Heidi Splete

WASHINGTON – Options and opportunity are the keys to navigating the 2014-2015 flu season, according to a panel of experts at a press conference sponsored by the National Foundation for Infectious Diseases.

“The easier we make it for people to get vaccinated, the more likely they are to get vaccinated,” said CDC Director Thomas Frieden, who received his flu shot at the press conference.

In interviews at the conference, Dr. Frieden, Dr. Paul A. Offit of the Children’s Hospital of Philadelphia; Dr. Laura E. Riley of Massachusetts General Hospital, Boston; and Dr. William Schaffner of Vanderbilt University, Nashville, Tenn., discussed making the most of opportunities to vaccinate patients, offering reassurance about vaccine safety (especially for pregnant women), setting an example in your practice by getting vaccinated yourself, and ensuring that everyone who works in your office receives a flu vaccine as well. 

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WASHINGTON – Options and opportunity are the keys to navigating the 2014-2015 flu season, according to a panel of experts at a press conference sponsored by the National Foundation for Infectious Diseases.

“The easier we make it for people to get vaccinated, the more likely they are to get vaccinated,” said CDC Director Thomas Frieden, who received his flu shot at the press conference.

In interviews at the conference, Dr. Frieden, Dr. Paul A. Offit of the Children’s Hospital of Philadelphia; Dr. Laura E. Riley of Massachusetts General Hospital, Boston; and Dr. William Schaffner of Vanderbilt University, Nashville, Tenn., discussed making the most of opportunities to vaccinate patients, offering reassurance about vaccine safety (especially for pregnant women), setting an example in your practice by getting vaccinated yourself, and ensuring that everyone who works in your office receives a flu vaccine as well. 

[email protected]

WASHINGTON – Options and opportunity are the keys to navigating the 2014-2015 flu season, according to a panel of experts at a press conference sponsored by the National Foundation for Infectious Diseases.

“The easier we make it for people to get vaccinated, the more likely they are to get vaccinated,” said CDC Director Thomas Frieden, who received his flu shot at the press conference.

In interviews at the conference, Dr. Frieden, Dr. Paul A. Offit of the Children’s Hospital of Philadelphia; Dr. Laura E. Riley of Massachusetts General Hospital, Boston; and Dr. William Schaffner of Vanderbilt University, Nashville, Tenn., discussed making the most of opportunities to vaccinate patients, offering reassurance about vaccine safety (especially for pregnant women), setting an example in your practice by getting vaccinated yourself, and ensuring that everyone who works in your office receives a flu vaccine as well. 

[email protected]

EDINBURGH – Is population screening for skin cancer worthwhile?

Yes, Dr. Eckhard Breitbart said in a debate at the 15th World Congress on Cancers of the Skin. "Screening is not a diagnostic procedure," he noted. But the potential benefits of screening, including a significant reduction in medical costs, outweigh the potential harms related to false negative or false positive findings, added Dr. Breitbart, a dermatologist in Hamburg, Germany.

In an interview at the meeting, Dr. Breitbart reviewed the findings from his study of the impact of a population-based skin cancer screening program in Germany, and he discussed what research is needed to support such screening elsewhere.

[email protected]

EDINBURGH – Is population screening for skin cancer worthwhile?

Yes, Dr. Eckhard Breitbart said in a debate at the 15th World Congress on Cancers of the Skin. "Screening is not a diagnostic procedure," he noted. But the potential benefits of screening, including a significant reduction in medical costs, outweigh the potential harms related to false negative or false positive findings, added Dr. Breitbart, a dermatologist in Hamburg, Germany.

In an interview at the meeting, Dr. Breitbart reviewed the findings from his study of the impact of a population-based skin cancer screening program in Germany, and he discussed what research is needed to support such screening elsewhere.

[email protected]

EDINBURGH – Is population screening for skin cancer worthwhile?

Yes, Dr. Eckhard Breitbart said in a debate at the 15th World Congress on Cancers of the Skin. "Screening is not a diagnostic procedure," he noted. But the potential benefits of screening, including a significant reduction in medical costs, outweigh the potential harms related to false negative or false positive findings, added Dr. Breitbart, a dermatologist in Hamburg, Germany.

In an interview at the meeting, Dr. Breitbart reviewed the findings from his study of the impact of a population-based skin cancer screening program in Germany, and he discussed what research is needed to support such screening elsewhere.

[email protected]

EDINBURGH – How would you like a smartphone app that offers a personalized sun protection strategy based on location and skin type?

At the 15th World Congress on Cancers of the Skin, Nina Goad, head of communications for the British Association of Dermatologists, discussed an app that does just that: the World UV App. The app, developed by the British Association of Dermatologists, provides daily UV forecasts based on an individual’s location via a smartphone or tablet. In addition, the app fine-tunes UV risk according to skin type.

In a video interview at the meeting, Ms. Goad discussed the app’s development and how patients can use it to improve their approach to sun protection.

[email protected]

EDINBURGH – How would you like a smartphone app that offers a personalized sun protection strategy based on location and skin type?

At the 15th World Congress on Cancers of the Skin, Nina Goad, head of communications for the British Association of Dermatologists, discussed an app that does just that: the World UV App. The app, developed by the British Association of Dermatologists, provides daily UV forecasts based on an individual’s location via a smartphone or tablet. In addition, the app fine-tunes UV risk according to skin type.

In a video interview at the meeting, Ms. Goad discussed the app’s development and how patients can use it to improve their approach to sun protection.

[email protected]

EDINBURGH – How would you like a smartphone app that offers a personalized sun protection strategy based on location and skin type?

At the 15th World Congress on Cancers of the Skin, Nina Goad, head of communications for the British Association of Dermatologists, discussed an app that does just that: the World UV App. The app, developed by the British Association of Dermatologists, provides daily UV forecasts based on an individual’s location via a smartphone or tablet. In addition, the app fine-tunes UV risk according to skin type.

In a video interview at the meeting, Ms. Goad discussed the app’s development and how patients can use it to improve their approach to sun protection.

[email protected]

Complete clearance occurred at 12 months in 31% of patients who received field treatment with ingenol mebutate gel after cryotherapy for actinic keratoses, compared with 19% of placebo patients in a phase III trial.

The findings were published in the June issue of the Journal of Drugs in Dermatology.

Recurrence rates for AKs treated with cryotherapy alone are high, possibly because the treatment is lesion-directed and fails to address field cancerization, wrote Dr. Brian Berman of the University of Miami.

The FIELD study 1, a phase III, multicenter, randomized trial, showed that ingenol mebutate gel was safe and effective as a follow-up to cryosurgery for AKs. Short-term efficacy data (11 weeks) have been previously reported.

In this study, the patients were followed for 12 months (J. Drugs Dermatol. 2014;13:741-7).

"In phase III clinical trials, 2 or 3 days of field-directed therapy with ingenol mebutate demonstrated high and sustained clearance of AKs on the head and body, and was well tolerated," noted Dr. Berman and his coauthors.

The percentage reduction in the number of AKs was significantly higher at 12 months in the treatment group compared with the placebo group (68% vs. 54%), and significantly fewer patients in the treatment group developed new lesions in the treatment area compared with the placebo group (39% vs. 52%). In addition, the probability of sustained clearance of AKs at 12 months was 55% in the treatment group vs. 40% in the placebo group.

The study included 329 adults aged 18 years and older with 4-8 clinically typical, visible, and discrete AKs within a 25-cm² treatment area on the face or scalp. The patients underwent cryosurgery, and 3 weeks later underwent field therapy with 0.015% ingenol mebutate gel or vehicle gel once a day for 3 consecutive days. Patients with suspected basal cell carcinoma or squamous cell carcinoma were excluded.

The findings were limited by the possible unblinding of treatment because of localized skin reactions, the researchers noted. However, few drug-related adverse events and no drug-related serious adverse events were reported, they said.

Dr. Berman has served as a consultant, received honoraria, and served on the speakers bureau for Leo Pharma, which funded the study.

[email protected]

Complete clearance occurred at 12 months in 31% of patients who received field treatment with ingenol mebutate gel after cryotherapy for actinic keratoses, compared with 19% of placebo patients in a phase III trial.

The findings were published in the June issue of the Journal of Drugs in Dermatology.

Recurrence rates for AKs treated with cryotherapy alone are high, possibly because the treatment is lesion-directed and fails to address field cancerization, wrote Dr. Brian Berman of the University of Miami.

The FIELD study 1, a phase III, multicenter, randomized trial, showed that ingenol mebutate gel was safe and effective as a follow-up to cryosurgery for AKs. Short-term efficacy data (11 weeks) have been previously reported.

In this study, the patients were followed for 12 months (J. Drugs Dermatol. 2014;13:741-7).

"In phase III clinical trials, 2 or 3 days of field-directed therapy with ingenol mebutate demonstrated high and sustained clearance of AKs on the head and body, and was well tolerated," noted Dr. Berman and his coauthors.

The percentage reduction in the number of AKs was significantly higher at 12 months in the treatment group compared with the placebo group (68% vs. 54%), and significantly fewer patients in the treatment group developed new lesions in the treatment area compared with the placebo group (39% vs. 52%). In addition, the probability of sustained clearance of AKs at 12 months was 55% in the treatment group vs. 40% in the placebo group.

The study included 329 adults aged 18 years and older with 4-8 clinically typical, visible, and discrete AKs within a 25-cm² treatment area on the face or scalp. The patients underwent cryosurgery, and 3 weeks later underwent field therapy with 0.015% ingenol mebutate gel or vehicle gel once a day for 3 consecutive days. Patients with suspected basal cell carcinoma or squamous cell carcinoma were excluded.

The findings were limited by the possible unblinding of treatment because of localized skin reactions, the researchers noted. However, few drug-related adverse events and no drug-related serious adverse events were reported, they said.

Dr. Berman has served as a consultant, received honoraria, and served on the speakers bureau for Leo Pharma, which funded the study.

[email protected]

Complete clearance occurred at 12 months in 31% of patients who received field treatment with ingenol mebutate gel after cryotherapy for actinic keratoses, compared with 19% of placebo patients in a phase III trial.

The findings were published in the June issue of the Journal of Drugs in Dermatology.

Recurrence rates for AKs treated with cryotherapy alone are high, possibly because the treatment is lesion-directed and fails to address field cancerization, wrote Dr. Brian Berman of the University of Miami.

The FIELD study 1, a phase III, multicenter, randomized trial, showed that ingenol mebutate gel was safe and effective as a follow-up to cryosurgery for AKs. Short-term efficacy data (11 weeks) have been previously reported.

In this study, the patients were followed for 12 months (J. Drugs Dermatol. 2014;13:741-7).

"In phase III clinical trials, 2 or 3 days of field-directed therapy with ingenol mebutate demonstrated high and sustained clearance of AKs on the head and body, and was well tolerated," noted Dr. Berman and his coauthors.

The percentage reduction in the number of AKs was significantly higher at 12 months in the treatment group compared with the placebo group (68% vs. 54%), and significantly fewer patients in the treatment group developed new lesions in the treatment area compared with the placebo group (39% vs. 52%). In addition, the probability of sustained clearance of AKs at 12 months was 55% in the treatment group vs. 40% in the placebo group.

The study included 329 adults aged 18 years and older with 4-8 clinically typical, visible, and discrete AKs within a 25-cm² treatment area on the face or scalp. The patients underwent cryosurgery, and 3 weeks later underwent field therapy with 0.015% ingenol mebutate gel or vehicle gel once a day for 3 consecutive days. Patients with suspected basal cell carcinoma or squamous cell carcinoma were excluded.

The findings were limited by the possible unblinding of treatment because of localized skin reactions, the researchers noted. However, few drug-related adverse events and no drug-related serious adverse events were reported, they said.

Dr. Berman has served as a consultant, received honoraria, and served on the speakers bureau for Leo Pharma, which funded the study.

[email protected]

Adolescents with eczema were significantly more likely to report suicidal ideation than those who did not have eczema, based on data from a population-based study of more than 3,000 adolescents. The findings were published in the Journal of Investigative Dermatology.

Data from previous studies have shown an increased suicide risk in patients with skin disorders, but the impact of eczema on adolescents in particular has not been well studied, wrote Dr. Jon A. Halvorsen of the department of dermatology at the University of Oslo and his colleagues (J. Invest. Dermatol. 2014;134:1847-54).

The researchers reviewed survey data from 3,556 adolescents aged 18-19 years collected as part of the Oslo section of the Youths 2004 study.

The overall prevalence of eczema was 10% (12% in girls and 7% in boys). The overall incidence of suicidal ideation was 11%, but 16% of adolescents with eczema reported suicidal ideation vs. 9% of those with no eczema (odds ratio, 1.87). The association was even stronger in adolescents who reported eczema with itching (OR, 3.57), compared with those who did not report itching (OR, 1.06).

"The risk of suicidal ideation increased nearly fourfold in this group," the researchers noted. "Our data suggest that itch is a major predictor of psychological problems and may be a greater risk factor for these problems than chronic eczema without itch."

In addition, adolescents with eczema were significantly more likely than those without eczema to report mental health problems (assessed by the Strengths and Difficulties Questionnaire) and mental distress (assessed by the Hopkins Symptom Checklist 10) and these associations were even more significant in adolescents who reported eczema with itch, compared with those who had eczema without itch.

The study was limited by the use of self-reports, but its strengths include a large sample size with high participation, the researchers said. The results suggest that "both treatment of eczema and psychological support in this high-risk group may help to reduce suicide and mental health problems in this vulnerable population," they added.

The researchers reported no financial conflicts.

[email protected]

Adolescents with eczema were significantly more likely to report suicidal ideation than those who did not have eczema, based on data from a population-based study of more than 3,000 adolescents. The findings were published in the Journal of Investigative Dermatology.

Data from previous studies have shown an increased suicide risk in patients with skin disorders, but the impact of eczema on adolescents in particular has not been well studied, wrote Dr. Jon A. Halvorsen of the department of dermatology at the University of Oslo and his colleagues (J. Invest. Dermatol. 2014;134:1847-54).

The researchers reviewed survey data from 3,556 adolescents aged 18-19 years collected as part of the Oslo section of the Youths 2004 study.

The overall prevalence of eczema was 10% (12% in girls and 7% in boys). The overall incidence of suicidal ideation was 11%, but 16% of adolescents with eczema reported suicidal ideation vs. 9% of those with no eczema (odds ratio, 1.87). The association was even stronger in adolescents who reported eczema with itching (OR, 3.57), compared with those who did not report itching (OR, 1.06).

"The risk of suicidal ideation increased nearly fourfold in this group," the researchers noted. "Our data suggest that itch is a major predictor of psychological problems and may be a greater risk factor for these problems than chronic eczema without itch."

In addition, adolescents with eczema were significantly more likely than those without eczema to report mental health problems (assessed by the Strengths and Difficulties Questionnaire) and mental distress (assessed by the Hopkins Symptom Checklist 10) and these associations were even more significant in adolescents who reported eczema with itch, compared with those who had eczema without itch.

The study was limited by the use of self-reports, but its strengths include a large sample size with high participation, the researchers said. The results suggest that "both treatment of eczema and psychological support in this high-risk group may help to reduce suicide and mental health problems in this vulnerable population," they added.

The researchers reported no financial conflicts.

[email protected]

Adolescents with eczema were significantly more likely to report suicidal ideation than those who did not have eczema, based on data from a population-based study of more than 3,000 adolescents. The findings were published in the Journal of Investigative Dermatology.

Data from previous studies have shown an increased suicide risk in patients with skin disorders, but the impact of eczema on adolescents in particular has not been well studied, wrote Dr. Jon A. Halvorsen of the department of dermatology at the University of Oslo and his colleagues (J. Invest. Dermatol. 2014;134:1847-54).

The researchers reviewed survey data from 3,556 adolescents aged 18-19 years collected as part of the Oslo section of the Youths 2004 study.

The overall prevalence of eczema was 10% (12% in girls and 7% in boys). The overall incidence of suicidal ideation was 11%, but 16% of adolescents with eczema reported suicidal ideation vs. 9% of those with no eczema (odds ratio, 1.87). The association was even stronger in adolescents who reported eczema with itching (OR, 3.57), compared with those who did not report itching (OR, 1.06).

"The risk of suicidal ideation increased nearly fourfold in this group," the researchers noted. "Our data suggest that itch is a major predictor of psychological problems and may be a greater risk factor for these problems than chronic eczema without itch."

In addition, adolescents with eczema were significantly more likely than those without eczema to report mental health problems (assessed by the Strengths and Difficulties Questionnaire) and mental distress (assessed by the Hopkins Symptom Checklist 10) and these associations were even more significant in adolescents who reported eczema with itch, compared with those who had eczema without itch.

The study was limited by the use of self-reports, but its strengths include a large sample size with high participation, the researchers said. The results suggest that "both treatment of eczema and psychological support in this high-risk group may help to reduce suicide and mental health problems in this vulnerable population," they added.

The researchers reported no financial conflicts.

[email protected]

DENVER – A sodium hypochlorite wash significantly improved symptoms and quality of life for children who had atopic dermatitis with bacterial colonization, in a small study.

Staphylococcus aureus colonization occurs in the lesional and nonlesional skin of many atopic dermatitis patients, and bleach baths at a concentration of approximately 0.005% sodium hypochlorite are a common treatment, but not always an easy or convenient one, Dr. Benjamin R. Bohaty noted in a poster at the annual meeting of the American Academy of Dermatology.

Courtesy Dr. Adelaide Hebert and Dr. Amy Paller

In an open-label study, Dr. Bohaty of the University of Texas Health Science Center in Houston and his colleagues tested a gel cleanser containing a dilute concentration of 0.006% sodium hypochlorite wash that could be used in the bath or shower. The product is designed to be lathered onto the skin and rinsed off after 1-2 minutes. The study population included 40 children, average age 9 years, with a diagnosis of moderate to severe atopic dermatitis and S. aureus colonization. The children were instructed to use the wash once daily for 6 weeks, and they were assessed at three office visits during this period.

At 2 weeks and 6 weeks, the patients had improved an average of 34% and 44% from baseline, respectively, on the Eczema Area and Severity Index, and 23% and 34% from baseline on the Investigator’s Global Assessment scale score.

Courtesy Dr. Adelaide Hebert and Dr. Amy Paller

The average improvement in pruritus visual analog scale score was 31% at 2 weeks and 37% at 6 weeks.

Quality of life measures also improved during the study period. The average change in the Children’s Dermatology Life Quality Index was 41% at 2 weeks, dropping to 32% at 6 weeks, but both were significant improvements from baseline. The average improvement in the Family Dermatology Life Quality Index score was 13% at 2 weeks and 43% at 6 weeks, compared with baseline.

The significant decreases and lack of reported adverse events suggest that the wash is "a simple alternative to bleach baths," Dr. Bohaty reported.

The product is available in the United States under the label CLn Skin Care, a trademark of TopMD Skin Care, which funded the trial through research grants to the universities of the investigators.

[email protected]

DENVER – A sodium hypochlorite wash significantly improved symptoms and quality of life for children who had atopic dermatitis with bacterial colonization, in a small study.

Staphylococcus aureus colonization occurs in the lesional and nonlesional skin of many atopic dermatitis patients, and bleach baths at a concentration of approximately 0.005% sodium hypochlorite are a common treatment, but not always an easy or convenient one, Dr. Benjamin R. Bohaty noted in a poster at the annual meeting of the American Academy of Dermatology.

Courtesy Dr. Adelaide Hebert and Dr. Amy Paller

In an open-label study, Dr. Bohaty of the University of Texas Health Science Center in Houston and his colleagues tested a gel cleanser containing a dilute concentration of 0.006% sodium hypochlorite wash that could be used in the bath or shower. The product is designed to be lathered onto the skin and rinsed off after 1-2 minutes. The study population included 40 children, average age 9 years, with a diagnosis of moderate to severe atopic dermatitis and S. aureus colonization. The children were instructed to use the wash once daily for 6 weeks, and they were assessed at three office visits during this period.

At 2 weeks and 6 weeks, the patients had improved an average of 34% and 44% from baseline, respectively, on the Eczema Area and Severity Index, and 23% and 34% from baseline on the Investigator’s Global Assessment scale score.

Courtesy Dr. Adelaide Hebert and Dr. Amy Paller

The average improvement in pruritus visual analog scale score was 31% at 2 weeks and 37% at 6 weeks.

Quality of life measures also improved during the study period. The average change in the Children’s Dermatology Life Quality Index was 41% at 2 weeks, dropping to 32% at 6 weeks, but both were significant improvements from baseline. The average improvement in the Family Dermatology Life Quality Index score was 13% at 2 weeks and 43% at 6 weeks, compared with baseline.

The significant decreases and lack of reported adverse events suggest that the wash is "a simple alternative to bleach baths," Dr. Bohaty reported.

The product is available in the United States under the label CLn Skin Care, a trademark of TopMD Skin Care, which funded the trial through research grants to the universities of the investigators.

[email protected]

DENVER – A sodium hypochlorite wash significantly improved symptoms and quality of life for children who had atopic dermatitis with bacterial colonization, in a small study.

Staphylococcus aureus colonization occurs in the lesional and nonlesional skin of many atopic dermatitis patients, and bleach baths at a concentration of approximately 0.005% sodium hypochlorite are a common treatment, but not always an easy or convenient one, Dr. Benjamin R. Bohaty noted in a poster at the annual meeting of the American Academy of Dermatology.

Courtesy Dr. Adelaide Hebert and Dr. Amy Paller

In an open-label study, Dr. Bohaty of the University of Texas Health Science Center in Houston and his colleagues tested a gel cleanser containing a dilute concentration of 0.006% sodium hypochlorite wash that could be used in the bath or shower. The product is designed to be lathered onto the skin and rinsed off after 1-2 minutes. The study population included 40 children, average age 9 years, with a diagnosis of moderate to severe atopic dermatitis and S. aureus colonization. The children were instructed to use the wash once daily for 6 weeks, and they were assessed at three office visits during this period.

At 2 weeks and 6 weeks, the patients had improved an average of 34% and 44% from baseline, respectively, on the Eczema Area and Severity Index, and 23% and 34% from baseline on the Investigator’s Global Assessment scale score.

Courtesy Dr. Adelaide Hebert and Dr. Amy Paller

The average improvement in pruritus visual analog scale score was 31% at 2 weeks and 37% at 6 weeks.

Quality of life measures also improved during the study period. The average change in the Children’s Dermatology Life Quality Index was 41% at 2 weeks, dropping to 32% at 6 weeks, but both were significant improvements from baseline. The average improvement in the Family Dermatology Life Quality Index score was 13% at 2 weeks and 43% at 6 weeks, compared with baseline.

The significant decreases and lack of reported adverse events suggest that the wash is "a simple alternative to bleach baths," Dr. Bohaty reported.

The product is available in the United States under the label CLn Skin Care, a trademark of TopMD Skin Care, which funded the trial through research grants to the universities of the investigators.

[email protected]

A 25-year-old man with plaque psoriasis and virtually no hair of any sort now sports a full head of hair plus body hair after treatment with the arthritis drug tofacitinib, according to Dr. Brittany G. Craiglow and Dr. Brett A. King of Yale University, New Haven, Conn.

The treatment has been so successful that Dr. King has submitted a proposal for a clinical trial involving a cream form of tofacitinib as a treatment for alopecia areata, according to a statement from the university.

Tofacitinib is approved only for the treatment of adult patients with moderately to severely active rheumatoid arthritis who have had an inadequate response or intolerance to methotrexate, but it is in clinical development for the treatment of psoriasis.

Dr. Craiglow and Dr. King began treating the patient with 10 mg oral tofacitinib (Xeljanz) daily. At baseline, the patient had been diagnosed with plaque psoriasis and alopecia universalis. His only body hair was a small amount of hair within the psoriasis plaques on his head, the researchers said (J. Invest. Dermatol. 2014 June 18 [doi:10.1038/jid.2014.260]). 

After 2 months of tofacitinib dosed at 5 mg twice daily, the psoriasis on the patient’s scalp, torso, and elbows showed some improvement, and there was some hair growth on his face and scalp. The researchers increased the dose to 10 mg in the morning and 5 mg at night. After 3 more months, the patient had complete regrowth of scalp hair, as well as some growth of eyebrows, eyelashes, armpit hair, and pubic hair. After 8 months, the patient had full regrowth of all body hair, with the exception of hair on the arms and legs (which had been sparse prior to his alopecia diagnosis, the researchers said).

Although the hair growth has been dramatic, improvements in the patient’s psoriasis have been slower, likely because of the dosage.

“While we considered increasing the dose of tofacitinib, the patient is so pleased with the regrowth of his hair (and is not particularly bothered by the remaining psoriasis) that he has chosen to continue at the present dose,” the researchers noted.

The researchers considered using tofacitinib to treat the patient’s alopecia universalis based on the research of Angela M. Christiano, Ph.D., of Columbia University, New York, in which the drug reversed hair loss in a mouse model of alopecia areata.

The patient has reported no side effects, and lab testing has shown no abnormalities in complete blood count, serum creatinine, electrolytes, liver function, glucose, or lipids, the researchers noted.
The researchers had no financial conflicts to disclose.

[email protected]

A 25-year-old man with plaque psoriasis and virtually no hair of any sort now sports a full head of hair plus body hair after treatment with the arthritis drug tofacitinib, according to Dr. Brittany G. Craiglow and Dr. Brett A. King of Yale University, New Haven, Conn.

The treatment has been so successful that Dr. King has submitted a proposal for a clinical trial involving a cream form of tofacitinib as a treatment for alopecia areata, according to a statement from the university.

Tofacitinib is approved only for the treatment of adult patients with moderately to severely active rheumatoid arthritis who have had an inadequate response or intolerance to methotrexate, but it is in clinical development for the treatment of psoriasis.

Dr. Craiglow and Dr. King began treating the patient with 10 mg oral tofacitinib (Xeljanz) daily. At baseline, the patient had been diagnosed with plaque psoriasis and alopecia universalis. His only body hair was a small amount of hair within the psoriasis plaques on his head, the researchers said (J. Invest. Dermatol. 2014 June 18 [doi:10.1038/jid.2014.260]). 

After 2 months of tofacitinib dosed at 5 mg twice daily, the psoriasis on the patient’s scalp, torso, and elbows showed some improvement, and there was some hair growth on his face and scalp. The researchers increased the dose to 10 mg in the morning and 5 mg at night. After 3 more months, the patient had complete regrowth of scalp hair, as well as some growth of eyebrows, eyelashes, armpit hair, and pubic hair. After 8 months, the patient had full regrowth of all body hair, with the exception of hair on the arms and legs (which had been sparse prior to his alopecia diagnosis, the researchers said).

Although the hair growth has been dramatic, improvements in the patient’s psoriasis have been slower, likely because of the dosage.

“While we considered increasing the dose of tofacitinib, the patient is so pleased with the regrowth of his hair (and is not particularly bothered by the remaining psoriasis) that he has chosen to continue at the present dose,” the researchers noted.

The researchers considered using tofacitinib to treat the patient’s alopecia universalis based on the research of Angela M. Christiano, Ph.D., of Columbia University, New York, in which the drug reversed hair loss in a mouse model of alopecia areata.

The patient has reported no side effects, and lab testing has shown no abnormalities in complete blood count, serum creatinine, electrolytes, liver function, glucose, or lipids, the researchers noted.
The researchers had no financial conflicts to disclose.

[email protected]

A 25-year-old man with plaque psoriasis and virtually no hair of any sort now sports a full head of hair plus body hair after treatment with the arthritis drug tofacitinib, according to Dr. Brittany G. Craiglow and Dr. Brett A. King of Yale University, New Haven, Conn.

The treatment has been so successful that Dr. King has submitted a proposal for a clinical trial involving a cream form of tofacitinib as a treatment for alopecia areata, according to a statement from the university.

Tofacitinib is approved only for the treatment of adult patients with moderately to severely active rheumatoid arthritis who have had an inadequate response or intolerance to methotrexate, but it is in clinical development for the treatment of psoriasis.

Dr. Craiglow and Dr. King began treating the patient with 10 mg oral tofacitinib (Xeljanz) daily. At baseline, the patient had been diagnosed with plaque psoriasis and alopecia universalis. His only body hair was a small amount of hair within the psoriasis plaques on his head, the researchers said (J. Invest. Dermatol. 2014 June 18 [doi:10.1038/jid.2014.260]). 

After 2 months of tofacitinib dosed at 5 mg twice daily, the psoriasis on the patient’s scalp, torso, and elbows showed some improvement, and there was some hair growth on his face and scalp. The researchers increased the dose to 10 mg in the morning and 5 mg at night. After 3 more months, the patient had complete regrowth of scalp hair, as well as some growth of eyebrows, eyelashes, armpit hair, and pubic hair. After 8 months, the patient had full regrowth of all body hair, with the exception of hair on the arms and legs (which had been sparse prior to his alopecia diagnosis, the researchers said).

Although the hair growth has been dramatic, improvements in the patient’s psoriasis have been slower, likely because of the dosage.

“While we considered increasing the dose of tofacitinib, the patient is so pleased with the regrowth of his hair (and is not particularly bothered by the remaining psoriasis) that he has chosen to continue at the present dose,” the researchers noted.

The researchers considered using tofacitinib to treat the patient’s alopecia universalis based on the research of Angela M. Christiano, Ph.D., of Columbia University, New York, in which the drug reversed hair loss in a mouse model of alopecia areata.

The patient has reported no side effects, and lab testing has shown no abnormalities in complete blood count, serum creatinine, electrolytes, liver function, glucose, or lipids, the researchers noted.
The researchers had no financial conflicts to disclose.

[email protected]

A 25-year-old man with plaque psoriasis and virtually no hair of any sort now sports a full head of hair plus body hair after treatment with the arthritis drug tofacitinib, according to Dr. Brittany G. Craiglow and Dr. Brett A. King of Yale University, New Haven, Conn.

The treatment has been so successful that Dr. King has submitted a proposal for a clinical trial involving a cream form of tofacitinib as a treatment for alopecia areata, according to a statement from the university.

Tofacitinib is approved only for the treatment of adult patients with moderately to severely active rheumatoid arthritis who have had an inadequate response or intolerance to methotrexate, but it is in clinical development for the treatment of psoriasis.

Dr. Craiglow and Dr. King began treating the patient with 10 mg oral tofacitinib (Xeljanz) daily. At baseline, the patient had been diagnosed with plaque psoriasis and alopecia universalis. His only body hair was a small amount of hair within the psoriasis plaques on his head, the researchers said (J. Invest. Dermatol. 2014 June 18 [doi:10.1038/jid.2014.260]). 

After 2 months of tofacitinib dosed at 5 mg twice daily, the psoriasis on the patient’s scalp, torso, and elbows showed some improvement, and there was some hair growth on his face and scalp. The researchers increased the dose to 10 mg in the morning and 5 mg at night. After 3 more months, the patient had complete regrowth of scalp hair, as well as some growth of eyebrows, eyelashes, armpit hair, and pubic hair. After 8 months, the patient had full regrowth of all body hair, with the exception of hair on the arms and legs (which had been sparse prior to his alopecia diagnosis, the researchers said).

Although the hair growth has been dramatic, improvements in the patient’s psoriasis have been slower, likely because of the dosage.

“While we considered increasing the dose of tofacitinib, the patient is so pleased with the regrowth of his hair (and is not particularly bothered by the remaining psoriasis) that he has chosen to continue at the present dose,” the researchers noted.

The researchers considered using tofacitinib to treat the patient’s alopecia universalis based on the research of Angela M. Christiano, Ph.D., of Columbia University, New York, in which the drug reversed hair loss in a mouse model of alopecia areata.

The patient has reported no side effects, and lab testing has shown no abnormalities in complete blood count, serum creatinine, electrolytes, liver function, glucose, or lipids, the researchers noted.
The researchers had no financial conflicts to disclose.

[email protected]

A 25-year-old man with plaque psoriasis and virtually no hair of any sort now sports a full head of hair plus body hair after treatment with the arthritis drug tofacitinib, according to Dr. Brittany G. Craiglow and Dr. Brett A. King of Yale University, New Haven, Conn.

The treatment has been so successful that Dr. King has submitted a proposal for a clinical trial involving a cream form of tofacitinib as a treatment for alopecia areata, according to a statement from the university.

Tofacitinib is approved only for the treatment of adult patients with moderately to severely active rheumatoid arthritis who have had an inadequate response or intolerance to methotrexate, but it is in clinical development for the treatment of psoriasis.

Dr. Craiglow and Dr. King began treating the patient with 10 mg oral tofacitinib (Xeljanz) daily. At baseline, the patient had been diagnosed with plaque psoriasis and alopecia universalis. His only body hair was a small amount of hair within the psoriasis plaques on his head, the researchers said (J. Invest. Dermatol. 2014 June 18 [doi:10.1038/jid.2014.260]). 

After 2 months of tofacitinib dosed at 5 mg twice daily, the psoriasis on the patient’s scalp, torso, and elbows showed some improvement, and there was some hair growth on his face and scalp. The researchers increased the dose to 10 mg in the morning and 5 mg at night. After 3 more months, the patient had complete regrowth of scalp hair, as well as some growth of eyebrows, eyelashes, armpit hair, and pubic hair. After 8 months, the patient had full regrowth of all body hair, with the exception of hair on the arms and legs (which had been sparse prior to his alopecia diagnosis, the researchers said).

Although the hair growth has been dramatic, improvements in the patient’s psoriasis have been slower, likely because of the dosage.

“While we considered increasing the dose of tofacitinib, the patient is so pleased with the regrowth of his hair (and is not particularly bothered by the remaining psoriasis) that he has chosen to continue at the present dose,” the researchers noted.

The researchers considered using tofacitinib to treat the patient’s alopecia universalis based on the research of Angela M. Christiano, Ph.D., of Columbia University, New York, in which the drug reversed hair loss in a mouse model of alopecia areata.

The patient has reported no side effects, and lab testing has shown no abnormalities in complete blood count, serum creatinine, electrolytes, liver function, glucose, or lipids, the researchers noted.
The researchers had no financial conflicts to disclose.

[email protected]

A 25-year-old man with plaque psoriasis and virtually no hair of any sort now sports a full head of hair plus body hair after treatment with the arthritis drug tofacitinib, according to Dr. Brittany G. Craiglow and Dr. Brett A. King of Yale University, New Haven, Conn.

The treatment has been so successful that Dr. King has submitted a proposal for a clinical trial involving a cream form of tofacitinib as a treatment for alopecia areata, according to a statement from the university.

Tofacitinib is approved only for the treatment of adult patients with moderately to severely active rheumatoid arthritis who have had an inadequate response or intolerance to methotrexate, but it is in clinical development for the treatment of psoriasis.

Dr. Craiglow and Dr. King began treating the patient with 10 mg oral tofacitinib (Xeljanz) daily. At baseline, the patient had been diagnosed with plaque psoriasis and alopecia universalis. His only body hair was a small amount of hair within the psoriasis plaques on his head, the researchers said (J. Invest. Dermatol. 2014 June 18 [doi:10.1038/jid.2014.260]). 

After 2 months of tofacitinib dosed at 5 mg twice daily, the psoriasis on the patient’s scalp, torso, and elbows showed some improvement, and there was some hair growth on his face and scalp. The researchers increased the dose to 10 mg in the morning and 5 mg at night. After 3 more months, the patient had complete regrowth of scalp hair, as well as some growth of eyebrows, eyelashes, armpit hair, and pubic hair. After 8 months, the patient had full regrowth of all body hair, with the exception of hair on the arms and legs (which had been sparse prior to his alopecia diagnosis, the researchers said).

Although the hair growth has been dramatic, improvements in the patient’s psoriasis have been slower, likely because of the dosage.

“While we considered increasing the dose of tofacitinib, the patient is so pleased with the regrowth of his hair (and is not particularly bothered by the remaining psoriasis) that he has chosen to continue at the present dose,” the researchers noted.

The researchers considered using tofacitinib to treat the patient’s alopecia universalis based on the research of Angela M. Christiano, Ph.D., of Columbia University, New York, in which the drug reversed hair loss in a mouse model of alopecia areata.

The patient has reported no side effects, and lab testing has shown no abnormalities in complete blood count, serum creatinine, electrolytes, liver function, glucose, or lipids, the researchers noted.
The researchers had no financial conflicts to disclose.

[email protected]

Twice-daily application of 0.05% desonide hydrogel significantly improved clinical symptoms of itching and quality of life scores in 100% of patients with mild to moderate atopic dermatitis after 7 days in a small preliminary study.

"Increasingly, researchers and clinicians recognize that disrupted barrier function contributes not only to the xerotic and pruritic manifestations of AD, but also to the inflammatory cascade that underlies the disease," wrote Dr. Leon Kircik of Indiana University, Indianapolis.

Data from previous studies have shown the effectiveness of desonide hydrogel 0.05% for atopic dermatitis in children, but few studies have examined the effectiveness of the gel on itching in particular. In this study, patients applied the gel twice daily, with assessments at baseline, day 3, and day 7 (J. Drugs Dermatol. 2014;13:725-8).

At day 7, all patients achieved the primary endpoint of at least a 50% reduction in pruritus. The average Investigator’s Global Assessment (IGA) scale score was .55 (down from 2.35 at baseline), which translated to a 76% improvement from baseline. The visual analog score decreased by an average of 6.4 points, for an average reduction of 85%. Statistically significant improvements from baseline in both IGA and visual analog scores also were noted at day 3, when the average IGA score improved 27% from baseline, and the mean visual analog score showed a 53% reduction.

The study included 20 atopic dermatitis patients ranging in age from 8 to 68 years, with an average age of 25 years; 60% were black, 40% were white, and 75% were female.

The results suggest that hydrogel is an appropriate option to relieve itchiness in AD patients, and a large, randomized, double-blind controlled trial would be helpful to further study effectiveness, Dr. Kircik said.

Dr. Kircik disclosed receiving funding as an investigator, consultant, or speaker for Bayer Dermatology, manufacturer of the product tested.

[email protected]

Twice-daily application of 0.05% desonide hydrogel significantly improved clinical symptoms of itching and quality of life scores in 100% of patients with mild to moderate atopic dermatitis after 7 days in a small preliminary study.

"Increasingly, researchers and clinicians recognize that disrupted barrier function contributes not only to the xerotic and pruritic manifestations of AD, but also to the inflammatory cascade that underlies the disease," wrote Dr. Leon Kircik of Indiana University, Indianapolis.

Data from previous studies have shown the effectiveness of desonide hydrogel 0.05% for atopic dermatitis in children, but few studies have examined the effectiveness of the gel on itching in particular. In this study, patients applied the gel twice daily, with assessments at baseline, day 3, and day 7 (J. Drugs Dermatol. 2014;13:725-8).

At day 7, all patients achieved the primary endpoint of at least a 50% reduction in pruritus. The average Investigator’s Global Assessment (IGA) scale score was .55 (down from 2.35 at baseline), which translated to a 76% improvement from baseline. The visual analog score decreased by an average of 6.4 points, for an average reduction of 85%. Statistically significant improvements from baseline in both IGA and visual analog scores also were noted at day 3, when the average IGA score improved 27% from baseline, and the mean visual analog score showed a 53% reduction.

The study included 20 atopic dermatitis patients ranging in age from 8 to 68 years, with an average age of 25 years; 60% were black, 40% were white, and 75% were female.

The results suggest that hydrogel is an appropriate option to relieve itchiness in AD patients, and a large, randomized, double-blind controlled trial would be helpful to further study effectiveness, Dr. Kircik said.

Dr. Kircik disclosed receiving funding as an investigator, consultant, or speaker for Bayer Dermatology, manufacturer of the product tested.

[email protected]

Twice-daily application of 0.05% desonide hydrogel significantly improved clinical symptoms of itching and quality of life scores in 100% of patients with mild to moderate atopic dermatitis after 7 days in a small preliminary study.

"Increasingly, researchers and clinicians recognize that disrupted barrier function contributes not only to the xerotic and pruritic manifestations of AD, but also to the inflammatory cascade that underlies the disease," wrote Dr. Leon Kircik of Indiana University, Indianapolis.

Data from previous studies have shown the effectiveness of desonide hydrogel 0.05% for atopic dermatitis in children, but few studies have examined the effectiveness of the gel on itching in particular. In this study, patients applied the gel twice daily, with assessments at baseline, day 3, and day 7 (J. Drugs Dermatol. 2014;13:725-8).

At day 7, all patients achieved the primary endpoint of at least a 50% reduction in pruritus. The average Investigator’s Global Assessment (IGA) scale score was .55 (down from 2.35 at baseline), which translated to a 76% improvement from baseline. The visual analog score decreased by an average of 6.4 points, for an average reduction of 85%. Statistically significant improvements from baseline in both IGA and visual analog scores also were noted at day 3, when the average IGA score improved 27% from baseline, and the mean visual analog score showed a 53% reduction.

The study included 20 atopic dermatitis patients ranging in age from 8 to 68 years, with an average age of 25 years; 60% were black, 40% were white, and 75% were female.

The results suggest that hydrogel is an appropriate option to relieve itchiness in AD patients, and a large, randomized, double-blind controlled trial would be helpful to further study effectiveness, Dr. Kircik said.

Dr. Kircik disclosed receiving funding as an investigator, consultant, or speaker for Bayer Dermatology, manufacturer of the product tested.

[email protected]