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Improving sunscreen use entails patient counseling
WAILEA, HAWAII – When sunscreens are tested for their SPF, testers apply 2 mg/cm2, but most people use only 20%-50% of that amount, which significantly reduces their protection, according to Dr. Julie C. Harper, director of the Dermatology & Skin Care Center of Birmingham, Ala.
The correct amount is 1 teaspoon of sunscreen on the face/head/neck, 1 teaspoon on each arm, 2 teaspoons on the torso, and 2 teaspoons on each leg, Dr. Harper said in a presentation at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation. Reapplication every 90 minutes to 2 hours is key to effective protection, Dr. Harper said.
However, “most people use less than one bottle of sunscreen per year,” she noted.
Prompting patients to improve their sunscreen use involves disproving some myths, Dr. Harper pointed out. When patients cite concerns about low vitamin D as a reason to avoid sunscreens, she recommended that they be counseled that there are three sources of vitamin D: foods such as fatty fish, vitamin D fortified foods, cheese, and egg yolks; vitamin D supplements; and skin synthesis through UVB exposure; and that only one of these – UVB exposure – is a known carcinogen.
Also, some patients express concern that sunscreen itself may be a carcinogen. Oxybenzone, a common sunscreen ingredient, has demonstrated some estrogenic effects in vitro and in vivo studies. However, the rat studies often cited in support of that finding involved the use of very high doses – approximately the equivalent of 277 years of daily sunscreen application with 6% oxybenzone, a much higher concentration than is found in commercial sunscreens, she said.
For patients interested in nontopical sun protection, polypodium leucotomos extract (PLE) is an option, Dr. Harper said. PLE, an antioxidant extract from a tropical fern, can be part of a skin cancer prevention strategy that also includes good sunscreen and protective clothing. PLE works by counteracting UV-induced immunosuppression, activating the tumor suppressor p53 gene, and inhibiting cyclooxygenase-2, all of which can help protect the skin from burning.
In addition, oral nicotinamide has been shown to help repair DNA damage in human keratinocytes, and in a clinical trial, has been associated with fewer actinic keratoses and squamous cell carcinoma, compared with placebo, she said.
However, more research in these options is needed, and patients should be encouraged to follow consistent sun protection practices, Dr. Harper emphasized.
Dr. Harper disclosed relationships with companies including Allergan, Bayer, Galderma, LaRoche-Posay, Promius, Valeant, and BioPharmX.
SDEF and this news organization are owned by the same parent company.
WAILEA, HAWAII – When sunscreens are tested for their SPF, testers apply 2 mg/cm2, but most people use only 20%-50% of that amount, which significantly reduces their protection, according to Dr. Julie C. Harper, director of the Dermatology & Skin Care Center of Birmingham, Ala.
The correct amount is 1 teaspoon of sunscreen on the face/head/neck, 1 teaspoon on each arm, 2 teaspoons on the torso, and 2 teaspoons on each leg, Dr. Harper said in a presentation at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation. Reapplication every 90 minutes to 2 hours is key to effective protection, Dr. Harper said.
However, “most people use less than one bottle of sunscreen per year,” she noted.
Prompting patients to improve their sunscreen use involves disproving some myths, Dr. Harper pointed out. When patients cite concerns about low vitamin D as a reason to avoid sunscreens, she recommended that they be counseled that there are three sources of vitamin D: foods such as fatty fish, vitamin D fortified foods, cheese, and egg yolks; vitamin D supplements; and skin synthesis through UVB exposure; and that only one of these – UVB exposure – is a known carcinogen.
Also, some patients express concern that sunscreen itself may be a carcinogen. Oxybenzone, a common sunscreen ingredient, has demonstrated some estrogenic effects in vitro and in vivo studies. However, the rat studies often cited in support of that finding involved the use of very high doses – approximately the equivalent of 277 years of daily sunscreen application with 6% oxybenzone, a much higher concentration than is found in commercial sunscreens, she said.
For patients interested in nontopical sun protection, polypodium leucotomos extract (PLE) is an option, Dr. Harper said. PLE, an antioxidant extract from a tropical fern, can be part of a skin cancer prevention strategy that also includes good sunscreen and protective clothing. PLE works by counteracting UV-induced immunosuppression, activating the tumor suppressor p53 gene, and inhibiting cyclooxygenase-2, all of which can help protect the skin from burning.
In addition, oral nicotinamide has been shown to help repair DNA damage in human keratinocytes, and in a clinical trial, has been associated with fewer actinic keratoses and squamous cell carcinoma, compared with placebo, she said.
However, more research in these options is needed, and patients should be encouraged to follow consistent sun protection practices, Dr. Harper emphasized.
Dr. Harper disclosed relationships with companies including Allergan, Bayer, Galderma, LaRoche-Posay, Promius, Valeant, and BioPharmX.
SDEF and this news organization are owned by the same parent company.
WAILEA, HAWAII – When sunscreens are tested for their SPF, testers apply 2 mg/cm2, but most people use only 20%-50% of that amount, which significantly reduces their protection, according to Dr. Julie C. Harper, director of the Dermatology & Skin Care Center of Birmingham, Ala.
The correct amount is 1 teaspoon of sunscreen on the face/head/neck, 1 teaspoon on each arm, 2 teaspoons on the torso, and 2 teaspoons on each leg, Dr. Harper said in a presentation at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation. Reapplication every 90 minutes to 2 hours is key to effective protection, Dr. Harper said.
However, “most people use less than one bottle of sunscreen per year,” she noted.
Prompting patients to improve their sunscreen use involves disproving some myths, Dr. Harper pointed out. When patients cite concerns about low vitamin D as a reason to avoid sunscreens, she recommended that they be counseled that there are three sources of vitamin D: foods such as fatty fish, vitamin D fortified foods, cheese, and egg yolks; vitamin D supplements; and skin synthesis through UVB exposure; and that only one of these – UVB exposure – is a known carcinogen.
Also, some patients express concern that sunscreen itself may be a carcinogen. Oxybenzone, a common sunscreen ingredient, has demonstrated some estrogenic effects in vitro and in vivo studies. However, the rat studies often cited in support of that finding involved the use of very high doses – approximately the equivalent of 277 years of daily sunscreen application with 6% oxybenzone, a much higher concentration than is found in commercial sunscreens, she said.
For patients interested in nontopical sun protection, polypodium leucotomos extract (PLE) is an option, Dr. Harper said. PLE, an antioxidant extract from a tropical fern, can be part of a skin cancer prevention strategy that also includes good sunscreen and protective clothing. PLE works by counteracting UV-induced immunosuppression, activating the tumor suppressor p53 gene, and inhibiting cyclooxygenase-2, all of which can help protect the skin from burning.
In addition, oral nicotinamide has been shown to help repair DNA damage in human keratinocytes, and in a clinical trial, has been associated with fewer actinic keratoses and squamous cell carcinoma, compared with placebo, she said.
However, more research in these options is needed, and patients should be encouraged to follow consistent sun protection practices, Dr. Harper emphasized.
Dr. Harper disclosed relationships with companies including Allergan, Bayer, Galderma, LaRoche-Posay, Promius, Valeant, and BioPharmX.
SDEF and this news organization are owned by the same parent company.
VIDEO: Oxymetazoline approval expands options for rosacea
WAILEA, Hawaii – The Food and Drug Administration approval of oxymetazoline 1% cream for the background erythema of rosacea is big news for dermatologists and patients, according to Linda Stein Gold, MD, director of dermatology research, Henry Ford Health System, Detroit.
In studies, patients showed a two grade improvement in baseline erythema, and erythema reduction that lasted for 9-12 hours in many patients, said Dr. Stein Gold in a video interview, who was involved in the clinical trials.
“We have safety data that lasts up to an entire year, with no new safety signals,” and the incidence of exacerbation of erythema was rare, she added in a video interview at the meeting provided by Global Academy for Medical Education/Skin Disease Education Foundation. Oxymetazoline 1% cream, which will be marketed as Rhofade by Allergan, was approved in January 2017 for the “topical treatment of persistent facial erythema associated with rosacea in adults.”
Dr. Stein Gold disclosed relationships with several companies, including Galderma, Leo, Novan, Valeant, Dermira, Novartis, Celgene, Allergan, Foamix, Anacor, Medimetriks, Sol-Gel, and Promius.
SDEF and this news organization are owned by the same parent organization.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
WAILEA, Hawaii – The Food and Drug Administration approval of oxymetazoline 1% cream for the background erythema of rosacea is big news for dermatologists and patients, according to Linda Stein Gold, MD, director of dermatology research, Henry Ford Health System, Detroit.
In studies, patients showed a two grade improvement in baseline erythema, and erythema reduction that lasted for 9-12 hours in many patients, said Dr. Stein Gold in a video interview, who was involved in the clinical trials.
“We have safety data that lasts up to an entire year, with no new safety signals,” and the incidence of exacerbation of erythema was rare, she added in a video interview at the meeting provided by Global Academy for Medical Education/Skin Disease Education Foundation. Oxymetazoline 1% cream, which will be marketed as Rhofade by Allergan, was approved in January 2017 for the “topical treatment of persistent facial erythema associated with rosacea in adults.”
Dr. Stein Gold disclosed relationships with several companies, including Galderma, Leo, Novan, Valeant, Dermira, Novartis, Celgene, Allergan, Foamix, Anacor, Medimetriks, Sol-Gel, and Promius.
SDEF and this news organization are owned by the same parent organization.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
WAILEA, Hawaii – The Food and Drug Administration approval of oxymetazoline 1% cream for the background erythema of rosacea is big news for dermatologists and patients, according to Linda Stein Gold, MD, director of dermatology research, Henry Ford Health System, Detroit.
In studies, patients showed a two grade improvement in baseline erythema, and erythema reduction that lasted for 9-12 hours in many patients, said Dr. Stein Gold in a video interview, who was involved in the clinical trials.
“We have safety data that lasts up to an entire year, with no new safety signals,” and the incidence of exacerbation of erythema was rare, she added in a video interview at the meeting provided by Global Academy for Medical Education/Skin Disease Education Foundation. Oxymetazoline 1% cream, which will be marketed as Rhofade by Allergan, was approved in January 2017 for the “topical treatment of persistent facial erythema associated with rosacea in adults.”
Dr. Stein Gold disclosed relationships with several companies, including Galderma, Leo, Novan, Valeant, Dermira, Novartis, Celgene, Allergan, Foamix, Anacor, Medimetriks, Sol-Gel, and Promius.
SDEF and this news organization are owned by the same parent organization.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
AT SDEF HAWAII DERMATOLOGY SEMINAR
VIDEO: Adding methotrexate to a biologic may help achieve treatment goal
WAILEA, Hawaii – Combining methotrexate with a biologic is an off-label use for psoriasis patients but is supported by information from the psoriatic arthritis literature, said J. Mark Jackson, MD, of the University of Louisville (Ky.).
In fact, the combination treatment may improve symptoms in patients with both psoriasis and arthritis not well controlled with one drug, Dr. Jackson explained in a video interview at the meeting, provided by Global Academy for Medical Education/Skin Disease Education Foundation.
As for dosage, “I do think we can use less methotrexate in combination” with a biologic for psoriasis when using methotrexate alone, he noted. “It’s like the addition of a spice to the right dish,” he added. Patients may need “just a little bit to get them over the edge and really get them to that efficacy point that creates the success that you need.”
Dr. Jackson disclosed financial relationships with companies including AbbVie, Amgen, Celgene, Dermira, Galderma, Genentech, Janssen, Lilly, Medimetriks, Merck, Novartis, Pfizer, Promius, and Top MD.
SDEF and this news organization are owned by the same parent organization.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
WAILEA, Hawaii – Combining methotrexate with a biologic is an off-label use for psoriasis patients but is supported by information from the psoriatic arthritis literature, said J. Mark Jackson, MD, of the University of Louisville (Ky.).
In fact, the combination treatment may improve symptoms in patients with both psoriasis and arthritis not well controlled with one drug, Dr. Jackson explained in a video interview at the meeting, provided by Global Academy for Medical Education/Skin Disease Education Foundation.
As for dosage, “I do think we can use less methotrexate in combination” with a biologic for psoriasis when using methotrexate alone, he noted. “It’s like the addition of a spice to the right dish,” he added. Patients may need “just a little bit to get them over the edge and really get them to that efficacy point that creates the success that you need.”
Dr. Jackson disclosed financial relationships with companies including AbbVie, Amgen, Celgene, Dermira, Galderma, Genentech, Janssen, Lilly, Medimetriks, Merck, Novartis, Pfizer, Promius, and Top MD.
SDEF and this news organization are owned by the same parent organization.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
WAILEA, Hawaii – Combining methotrexate with a biologic is an off-label use for psoriasis patients but is supported by information from the psoriatic arthritis literature, said J. Mark Jackson, MD, of the University of Louisville (Ky.).
In fact, the combination treatment may improve symptoms in patients with both psoriasis and arthritis not well controlled with one drug, Dr. Jackson explained in a video interview at the meeting, provided by Global Academy for Medical Education/Skin Disease Education Foundation.
As for dosage, “I do think we can use less methotrexate in combination” with a biologic for psoriasis when using methotrexate alone, he noted. “It’s like the addition of a spice to the right dish,” he added. Patients may need “just a little bit to get them over the edge and really get them to that efficacy point that creates the success that you need.”
Dr. Jackson disclosed financial relationships with companies including AbbVie, Amgen, Celgene, Dermira, Galderma, Genentech, Janssen, Lilly, Medimetriks, Merck, Novartis, Pfizer, Promius, and Top MD.
SDEF and this news organization are owned by the same parent organization.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
AT SDEF HAWAII DERMATOLOGY SEMINAR
VIDEO: Interchangeability of biosimilars and parent compounds raise potential efficacy issues
WAILEA, Hawaii – Biosimilars are coming to dermatology, but their impact from a clinical and insurance standpoint has yet to be determined, according to Kenneth B. Gordon, MD, professor and chair of the department of dermatology at the Medical College of Wisconsin, Milwaukee.
Biosimilars seem to have reasonably good efficacy, and safety to date has been “pretty consistent” with safety associated with the parent compounds, but a key issue will be how they are used in patients on anti-TNF agents who have been doing well over time, Dr. Gordon said in a video interview. Because these medicines cross react in terms of immunogenicity and are not quite the same, “trying to use them interchangeably, as many insurance companies will ask us to do, is going to be difficult,” he noted.
His concern does not apply to a new patient starting on a biosimilar. “The problem I see is when insurance companies and pharmacies start mandating us going back and forth between medicines, and running into difficulty with loss of effect of those drugs,” he explained. “It’s not a safety issue, it’s more of an issue of losing efficacy of a formerly active drug,” he said at the meeting provided by Global Academy for Medical Education/Skin Disease Education Foundation.
Dr. Gordon disclosed financial relationships with AbbVie, Amgen, Boehringer Ingelheim, Janssen, Lilly, Celgene, Novartis, and Sun.
SDEF and this news organization are owned by the same parent organization.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
WAILEA, Hawaii – Biosimilars are coming to dermatology, but their impact from a clinical and insurance standpoint has yet to be determined, according to Kenneth B. Gordon, MD, professor and chair of the department of dermatology at the Medical College of Wisconsin, Milwaukee.
Biosimilars seem to have reasonably good efficacy, and safety to date has been “pretty consistent” with safety associated with the parent compounds, but a key issue will be how they are used in patients on anti-TNF agents who have been doing well over time, Dr. Gordon said in a video interview. Because these medicines cross react in terms of immunogenicity and are not quite the same, “trying to use them interchangeably, as many insurance companies will ask us to do, is going to be difficult,” he noted.
His concern does not apply to a new patient starting on a biosimilar. “The problem I see is when insurance companies and pharmacies start mandating us going back and forth between medicines, and running into difficulty with loss of effect of those drugs,” he explained. “It’s not a safety issue, it’s more of an issue of losing efficacy of a formerly active drug,” he said at the meeting provided by Global Academy for Medical Education/Skin Disease Education Foundation.
Dr. Gordon disclosed financial relationships with AbbVie, Amgen, Boehringer Ingelheim, Janssen, Lilly, Celgene, Novartis, and Sun.
SDEF and this news organization are owned by the same parent organization.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
WAILEA, Hawaii – Biosimilars are coming to dermatology, but their impact from a clinical and insurance standpoint has yet to be determined, according to Kenneth B. Gordon, MD, professor and chair of the department of dermatology at the Medical College of Wisconsin, Milwaukee.
Biosimilars seem to have reasonably good efficacy, and safety to date has been “pretty consistent” with safety associated with the parent compounds, but a key issue will be how they are used in patients on anti-TNF agents who have been doing well over time, Dr. Gordon said in a video interview. Because these medicines cross react in terms of immunogenicity and are not quite the same, “trying to use them interchangeably, as many insurance companies will ask us to do, is going to be difficult,” he noted.
His concern does not apply to a new patient starting on a biosimilar. “The problem I see is when insurance companies and pharmacies start mandating us going back and forth between medicines, and running into difficulty with loss of effect of those drugs,” he explained. “It’s not a safety issue, it’s more of an issue of losing efficacy of a formerly active drug,” he said at the meeting provided by Global Academy for Medical Education/Skin Disease Education Foundation.
Dr. Gordon disclosed financial relationships with AbbVie, Amgen, Boehringer Ingelheim, Janssen, Lilly, Celgene, Novartis, and Sun.
SDEF and this news organization are owned by the same parent organization.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
AT SDEF HAWAII DERMATOLOGY SEMINAR
VIDEO: Spironolactone holds its own for treating women’s acne
WAILEA, Hawaii – While spironolactone is an old drug, it remains a safe and effective treatment option for acne in women, according to Julie Harper, MD, of the University of Alabama, Birmingham.
In a video interview, Dr. Harper said that she usually does not choose spironolactone as a first-line drug, “but more often than not this is a drug that is an add-on to other therapies” that have been tried. She tends to start with a low dose and titrates up based on side effects. The drug has been tested in men, but Dr. Harper cited a Japanese study that discontinued a male treatment arm because men developed gynecomastia.
In her opinion, it isn’t always necessary to routinely check potassium levels in patients on spironolactone. “In the vast majority of patients, I do not check labs routinely” before starting spironolactone, she said at the meeting, provided by Global Academy for Medical Education/Skin Disease Education Foundation. But she noted that some physicians feel more comfortable checking baseline labs.
Dr. Harper disclosed financial relationships with Allergan, Galderma, BioPharmX, La Roche-Posay, Promius, Valeant, and Bayer.
SDEF and this news organization are owned by the same parent organization.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
WAILEA, Hawaii – While spironolactone is an old drug, it remains a safe and effective treatment option for acne in women, according to Julie Harper, MD, of the University of Alabama, Birmingham.
In a video interview, Dr. Harper said that she usually does not choose spironolactone as a first-line drug, “but more often than not this is a drug that is an add-on to other therapies” that have been tried. She tends to start with a low dose and titrates up based on side effects. The drug has been tested in men, but Dr. Harper cited a Japanese study that discontinued a male treatment arm because men developed gynecomastia.
In her opinion, it isn’t always necessary to routinely check potassium levels in patients on spironolactone. “In the vast majority of patients, I do not check labs routinely” before starting spironolactone, she said at the meeting, provided by Global Academy for Medical Education/Skin Disease Education Foundation. But she noted that some physicians feel more comfortable checking baseline labs.
Dr. Harper disclosed financial relationships with Allergan, Galderma, BioPharmX, La Roche-Posay, Promius, Valeant, and Bayer.
SDEF and this news organization are owned by the same parent organization.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
WAILEA, Hawaii – While spironolactone is an old drug, it remains a safe and effective treatment option for acne in women, according to Julie Harper, MD, of the University of Alabama, Birmingham.
In a video interview, Dr. Harper said that she usually does not choose spironolactone as a first-line drug, “but more often than not this is a drug that is an add-on to other therapies” that have been tried. She tends to start with a low dose and titrates up based on side effects. The drug has been tested in men, but Dr. Harper cited a Japanese study that discontinued a male treatment arm because men developed gynecomastia.
In her opinion, it isn’t always necessary to routinely check potassium levels in patients on spironolactone. “In the vast majority of patients, I do not check labs routinely” before starting spironolactone, she said at the meeting, provided by Global Academy for Medical Education/Skin Disease Education Foundation. But she noted that some physicians feel more comfortable checking baseline labs.
Dr. Harper disclosed financial relationships with Allergan, Galderma, BioPharmX, La Roche-Posay, Promius, Valeant, and Bayer.
SDEF and this news organization are owned by the same parent organization.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
AT SDEF HAWAII DERMATOLOGY SEMINAR
SDEF experts tackle atopic dermatitis
Atopic dermatitis (AD) is among the nuts and bolts of any dermatology practice, and as such, gets its time in the spotlight at SDEF’s Annual Hawaii Dermatology Seminar.
This year, SDEF celebrates 41 years of educating dermatologists with the latest in dermatology, featuring presentations from experts on topics ranging from AD treatments and skin cancer chemoprevention to botulinum toxin injections and fillers.
Also last year, Joseph F. Fowler Jr., MD, meeting codirector and clinical professor of dermatology at the University of Louisville (Ky.), shared in a video interview his perspective on addressing parents’ safety concerns about the boxed warning for topical calcineurin inhibitors.
Watch for more coverage and comments from experts at this year’s meeting.
SDEF and this news organization are owned by the same parent company.
Atopic dermatitis (AD) is among the nuts and bolts of any dermatology practice, and as such, gets its time in the spotlight at SDEF’s Annual Hawaii Dermatology Seminar.
This year, SDEF celebrates 41 years of educating dermatologists with the latest in dermatology, featuring presentations from experts on topics ranging from AD treatments and skin cancer chemoprevention to botulinum toxin injections and fillers.
Also last year, Joseph F. Fowler Jr., MD, meeting codirector and clinical professor of dermatology at the University of Louisville (Ky.), shared in a video interview his perspective on addressing parents’ safety concerns about the boxed warning for topical calcineurin inhibitors.
Watch for more coverage and comments from experts at this year’s meeting.
SDEF and this news organization are owned by the same parent company.
Atopic dermatitis (AD) is among the nuts and bolts of any dermatology practice, and as such, gets its time in the spotlight at SDEF’s Annual Hawaii Dermatology Seminar.
This year, SDEF celebrates 41 years of educating dermatologists with the latest in dermatology, featuring presentations from experts on topics ranging from AD treatments and skin cancer chemoprevention to botulinum toxin injections and fillers.
Also last year, Joseph F. Fowler Jr., MD, meeting codirector and clinical professor of dermatology at the University of Louisville (Ky.), shared in a video interview his perspective on addressing parents’ safety concerns about the boxed warning for topical calcineurin inhibitors.
Watch for more coverage and comments from experts at this year’s meeting.
SDEF and this news organization are owned by the same parent company.
An insider’s guide to aesthetic dermatology
When aesthetic dermatology takes the stage at SDEF’s Annual Hawaii Dermatology Seminar, experts will address the latest tips for successful outcomes with filler and toxins, offer guidance on choosing devices, and explain how to make the most of cosmeceuticals in a dermatology practice.
Christopher B. Zachary, MD, meeting codirector and professor and chair of the department of dermatology at the University of California, Irvine, cochairs a pair of aesthetic and procedural dermatology sessions with Michael S. Kaminer, MD, of Yale University, New Haven, Conn., and SkinCare Physicians, Chestnut Hill, Mass.
Last year, Dr. Zachary and a panel of expert aesthetic dermatologists addressed the enduring value of topical retinoids for facial rejuvenation. Read their comments here.
Stay tuned for the latest tips and techniques in aesthetic dermatology from the 2017 SDEF Hawaii Dermatology Seminar.
When aesthetic dermatology takes the stage at SDEF’s Annual Hawaii Dermatology Seminar, experts will address the latest tips for successful outcomes with filler and toxins, offer guidance on choosing devices, and explain how to make the most of cosmeceuticals in a dermatology practice.
Christopher B. Zachary, MD, meeting codirector and professor and chair of the department of dermatology at the University of California, Irvine, cochairs a pair of aesthetic and procedural dermatology sessions with Michael S. Kaminer, MD, of Yale University, New Haven, Conn., and SkinCare Physicians, Chestnut Hill, Mass.
Last year, Dr. Zachary and a panel of expert aesthetic dermatologists addressed the enduring value of topical retinoids for facial rejuvenation. Read their comments here.
Stay tuned for the latest tips and techniques in aesthetic dermatology from the 2017 SDEF Hawaii Dermatology Seminar.
When aesthetic dermatology takes the stage at SDEF’s Annual Hawaii Dermatology Seminar, experts will address the latest tips for successful outcomes with filler and toxins, offer guidance on choosing devices, and explain how to make the most of cosmeceuticals in a dermatology practice.
Christopher B. Zachary, MD, meeting codirector and professor and chair of the department of dermatology at the University of California, Irvine, cochairs a pair of aesthetic and procedural dermatology sessions with Michael S. Kaminer, MD, of Yale University, New Haven, Conn., and SkinCare Physicians, Chestnut Hill, Mass.
Last year, Dr. Zachary and a panel of expert aesthetic dermatologists addressed the enduring value of topical retinoids for facial rejuvenation. Read their comments here.
Stay tuned for the latest tips and techniques in aesthetic dermatology from the 2017 SDEF Hawaii Dermatology Seminar.
Topical treatments for rosacea to be reviewed at this year’s meeting
This year’s SDEF Hawaii Dermatology Seminar is set to showcase the latest research and expert tips, advice, and perspective on a range of topics.
Linda Stein Gold, MD, director of dermatology research, Henry Ford Health System, Detroit, and a codirector of the meeting, shared a taste of the topics she will be presenting.
In the field of rosacea, “topical ivermectin has proven to be a very effective and safe treatment,” she said in an interview. “On the horizon we will have a new treatment for the erythema of rosacea which seems very well tolerated. Also, topical minocycline foam appears to be very promising in phase II studies.”
See our video interview with Dr. Stein Gold from last year’s Hawaii Dermatology Seminar, where she discussed new approaches for the topical treatment of acne that are on the horizon.
The Hawaii Dermatology Seminar is provided by Global Academy for Medical Education/Skin Disease Education Foundation. SDEF and this news organization are owned by the same parent company. It is being held in Maui, Jan. 29-Feb. 3.
Dr. Stein Gold disclosed relationships with companies including Galderma, Leo, Novan, Valeant, Dermira, Novartis, Celgene, Allergan, Foamix, and Promius.
This year’s SDEF Hawaii Dermatology Seminar is set to showcase the latest research and expert tips, advice, and perspective on a range of topics.
Linda Stein Gold, MD, director of dermatology research, Henry Ford Health System, Detroit, and a codirector of the meeting, shared a taste of the topics she will be presenting.
In the field of rosacea, “topical ivermectin has proven to be a very effective and safe treatment,” she said in an interview. “On the horizon we will have a new treatment for the erythema of rosacea which seems very well tolerated. Also, topical minocycline foam appears to be very promising in phase II studies.”
See our video interview with Dr. Stein Gold from last year’s Hawaii Dermatology Seminar, where she discussed new approaches for the topical treatment of acne that are on the horizon.
The Hawaii Dermatology Seminar is provided by Global Academy for Medical Education/Skin Disease Education Foundation. SDEF and this news organization are owned by the same parent company. It is being held in Maui, Jan. 29-Feb. 3.
Dr. Stein Gold disclosed relationships with companies including Galderma, Leo, Novan, Valeant, Dermira, Novartis, Celgene, Allergan, Foamix, and Promius.
This year’s SDEF Hawaii Dermatology Seminar is set to showcase the latest research and expert tips, advice, and perspective on a range of topics.
Linda Stein Gold, MD, director of dermatology research, Henry Ford Health System, Detroit, and a codirector of the meeting, shared a taste of the topics she will be presenting.
In the field of rosacea, “topical ivermectin has proven to be a very effective and safe treatment,” she said in an interview. “On the horizon we will have a new treatment for the erythema of rosacea which seems very well tolerated. Also, topical minocycline foam appears to be very promising in phase II studies.”
See our video interview with Dr. Stein Gold from last year’s Hawaii Dermatology Seminar, where she discussed new approaches for the topical treatment of acne that are on the horizon.
The Hawaii Dermatology Seminar is provided by Global Academy for Medical Education/Skin Disease Education Foundation. SDEF and this news organization are owned by the same parent company. It is being held in Maui, Jan. 29-Feb. 3.
Dr. Stein Gold disclosed relationships with companies including Galderma, Leo, Novan, Valeant, Dermira, Novartis, Celgene, Allergan, Foamix, and Promius.
Children in United States vaccinated for polio elsewhere may require revaccination
Poliovirus vaccinations for children in the United States who may have been vaccinated elsewhere must meet Advisory Committee on Immunization Practices recommendations to ensure protection against all three poliovirus types, according to guidance published in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.
Although the United States continues to use an inactivated polio vaccine (IPV) that contains all three types, other countries using an oral polio vaccine (OPV) switched from a trivalent oral poliovirus vaccine (tOPV) to a bivalent version (bOPV) after the World Health Organization declared type 2 polio virus eradicated in September 2015.
The researchers note that only written, dated records are acceptable evidence of complete vaccination, and documentation of polio vaccination outside of the United States should specify that the child has been vaccinated against all three types. “If both tOPV and IPV were administered as part of a series, the total number of doses needed to complete the series is the same as that recommended for the U.S. IPV schedule,” they wrote. That is, all infants and children should receive four doses of IPV at ages 2 months, 4 months, 6-18 months, and at 4-6 years. The minimum interval between the third and fourth doses should be 6 months.
Children younger than 18 years lacking written, dated documentation of poliovirus vaccination should be vaccinated or revaccinated according to the U.S. IPV schedule for their age, according to the guidelines.
Serologic testing, once used to confirm immunity to polio, is not recommended as a measure of immunity in the United States because antibody testing against type 2 poliovirus often is not available, the researchers added.
The full guidelines are available at MMWR. 2017 Jan 13. doi: 10.15585/mmwr.mm6601a6.
Poliovirus vaccinations for children in the United States who may have been vaccinated elsewhere must meet Advisory Committee on Immunization Practices recommendations to ensure protection against all three poliovirus types, according to guidance published in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.
Although the United States continues to use an inactivated polio vaccine (IPV) that contains all three types, other countries using an oral polio vaccine (OPV) switched from a trivalent oral poliovirus vaccine (tOPV) to a bivalent version (bOPV) after the World Health Organization declared type 2 polio virus eradicated in September 2015.
The researchers note that only written, dated records are acceptable evidence of complete vaccination, and documentation of polio vaccination outside of the United States should specify that the child has been vaccinated against all three types. “If both tOPV and IPV were administered as part of a series, the total number of doses needed to complete the series is the same as that recommended for the U.S. IPV schedule,” they wrote. That is, all infants and children should receive four doses of IPV at ages 2 months, 4 months, 6-18 months, and at 4-6 years. The minimum interval between the third and fourth doses should be 6 months.
Children younger than 18 years lacking written, dated documentation of poliovirus vaccination should be vaccinated or revaccinated according to the U.S. IPV schedule for their age, according to the guidelines.
Serologic testing, once used to confirm immunity to polio, is not recommended as a measure of immunity in the United States because antibody testing against type 2 poliovirus often is not available, the researchers added.
The full guidelines are available at MMWR. 2017 Jan 13. doi: 10.15585/mmwr.mm6601a6.
Poliovirus vaccinations for children in the United States who may have been vaccinated elsewhere must meet Advisory Committee on Immunization Practices recommendations to ensure protection against all three poliovirus types, according to guidance published in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.
Although the United States continues to use an inactivated polio vaccine (IPV) that contains all three types, other countries using an oral polio vaccine (OPV) switched from a trivalent oral poliovirus vaccine (tOPV) to a bivalent version (bOPV) after the World Health Organization declared type 2 polio virus eradicated in September 2015.
The researchers note that only written, dated records are acceptable evidence of complete vaccination, and documentation of polio vaccination outside of the United States should specify that the child has been vaccinated against all three types. “If both tOPV and IPV were administered as part of a series, the total number of doses needed to complete the series is the same as that recommended for the U.S. IPV schedule,” they wrote. That is, all infants and children should receive four doses of IPV at ages 2 months, 4 months, 6-18 months, and at 4-6 years. The minimum interval between the third and fourth doses should be 6 months.
Children younger than 18 years lacking written, dated documentation of poliovirus vaccination should be vaccinated or revaccinated according to the U.S. IPV schedule for their age, according to the guidelines.
Serologic testing, once used to confirm immunity to polio, is not recommended as a measure of immunity in the United States because antibody testing against type 2 poliovirus often is not available, the researchers added.
The full guidelines are available at MMWR. 2017 Jan 13. doi: 10.15585/mmwr.mm6601a6.
FROM MMWR
High-risk relatives of MS patients show early signs of disease
Asymptomatic first-degree relatives of multiple sclerosis patients at high risk for developing the disease were significantly more likely to show subclinical signs of MS than were family members at lower risk, in the Genes and Environment in Multiple Sclerosis prospective cohort study. The findings were published online on Jan. 17 in JAMA Neurology.
The Genes and Environment in Multiple Sclerosis (GEMS) project is the first prospective study of populations at risk for MS and is the first detailed cross-sectional examination of higher-risk and lower-risk family members to date, according to investigators led by Zongqi Xia, MD, PhD, of Brigham and Women’s Hospital, Boston. Although the totality of evidence put together through neuroimaging and numerous clinical tests in the study indicate that individuals with the highest risk for MS have higher risk for the disease than do those with the lowest risk, simple vibration threshold testing gave the best results, Dr. Xia and his colleagues reported.
The study involved 100 neurologically asymptomatic adults aged 18-50 years who were first-degree relatives of people with MS who participated in the GEMS project during August 2012 to July 2015. These 100 comprised 41 high-risk participants from the top 10% of a Genetic and Environmental Risk Score (GERS) and 59 low-risk participants from the bottom 10% on the GERS. The GERS included genetic risk factors (HLA alleles and several MS-associated non-HLA genetic variants) and environmental factors, such as smoking status, body mass index, history of infectious mononucleosis and migraine, and vitamin D levels.
However, because 40 of the 41 high-risk individuals were female and 25 of the 59 low-risk individuals were female, the investigators limited the study to the 65 female participants to avoid “attributing any potential difference primarily to the role of sex.”
To help in identifying early signs of MS, the researchers used brain MRI and optical coherence tomography and other measures of neurological function, including the Expanded Disability Status Scale, timed 25-foot walk, Nine-Hole Peg Test, Paced Auditory Serial Addition Test, Symbol Digit Modalities Test, Timed Up and Go, and high-contrast and low-contrast visual acuity (JAMA Neurol. 2017 Jan 17. doi: 10.1001/jamaneurol.2016.5056).
Overall, high-risk women showed more subclinical signs of MS than did low-risk women based on an omnibus test that globally assessed the burden of neurological dysfunction by comparing the overall differences between the two groups when considering all of the measured outcomes (P = .01). However, impaired vibration perception yielded a stronger result; of 47 women (27 high-risk and 20 low-risk) tested in this manner, high-risk women showed significantly reduced vibration perception in the distal lower extremities (P = .008).
One individual in the high-risk group converted to clinically definite MS during the study. Four of the high-risk women had T2-weighted hyperintense lesions that met the 2010 McDonald MRI criteria for dissemination in space, compared with one low-risk woman. The 2016 proposed consensus MRI criteria for MS diagnosis were met by two high-risk women and one low-risk woman. Radiological isolated syndrome occurred in one woman of each group, and there was a single foci of leptominengeal enhancement in three high-risk women and one low-risk woman.
The findings were limited by several factors including the small size, lack of male participants, cross-sectional nature of the study, and the fact that vibration sensitivity thresholds were in the normal range for high-risk and low-risk individuals. However, the researchers wrote that they “plan to confirm the finding of change in vibration sensitivity with a follow-up study,” and they noted that the “study highlights the important need to develop and test more sensitive measures, particularly with biometric devices, to detect subtle subclinical changes early in the disease process.”
The National Institutes of Health and the National Multiple Sclerosis Society supported the study. Some of the authors reported receiving awards from the National Multiple Sclerosis Society, the American Academy of Neurology, and the National Institute of Neurological Disorders and Stroke.
The GEMS study represents the most ambitious effort yet to identify presymptomatic individuals who are at increased risk for MS, and it is a valuable first step toward targeted screening. Even if we cannot yet intervene therapeutically using currently available disease-modifying treatments in presymptomatic stages of MS, the ability to better define high-risk individuals is likely to make active surveillance programs more cost effective. It also provides important information to counsel individuals about lifestyle changes, such as quitting smoking.
The GERS also can likely be further refined with more up-to-date data on the interaction between specific genetic and environmental factors.
Fredrik Piehl, MD, PhD, is a member of the department of neurology at the Karolinska Institutet and Karolinska University Hospital, Stockholm. His comments are derived from an editorial accompanying the report by Dr. Xia and colleagues (JAMA Neurol. 2017 Jan 17. doi: 10.1001/jamaneurol.2016.5126). He disclosed research support, travel grants, and other relationships with Biogen, Genzyme, Novartis, Merck, Roche, Serono, and Teva.
The GEMS study represents the most ambitious effort yet to identify presymptomatic individuals who are at increased risk for MS, and it is a valuable first step toward targeted screening. Even if we cannot yet intervene therapeutically using currently available disease-modifying treatments in presymptomatic stages of MS, the ability to better define high-risk individuals is likely to make active surveillance programs more cost effective. It also provides important information to counsel individuals about lifestyle changes, such as quitting smoking.
The GERS also can likely be further refined with more up-to-date data on the interaction between specific genetic and environmental factors.
Fredrik Piehl, MD, PhD, is a member of the department of neurology at the Karolinska Institutet and Karolinska University Hospital, Stockholm. His comments are derived from an editorial accompanying the report by Dr. Xia and colleagues (JAMA Neurol. 2017 Jan 17. doi: 10.1001/jamaneurol.2016.5126). He disclosed research support, travel grants, and other relationships with Biogen, Genzyme, Novartis, Merck, Roche, Serono, and Teva.
The GEMS study represents the most ambitious effort yet to identify presymptomatic individuals who are at increased risk for MS, and it is a valuable first step toward targeted screening. Even if we cannot yet intervene therapeutically using currently available disease-modifying treatments in presymptomatic stages of MS, the ability to better define high-risk individuals is likely to make active surveillance programs more cost effective. It also provides important information to counsel individuals about lifestyle changes, such as quitting smoking.
The GERS also can likely be further refined with more up-to-date data on the interaction between specific genetic and environmental factors.
Fredrik Piehl, MD, PhD, is a member of the department of neurology at the Karolinska Institutet and Karolinska University Hospital, Stockholm. His comments are derived from an editorial accompanying the report by Dr. Xia and colleagues (JAMA Neurol. 2017 Jan 17. doi: 10.1001/jamaneurol.2016.5126). He disclosed research support, travel grants, and other relationships with Biogen, Genzyme, Novartis, Merck, Roche, Serono, and Teva.
Asymptomatic first-degree relatives of multiple sclerosis patients at high risk for developing the disease were significantly more likely to show subclinical signs of MS than were family members at lower risk, in the Genes and Environment in Multiple Sclerosis prospective cohort study. The findings were published online on Jan. 17 in JAMA Neurology.
The Genes and Environment in Multiple Sclerosis (GEMS) project is the first prospective study of populations at risk for MS and is the first detailed cross-sectional examination of higher-risk and lower-risk family members to date, according to investigators led by Zongqi Xia, MD, PhD, of Brigham and Women’s Hospital, Boston. Although the totality of evidence put together through neuroimaging and numerous clinical tests in the study indicate that individuals with the highest risk for MS have higher risk for the disease than do those with the lowest risk, simple vibration threshold testing gave the best results, Dr. Xia and his colleagues reported.
The study involved 100 neurologically asymptomatic adults aged 18-50 years who were first-degree relatives of people with MS who participated in the GEMS project during August 2012 to July 2015. These 100 comprised 41 high-risk participants from the top 10% of a Genetic and Environmental Risk Score (GERS) and 59 low-risk participants from the bottom 10% on the GERS. The GERS included genetic risk factors (HLA alleles and several MS-associated non-HLA genetic variants) and environmental factors, such as smoking status, body mass index, history of infectious mononucleosis and migraine, and vitamin D levels.
However, because 40 of the 41 high-risk individuals were female and 25 of the 59 low-risk individuals were female, the investigators limited the study to the 65 female participants to avoid “attributing any potential difference primarily to the role of sex.”
To help in identifying early signs of MS, the researchers used brain MRI and optical coherence tomography and other measures of neurological function, including the Expanded Disability Status Scale, timed 25-foot walk, Nine-Hole Peg Test, Paced Auditory Serial Addition Test, Symbol Digit Modalities Test, Timed Up and Go, and high-contrast and low-contrast visual acuity (JAMA Neurol. 2017 Jan 17. doi: 10.1001/jamaneurol.2016.5056).
Overall, high-risk women showed more subclinical signs of MS than did low-risk women based on an omnibus test that globally assessed the burden of neurological dysfunction by comparing the overall differences between the two groups when considering all of the measured outcomes (P = .01). However, impaired vibration perception yielded a stronger result; of 47 women (27 high-risk and 20 low-risk) tested in this manner, high-risk women showed significantly reduced vibration perception in the distal lower extremities (P = .008).
One individual in the high-risk group converted to clinically definite MS during the study. Four of the high-risk women had T2-weighted hyperintense lesions that met the 2010 McDonald MRI criteria for dissemination in space, compared with one low-risk woman. The 2016 proposed consensus MRI criteria for MS diagnosis were met by two high-risk women and one low-risk woman. Radiological isolated syndrome occurred in one woman of each group, and there was a single foci of leptominengeal enhancement in three high-risk women and one low-risk woman.
The findings were limited by several factors including the small size, lack of male participants, cross-sectional nature of the study, and the fact that vibration sensitivity thresholds were in the normal range for high-risk and low-risk individuals. However, the researchers wrote that they “plan to confirm the finding of change in vibration sensitivity with a follow-up study,” and they noted that the “study highlights the important need to develop and test more sensitive measures, particularly with biometric devices, to detect subtle subclinical changes early in the disease process.”
The National Institutes of Health and the National Multiple Sclerosis Society supported the study. Some of the authors reported receiving awards from the National Multiple Sclerosis Society, the American Academy of Neurology, and the National Institute of Neurological Disorders and Stroke.
Asymptomatic first-degree relatives of multiple sclerosis patients at high risk for developing the disease were significantly more likely to show subclinical signs of MS than were family members at lower risk, in the Genes and Environment in Multiple Sclerosis prospective cohort study. The findings were published online on Jan. 17 in JAMA Neurology.
The Genes and Environment in Multiple Sclerosis (GEMS) project is the first prospective study of populations at risk for MS and is the first detailed cross-sectional examination of higher-risk and lower-risk family members to date, according to investigators led by Zongqi Xia, MD, PhD, of Brigham and Women’s Hospital, Boston. Although the totality of evidence put together through neuroimaging and numerous clinical tests in the study indicate that individuals with the highest risk for MS have higher risk for the disease than do those with the lowest risk, simple vibration threshold testing gave the best results, Dr. Xia and his colleagues reported.
The study involved 100 neurologically asymptomatic adults aged 18-50 years who were first-degree relatives of people with MS who participated in the GEMS project during August 2012 to July 2015. These 100 comprised 41 high-risk participants from the top 10% of a Genetic and Environmental Risk Score (GERS) and 59 low-risk participants from the bottom 10% on the GERS. The GERS included genetic risk factors (HLA alleles and several MS-associated non-HLA genetic variants) and environmental factors, such as smoking status, body mass index, history of infectious mononucleosis and migraine, and vitamin D levels.
However, because 40 of the 41 high-risk individuals were female and 25 of the 59 low-risk individuals were female, the investigators limited the study to the 65 female participants to avoid “attributing any potential difference primarily to the role of sex.”
To help in identifying early signs of MS, the researchers used brain MRI and optical coherence tomography and other measures of neurological function, including the Expanded Disability Status Scale, timed 25-foot walk, Nine-Hole Peg Test, Paced Auditory Serial Addition Test, Symbol Digit Modalities Test, Timed Up and Go, and high-contrast and low-contrast visual acuity (JAMA Neurol. 2017 Jan 17. doi: 10.1001/jamaneurol.2016.5056).
Overall, high-risk women showed more subclinical signs of MS than did low-risk women based on an omnibus test that globally assessed the burden of neurological dysfunction by comparing the overall differences between the two groups when considering all of the measured outcomes (P = .01). However, impaired vibration perception yielded a stronger result; of 47 women (27 high-risk and 20 low-risk) tested in this manner, high-risk women showed significantly reduced vibration perception in the distal lower extremities (P = .008).
One individual in the high-risk group converted to clinically definite MS during the study. Four of the high-risk women had T2-weighted hyperintense lesions that met the 2010 McDonald MRI criteria for dissemination in space, compared with one low-risk woman. The 2016 proposed consensus MRI criteria for MS diagnosis were met by two high-risk women and one low-risk woman. Radiological isolated syndrome occurred in one woman of each group, and there was a single foci of leptominengeal enhancement in three high-risk women and one low-risk woman.
The findings were limited by several factors including the small size, lack of male participants, cross-sectional nature of the study, and the fact that vibration sensitivity thresholds were in the normal range for high-risk and low-risk individuals. However, the researchers wrote that they “plan to confirm the finding of change in vibration sensitivity with a follow-up study,” and they noted that the “study highlights the important need to develop and test more sensitive measures, particularly with biometric devices, to detect subtle subclinical changes early in the disease process.”
The National Institutes of Health and the National Multiple Sclerosis Society supported the study. Some of the authors reported receiving awards from the National Multiple Sclerosis Society, the American Academy of Neurology, and the National Institute of Neurological Disorders and Stroke.
FROM JAMA NEUROLOGY
Key clinical point: Higher-risk asymptomatic female family relatives of patients with MS are more likely to have early subclinical manifestations of the disease and deserve further monitoring.
Major finding: Women at high risk for MS scored significantly higher on a composite of measured outcomes (P = .01) and on a vibration sensitivity test (P = .008), compared with lower-risk women.
Data source: A prospective, cross-sectional, cohort study of 65 adult women at risk for MS.
Disclosures: The National Institutes of Health and the National Multiple Sclerosis Society supported the study. Some of the authors reported receiving awards from the National Multiple Sclerosis Society, the American Academy of Neurology, and the National Institute of Neurological Disorders and Stroke.