Video

This video was filmed at Metabolic & Endocrine Disease Summit (MEDS). Click here to learn more.

This video was filmed at Metabolic & Endocrine Disease Summit (MEDS). Click here to learn more.

This video was filmed at Metabolic & Endocrine Disease Summit (MEDS). Click here to learn more.

KAUAI, HAWAII – When it comes to diagnosing tinea capitis, you really can’t rely on a Wood’s lamp, according to pediatric dermatologist Robert Silverman, MD.

The Wood’s lamp generally misses the most common cause of tinea capitis in urban and suburban environments today, Trichophyton tonsurans, said Dr. Silverman, a pediatric dermatologist and clinical associate professor in the department of pediatrics at Georgetown University, Washington.

The dermatoscope, which “will allow you to see what is called the black dots of tinea capitis very, very closely,” is far better, he said in an interview at the Hawaii Dermatology Seminar provided by the Global Academy for Medical Education/Skin Disease Education Foundation

He explained the limitations of the Wood’s lamp in this setting, and what to look for with a dermatoscope. He had other tips to share, too, from years of experience treating the condition, including how to differentiate tinea capitis on exam from its most common mimics, why it’s best to include a counter stain when using potassium hydroxide, and how to motivate parents to wash their child’s hair more frequently to reduce spores on the hair and scalp.

Dr. Silverman disclosed relationships with Pierre Fabre, Pfizer, and Regeneron.

SDEF/Global Academy for Medical Education and this news organization are owned by the same parent company.

[email protected]

KAUAI, HAWAII – When it comes to diagnosing tinea capitis, you really can’t rely on a Wood’s lamp, according to pediatric dermatologist Robert Silverman, MD.

The Wood’s lamp generally misses the most common cause of tinea capitis in urban and suburban environments today, Trichophyton tonsurans, said Dr. Silverman, a pediatric dermatologist and clinical associate professor in the department of pediatrics at Georgetown University, Washington.

The dermatoscope, which “will allow you to see what is called the black dots of tinea capitis very, very closely,” is far better, he said in an interview at the Hawaii Dermatology Seminar provided by the Global Academy for Medical Education/Skin Disease Education Foundation

He explained the limitations of the Wood’s lamp in this setting, and what to look for with a dermatoscope. He had other tips to share, too, from years of experience treating the condition, including how to differentiate tinea capitis on exam from its most common mimics, why it’s best to include a counter stain when using potassium hydroxide, and how to motivate parents to wash their child’s hair more frequently to reduce spores on the hair and scalp.

Dr. Silverman disclosed relationships with Pierre Fabre, Pfizer, and Regeneron.

SDEF/Global Academy for Medical Education and this news organization are owned by the same parent company.

[email protected]

KAUAI, HAWAII – When it comes to diagnosing tinea capitis, you really can’t rely on a Wood’s lamp, according to pediatric dermatologist Robert Silverman, MD.

The Wood’s lamp generally misses the most common cause of tinea capitis in urban and suburban environments today, Trichophyton tonsurans, said Dr. Silverman, a pediatric dermatologist and clinical associate professor in the department of pediatrics at Georgetown University, Washington.

The dermatoscope, which “will allow you to see what is called the black dots of tinea capitis very, very closely,” is far better, he said in an interview at the Hawaii Dermatology Seminar provided by the Global Academy for Medical Education/Skin Disease Education Foundation

He explained the limitations of the Wood’s lamp in this setting, and what to look for with a dermatoscope. He had other tips to share, too, from years of experience treating the condition, including how to differentiate tinea capitis on exam from its most common mimics, why it’s best to include a counter stain when using potassium hydroxide, and how to motivate parents to wash their child’s hair more frequently to reduce spores on the hair and scalp.

Dr. Silverman disclosed relationships with Pierre Fabre, Pfizer, and Regeneron.

SDEF/Global Academy for Medical Education and this news organization are owned by the same parent company.

[email protected]

SAN DIEGO – New industry-funded research finds that patients with relapsing-remitting multiple sclerosis (MS) who took teriflunomide fared similarly to those who took dimethyl fumarate.

“The fundamental conclusion is that there’s little to separate them. If you look at efficacy, safety, and MRI scanning, there were no differences between the two medications that matter. ... Both drugs can be used with equal confidence,” said Stanley Cohan, MD, PhD, medical director of Providence MS Center in Portland, Ore.

Dr. Cohan spoke in a video interview at the meeting held by the Americas Committee for Treatment and Research in Multiple Sclerosis.

The researchers analyzed retrospective data collected in the phase 4 Teri-RADAR study, which tracked two groups of 50 patients each at MS centers in the United States as they took 14 mg of teriflunomide (Aubagio) daily or 240 mg of delayed-release dimethyl fumarate (Tecfidera) twice daily.

In both groups, participants had an average age of about 49 years, about three-quarters were women, and about 93% were white. Twenty-two percent of those in the teriflunomide group had relapses in the 18 months before the index date, compared with 10% of the dimethyl fumarate group.

The study – funded by Sanofi, maker of teriflunomide – followed up with patients at a mean of 15-16 months.

Mean annualized percentage of brain volume change (PBVC) was lower in teriflunomide-treated patients, compared with those treated with dimethyl fumarate (–0.2% vs. –0.5%; P = .02). Also, fewer teriflunomide-treated patients showed signs of annualized PBVC above a mean annualized brain volume loss rate threshold of 0.4% (25.9% vs. 58.6%; P = .01).

As for adverse effects, rashes affected none of the teriflunomide group but 28% of the dimethyl fumarate group. The teriflunomide group experienced skin reactions (12%) and diarrhea (16%), while these adverse events were not reported in the dimethyl fumarate group.

The study authors reported a variety of disclosures, and several are employees of Sanofi. Dr. Cohan reported a variety of disclosures, including multiple relationships with Sanofi.

SAN DIEGO – New industry-funded research finds that patients with relapsing-remitting multiple sclerosis (MS) who took teriflunomide fared similarly to those who took dimethyl fumarate.

“The fundamental conclusion is that there’s little to separate them. If you look at efficacy, safety, and MRI scanning, there were no differences between the two medications that matter. ... Both drugs can be used with equal confidence,” said Stanley Cohan, MD, PhD, medical director of Providence MS Center in Portland, Ore.

Dr. Cohan spoke in a video interview at the meeting held by the Americas Committee for Treatment and Research in Multiple Sclerosis.

The researchers analyzed retrospective data collected in the phase 4 Teri-RADAR study, which tracked two groups of 50 patients each at MS centers in the United States as they took 14 mg of teriflunomide (Aubagio) daily or 240 mg of delayed-release dimethyl fumarate (Tecfidera) twice daily.

In both groups, participants had an average age of about 49 years, about three-quarters were women, and about 93% were white. Twenty-two percent of those in the teriflunomide group had relapses in the 18 months before the index date, compared with 10% of the dimethyl fumarate group.

The study – funded by Sanofi, maker of teriflunomide – followed up with patients at a mean of 15-16 months.

Mean annualized percentage of brain volume change (PBVC) was lower in teriflunomide-treated patients, compared with those treated with dimethyl fumarate (–0.2% vs. –0.5%; P = .02). Also, fewer teriflunomide-treated patients showed signs of annualized PBVC above a mean annualized brain volume loss rate threshold of 0.4% (25.9% vs. 58.6%; P = .01).

As for adverse effects, rashes affected none of the teriflunomide group but 28% of the dimethyl fumarate group. The teriflunomide group experienced skin reactions (12%) and diarrhea (16%), while these adverse events were not reported in the dimethyl fumarate group.

The study authors reported a variety of disclosures, and several are employees of Sanofi. Dr. Cohan reported a variety of disclosures, including multiple relationships with Sanofi.

SAN DIEGO – New industry-funded research finds that patients with relapsing-remitting multiple sclerosis (MS) who took teriflunomide fared similarly to those who took dimethyl fumarate.

“The fundamental conclusion is that there’s little to separate them. If you look at efficacy, safety, and MRI scanning, there were no differences between the two medications that matter. ... Both drugs can be used with equal confidence,” said Stanley Cohan, MD, PhD, medical director of Providence MS Center in Portland, Ore.

Dr. Cohan spoke in a video interview at the meeting held by the Americas Committee for Treatment and Research in Multiple Sclerosis.

The researchers analyzed retrospective data collected in the phase 4 Teri-RADAR study, which tracked two groups of 50 patients each at MS centers in the United States as they took 14 mg of teriflunomide (Aubagio) daily or 240 mg of delayed-release dimethyl fumarate (Tecfidera) twice daily.

In both groups, participants had an average age of about 49 years, about three-quarters were women, and about 93% were white. Twenty-two percent of those in the teriflunomide group had relapses in the 18 months before the index date, compared with 10% of the dimethyl fumarate group.

The study – funded by Sanofi, maker of teriflunomide – followed up with patients at a mean of 15-16 months.

Mean annualized percentage of brain volume change (PBVC) was lower in teriflunomide-treated patients, compared with those treated with dimethyl fumarate (–0.2% vs. –0.5%; P = .02). Also, fewer teriflunomide-treated patients showed signs of annualized PBVC above a mean annualized brain volume loss rate threshold of 0.4% (25.9% vs. 58.6%; P = .01).

As for adverse effects, rashes affected none of the teriflunomide group but 28% of the dimethyl fumarate group. The teriflunomide group experienced skin reactions (12%) and diarrhea (16%), while these adverse events were not reported in the dimethyl fumarate group.

The study authors reported a variety of disclosures, and several are employees of Sanofi. Dr. Cohan reported a variety of disclosures, including multiple relationships with Sanofi.

KAUAI, HAWAII – Pediatric dermatologists aren’t waiting for Food and Drug Administration approval to try dupilumab (Dupixent) for their patients with severe atopic dermatitis.

It’s not approved in children, but the possibility of good control without the side effects of cyclosporine and other alternatives is too much to resist. A phase 2, company-sponsored study reported Eczema Area and Severity Index score improvements of up to 76% in pediatric patients treated with dupilumab, an interleukin-4 and IL-13 signaling blocker approved in 2017 for moderate to severe AD in adults.

Large pediatric trials are pending, but with results like that, “many of us just feel if it was our own kid, and we could get dupilumab, we would like to do that first,” said Lawrence Eichenfield, MD, professor of dermatology and pediatrics at the University of California, San Diego.

It’s not just dupilumab that’s causing excitement. With almost 20 biologics in the pipeline, eczema seems poised to undergo a revolution in treatment much like psoriasis has in recent years.

Dr. Eichenfield explained how the field is evolving and discussed the pediatric experience with dupilumab to date, in addition to how he is using crisaborole (Eucrisa), a topical nonsteroidal phosphodiesterase-4 inhibitor approved for mild to moderate AD for children and adults ages two and older in December 2016, which doesn’t seem to have the duration limits of steroids, he said in an interview at the Hawaii Dermatology Seminar provided by the Global Academy for Medical Education/Skin Disease Education Foundation.

Treatment of pediatric AD is “going to be a very different picture over the next few years,” he said.

Dr. Eichenfield is a consultant or investigator for many companies, including Regeneron/Sanofi, Genentech, Novartis, Pfizer, Lilly, and Allergan.

SDEF/Global Academy for Medical Education and this news organization are owned by the same parent company.

[email protected]

KAUAI, HAWAII – Pediatric dermatologists aren’t waiting for Food and Drug Administration approval to try dupilumab (Dupixent) for their patients with severe atopic dermatitis.

It’s not approved in children, but the possibility of good control without the side effects of cyclosporine and other alternatives is too much to resist. A phase 2, company-sponsored study reported Eczema Area and Severity Index score improvements of up to 76% in pediatric patients treated with dupilumab, an interleukin-4 and IL-13 signaling blocker approved in 2017 for moderate to severe AD in adults.

Large pediatric trials are pending, but with results like that, “many of us just feel if it was our own kid, and we could get dupilumab, we would like to do that first,” said Lawrence Eichenfield, MD, professor of dermatology and pediatrics at the University of California, San Diego.

It’s not just dupilumab that’s causing excitement. With almost 20 biologics in the pipeline, eczema seems poised to undergo a revolution in treatment much like psoriasis has in recent years.

Dr. Eichenfield explained how the field is evolving and discussed the pediatric experience with dupilumab to date, in addition to how he is using crisaborole (Eucrisa), a topical nonsteroidal phosphodiesterase-4 inhibitor approved for mild to moderate AD for children and adults ages two and older in December 2016, which doesn’t seem to have the duration limits of steroids, he said in an interview at the Hawaii Dermatology Seminar provided by the Global Academy for Medical Education/Skin Disease Education Foundation.

Treatment of pediatric AD is “going to be a very different picture over the next few years,” he said.

Dr. Eichenfield is a consultant or investigator for many companies, including Regeneron/Sanofi, Genentech, Novartis, Pfizer, Lilly, and Allergan.

SDEF/Global Academy for Medical Education and this news organization are owned by the same parent company.

[email protected]

KAUAI, HAWAII – Pediatric dermatologists aren’t waiting for Food and Drug Administration approval to try dupilumab (Dupixent) for their patients with severe atopic dermatitis.

It’s not approved in children, but the possibility of good control without the side effects of cyclosporine and other alternatives is too much to resist. A phase 2, company-sponsored study reported Eczema Area and Severity Index score improvements of up to 76% in pediatric patients treated with dupilumab, an interleukin-4 and IL-13 signaling blocker approved in 2017 for moderate to severe AD in adults.

Large pediatric trials are pending, but with results like that, “many of us just feel if it was our own kid, and we could get dupilumab, we would like to do that first,” said Lawrence Eichenfield, MD, professor of dermatology and pediatrics at the University of California, San Diego.

It’s not just dupilumab that’s causing excitement. With almost 20 biologics in the pipeline, eczema seems poised to undergo a revolution in treatment much like psoriasis has in recent years.

Dr. Eichenfield explained how the field is evolving and discussed the pediatric experience with dupilumab to date, in addition to how he is using crisaborole (Eucrisa), a topical nonsteroidal phosphodiesterase-4 inhibitor approved for mild to moderate AD for children and adults ages two and older in December 2016, which doesn’t seem to have the duration limits of steroids, he said in an interview at the Hawaii Dermatology Seminar provided by the Global Academy for Medical Education/Skin Disease Education Foundation.

Treatment of pediatric AD is “going to be a very different picture over the next few years,” he said.

Dr. Eichenfield is a consultant or investigator for many companies, including Regeneron/Sanofi, Genentech, Novartis, Pfizer, Lilly, and Allergan.

SDEF/Global Academy for Medical Education and this news organization are owned by the same parent company.

[email protected]

Being a peer-reviewed journal, Federal Practitioner relies on the dedicated efforts of a great number of unsung (and uncompensated) people, and we would like to recognize these efforts. This journal exists because of the large body of federal health care providers who devote their time and energy to sharing best practices, case studies, literature reviews, and original research. An even larger number of men and women review the many submissions, check the research, and provide essential feedback to our authors. By design, this army of reviewers remains anonymous, but that does not diminish their importance.

Although it would be impossible to adequately thank our reviewers, authors, and other contributors, sufficiently, we are trying. We are delighted to induct some of the most engaged members of the Federal Practitioner community to the Editorial Advisory Association (EAA). The EAA helps guide the journal to ensure it remains focused on the essential issues that confront federal health care providers. Federal Practitioner strives for continuous improvement and is focused on enhancing the breadth, depth, and quality of the online and print content. The EAA plays an important role in that process, and we thank all the current EAA and new members for their guidance.

New EAA Members

Susanne G. Barnett, PharmD, BCPS, has directed the Pharmacy Notes column for Federal Practitioner since 2015. Dr. Barnett is an associate professor at the University of Wisconsin-Madison School of Pharmacy and a clinical pharmacist at the William S. Middleton Memorial Veterans Hospital. She has focused on antimicrobial stewardship and infectious diseases.

Anthony Breu, MD, conceived and directs the VA Boston Medical Forum series. The series highlights unique case studies and the important role the VA plays in graduate medical education. Dr. Breu is an assistant professor of medicine at Harvard Medical School and the director of resident education at the VA Boston Healthcare System.

Maggie Chartier, PsyD, MPH, has authored multiple articles for Federal Practitioner and provided guidance and direction for the 2017 and (forthcoming) 2018 editions of the public pathogens/infectious diseases special issues. Dr. Chartier is the deputy director for the HIV, Hepatitis, and Related Conditions Program in the VHA Office of Specialty Care Services and an assistant clinical professor at the University of California, San Francisco.

Marcia Johnson, DNP, FNP-BC, has been a highly active author and peer reviewer. Dr. Johnson has been a nurse practitioner at the VA for 18 years, and currently provides primary care at the Clermont CBOC in Florida. She previously served as the hepatitis C research coordinator at Philadelphia VAMC and practiced at the Orlando VAMC spinal cord injury clinic.

William Rodríguez-Cintrón, MD, is another active peer reviewer and a prolific contributor. Dr. Rodríguez-Cintrón is chief of the pulmonary, critical care and sleep medicine departments at the VA Caribbean Healthcare System in Puerto Rico.

Col. (Ret) Mona Pearl Treyball, PhD, MS, RN, USAF, also has been a dedicated peer reviewer. Col. Treyball is professor and specialty director of the Veteran and Military Care Academic Programs at the University of Colorado College of Nursing, which trains health care providers to address the unique needs of both veteran and active-duty populations.

Federal Practitioner would like to thank all of the current and new members of the EAA for their continued support. All of the journal’s successes are built on their dedication and commitment. Federal Practitioner encourages all the members of the federal health care community to become more involved, whether as a peer reviewer, author, or by responding to our content in print, online, or via social media. Your feedback and involvement makes this journal better.

Being a peer-reviewed journal, Federal Practitioner relies on the dedicated efforts of a great number of unsung (and uncompensated) people, and we would like to recognize these efforts. This journal exists because of the large body of federal health care providers who devote their time and energy to sharing best practices, case studies, literature reviews, and original research. An even larger number of men and women review the many submissions, check the research, and provide essential feedback to our authors. By design, this army of reviewers remains anonymous, but that does not diminish their importance.

Although it would be impossible to adequately thank our reviewers, authors, and other contributors, sufficiently, we are trying. We are delighted to induct some of the most engaged members of the Federal Practitioner community to the Editorial Advisory Association (EAA). The EAA helps guide the journal to ensure it remains focused on the essential issues that confront federal health care providers. Federal Practitioner strives for continuous improvement and is focused on enhancing the breadth, depth, and quality of the online and print content. The EAA plays an important role in that process, and we thank all the current EAA and new members for their guidance.

New EAA Members

Susanne G. Barnett, PharmD, BCPS, has directed the Pharmacy Notes column for Federal Practitioner since 2015. Dr. Barnett is an associate professor at the University of Wisconsin-Madison School of Pharmacy and a clinical pharmacist at the William S. Middleton Memorial Veterans Hospital. She has focused on antimicrobial stewardship and infectious diseases.

Anthony Breu, MD, conceived and directs the VA Boston Medical Forum series. The series highlights unique case studies and the important role the VA plays in graduate medical education. Dr. Breu is an assistant professor of medicine at Harvard Medical School and the director of resident education at the VA Boston Healthcare System.

Maggie Chartier, PsyD, MPH, has authored multiple articles for Federal Practitioner and provided guidance and direction for the 2017 and (forthcoming) 2018 editions of the public pathogens/infectious diseases special issues. Dr. Chartier is the deputy director for the HIV, Hepatitis, and Related Conditions Program in the VHA Office of Specialty Care Services and an assistant clinical professor at the University of California, San Francisco.

Marcia Johnson, DNP, FNP-BC, has been a highly active author and peer reviewer. Dr. Johnson has been a nurse practitioner at the VA for 18 years, and currently provides primary care at the Clermont CBOC in Florida. She previously served as the hepatitis C research coordinator at Philadelphia VAMC and practiced at the Orlando VAMC spinal cord injury clinic.

William Rodríguez-Cintrón, MD, is another active peer reviewer and a prolific contributor. Dr. Rodríguez-Cintrón is chief of the pulmonary, critical care and sleep medicine departments at the VA Caribbean Healthcare System in Puerto Rico.

Col. (Ret) Mona Pearl Treyball, PhD, MS, RN, USAF, also has been a dedicated peer reviewer. Col. Treyball is professor and specialty director of the Veteran and Military Care Academic Programs at the University of Colorado College of Nursing, which trains health care providers to address the unique needs of both veteran and active-duty populations.

Federal Practitioner would like to thank all of the current and new members of the EAA for their continued support. All of the journal’s successes are built on their dedication and commitment. Federal Practitioner encourages all the members of the federal health care community to become more involved, whether as a peer reviewer, author, or by responding to our content in print, online, or via social media. Your feedback and involvement makes this journal better.

Being a peer-reviewed journal, Federal Practitioner relies on the dedicated efforts of a great number of unsung (and uncompensated) people, and we would like to recognize these efforts. This journal exists because of the large body of federal health care providers who devote their time and energy to sharing best practices, case studies, literature reviews, and original research. An even larger number of men and women review the many submissions, check the research, and provide essential feedback to our authors. By design, this army of reviewers remains anonymous, but that does not diminish their importance.

Although it would be impossible to adequately thank our reviewers, authors, and other contributors, sufficiently, we are trying. We are delighted to induct some of the most engaged members of the Federal Practitioner community to the Editorial Advisory Association (EAA). The EAA helps guide the journal to ensure it remains focused on the essential issues that confront federal health care providers. Federal Practitioner strives for continuous improvement and is focused on enhancing the breadth, depth, and quality of the online and print content. The EAA plays an important role in that process, and we thank all the current EAA and new members for their guidance.

New EAA Members

Susanne G. Barnett, PharmD, BCPS, has directed the Pharmacy Notes column for Federal Practitioner since 2015. Dr. Barnett is an associate professor at the University of Wisconsin-Madison School of Pharmacy and a clinical pharmacist at the William S. Middleton Memorial Veterans Hospital. She has focused on antimicrobial stewardship and infectious diseases.

Anthony Breu, MD, conceived and directs the VA Boston Medical Forum series. The series highlights unique case studies and the important role the VA plays in graduate medical education. Dr. Breu is an assistant professor of medicine at Harvard Medical School and the director of resident education at the VA Boston Healthcare System.

Maggie Chartier, PsyD, MPH, has authored multiple articles for Federal Practitioner and provided guidance and direction for the 2017 and (forthcoming) 2018 editions of the public pathogens/infectious diseases special issues. Dr. Chartier is the deputy director for the HIV, Hepatitis, and Related Conditions Program in the VHA Office of Specialty Care Services and an assistant clinical professor at the University of California, San Francisco.

Marcia Johnson, DNP, FNP-BC, has been a highly active author and peer reviewer. Dr. Johnson has been a nurse practitioner at the VA for 18 years, and currently provides primary care at the Clermont CBOC in Florida. She previously served as the hepatitis C research coordinator at Philadelphia VAMC and practiced at the Orlando VAMC spinal cord injury clinic.

William Rodríguez-Cintrón, MD, is another active peer reviewer and a prolific contributor. Dr. Rodríguez-Cintrón is chief of the pulmonary, critical care and sleep medicine departments at the VA Caribbean Healthcare System in Puerto Rico.

Col. (Ret) Mona Pearl Treyball, PhD, MS, RN, USAF, also has been a dedicated peer reviewer. Col. Treyball is professor and specialty director of the Veteran and Military Care Academic Programs at the University of Colorado College of Nursing, which trains health care providers to address the unique needs of both veteran and active-duty populations.

Federal Practitioner would like to thank all of the current and new members of the EAA for their continued support. All of the journal’s successes are built on their dedication and commitment. Federal Practitioner encourages all the members of the federal health care community to become more involved, whether as a peer reviewer, author, or by responding to our content in print, online, or via social media. Your feedback and involvement makes this journal better.