis and therapy. Skin Therapy Lett. 2013 Jan;18(1):4-9 Authors: Dreyfus DH Abstract Urticaria and angioedema are common allergic manifestations and some forms of this disorder may be increasing in both prevalence and severity due to changes in medications, environment and other unknown factors. This review focuses on a rational approach to differential diagnosis and therapy of the most common forms of urticaria and angioedema. PMID: 23474656 [PubMed - in process] (Source: Skin Therapy Letter)
Source: Skin Therapy Letter - January 1, 2013 Category: Dermatology Authors: Dreyfus DH Tags: Skin Therapy Lett Source Type: research

Rosacea: update on management and emerging therapies.
Abstract Rosacea is a common chronic skin disorder that has significant impact on the self-esteem and quality of life of affected individuals. Currently understood as an inflammatory condition that occurs in the context of an altered innate immune response, the available topical and systemic therapies function as immunomodulators to restore cutaneous homeostasis. The goals of therapy include reduction of papules, pustules, erythema and physical discomfort with improvement in quality of life. Standard topical treatments include metronidazole and azelaic acid, although many other agents and regimens have been presen...
Source: Skin Therapy Letter - December 1, 2012 Category: Dermatology Authors: Fallen RS, Gooderham M Tags: Skin Therapy Lett Source Type: research

A practical approach to accurate classification and staging of mycosis fungoides and sézary syndrome.
A practical approach to accurate classification and staging of mycosis fungoides and sézary syndrome. Skin Therapy Lett. 2012 Dec;17(10):5-9 Authors: Thomas BR, Whittaker S Abstract Cutaneous T-cell lymphomas are rare, distinct forms of non-Hodgkin´s lymphomas. Of which, mycosis fungoides (MF) and Sézary syndrome (SS) are two of the most common forms. Careful, clear classification and staging of these lymphomas allow dermatologists to commence appropriate therapy and allow correct prognostic stratification for those patients affected. Of note, patients with more advanced disease will re...
Source: Skin Therapy Letter - December 1, 2012 Category: Dermatology Authors: Thomas BR, Whittaker S Tags: Skin Therapy Lett Source Type: research