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VIDEO: Rosacea patients no longer considered in ‘buckets’
LAS VEGAS – Clinicians are starting to see and treat rosacea differently, Julie Harper, MD, said in a video interview at Skin Disease Education Foundation’s annual Las Vegas Dermatology Seminar.
“For a long time, we thought about putting rosacea patients into buckets,” based on the predominant type of rosacea they had, such as papulopustular, ocular, or erythematotelangiectatic rosacea, but “what we find is that people have pieces and parts of all of those,” she commented.
In the interview, Dr. Harper, a dermatologist in private practice in Birmingham, Ala., emphasized the importance of directing treatment to all aspects of an individual patient’s rosacea, using combinations of treatments that are approved by the Food and Drug Administration, “or at least proven to be effective for these different parts” of the disease. “That’s something that’s really new in our thinking,” she said.
Dr. Harper disclosed relationships with multiple companies including Allergan, Bayer, Galderma, La Roche-Posay, Promius, and Valeant.
SDEF and this news organization are owned by the same parent company.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
LAS VEGAS – Clinicians are starting to see and treat rosacea differently, Julie Harper, MD, said in a video interview at Skin Disease Education Foundation’s annual Las Vegas Dermatology Seminar.
“For a long time, we thought about putting rosacea patients into buckets,” based on the predominant type of rosacea they had, such as papulopustular, ocular, or erythematotelangiectatic rosacea, but “what we find is that people have pieces and parts of all of those,” she commented.
In the interview, Dr. Harper, a dermatologist in private practice in Birmingham, Ala., emphasized the importance of directing treatment to all aspects of an individual patient’s rosacea, using combinations of treatments that are approved by the Food and Drug Administration, “or at least proven to be effective for these different parts” of the disease. “That’s something that’s really new in our thinking,” she said.
Dr. Harper disclosed relationships with multiple companies including Allergan, Bayer, Galderma, La Roche-Posay, Promius, and Valeant.
SDEF and this news organization are owned by the same parent company.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
LAS VEGAS – Clinicians are starting to see and treat rosacea differently, Julie Harper, MD, said in a video interview at Skin Disease Education Foundation’s annual Las Vegas Dermatology Seminar.
“For a long time, we thought about putting rosacea patients into buckets,” based on the predominant type of rosacea they had, such as papulopustular, ocular, or erythematotelangiectatic rosacea, but “what we find is that people have pieces and parts of all of those,” she commented.
In the interview, Dr. Harper, a dermatologist in private practice in Birmingham, Ala., emphasized the importance of directing treatment to all aspects of an individual patient’s rosacea, using combinations of treatments that are approved by the Food and Drug Administration, “or at least proven to be effective for these different parts” of the disease. “That’s something that’s really new in our thinking,” she said.
Dr. Harper disclosed relationships with multiple companies including Allergan, Bayer, Galderma, La Roche-Posay, Promius, and Valeant.
SDEF and this news organization are owned by the same parent company.
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 LAS VEGAS DERMATOLOGY SEMINAR
Sebum inhibition steps up against acne
In the future, topical agents that target sebum production could play a greater role in acne management.
Linda F. Stein Gold, MD, director of dermatology research at the Henry Ford Health System in Detroit highlighted several studies of these investigational therapies in a presentation on acne at the Skin Disease Education Foundation’s annual Las Vegas Dermatology Seminar.
• SB204, a topical agent that releases nitric oxide.
• DRM01, a topical sebum inhibitor that inhibits acetyl coenzyme-A carboxylase, an enzyme involved in the synthesis of fatty acids.
• Cortexolone 17a-propionate (CB-03-01) 1% cream, a topical antiandrogen.
A 4% gel formulation of SB204 once a day was compared with a vehicle, also applied topically once a day, in a pair of phase 3 randomized, multicenter pivotal trials of 2,639 patients aged 9 years and older with moderate to severe acne, Dr. Stein Gold said. At 12 weeks, the absolute change in number of noninflammatory lesions among those treated with SB204 was a reduction by 15.4 vs. 13.4 among those treated with a vehicle in one study (P = .03) and by 14.9 vs. 12.3 with a vehicle in the other study (P = .001). The absolute change in the number of inflammatory lesions among those using SB204 in the first study was not significantly different from those seen among patients using the vehicle (a reduction of 12.1 vs. 11.1, respectively) but was significant in the second study (a reduction of 12.9 vs. 10.6 for vehicle; P less than .001).
No new safety signals were observed and treatment was “generally safe and well tolerated,” with fewer than 2% of patients discontinuing treatment because of treatment-emergent adverse events, she noted.
In a phase 2 study, those treated with a 4% formulation of SB204 had a significant reduction in inflammatory and noninflammatory lesions at 12 weeks, with mild local irritation as the main adverse effect, she said (J. Drugs Dermatol. 2016 Dec 1;15[12]:1496-527). The treatment was generally safe and well tolerated, said Dr. Stein Gold, one of the study authors.
In a phase 2 randomized, multicenter, double-blind study of 108 patients with moderate or severe acne, she continued, those treated with DRM01 7.5% applied to the face twice a day for 12 weeks, those treated with DRM01 showed significant improvement across all efficacy measures at 12 weeks, including a significantly greater reduction in both inflammatory and noninflammatory lesions, and on measures of investigator’s global assessment – after 12 weeks of twice-daily treatment. Treatment was well tolerated, and no serious adverse events related to the treatment were reported, Dr. Stein Gold said.
(In October, the manufacturer, Dermira, announced that patient enrollment in two phase 3 trials of DRM01– now known as olumacostat glasaretil – in patients aged 9 years and older with facial acne had been completed.)
Phase 3 studies of cortexolone 17a-propionate (CB-03-01) 1% cream are underway, Dr. Stein Gold said.
Dr. Stein Gold disclosed relationships with multiple companies including Galderma, Leo, Novan, Valeant, Dermira, Novartis, Celgene, Allergan, Foamix, Promius, Anacor, and Medimetriks.
SDEF and this news organization are owned by the same parent company.
In the future, topical agents that target sebum production could play a greater role in acne management.
Linda F. Stein Gold, MD, director of dermatology research at the Henry Ford Health System in Detroit highlighted several studies of these investigational therapies in a presentation on acne at the Skin Disease Education Foundation’s annual Las Vegas Dermatology Seminar.
• SB204, a topical agent that releases nitric oxide.
• DRM01, a topical sebum inhibitor that inhibits acetyl coenzyme-A carboxylase, an enzyme involved in the synthesis of fatty acids.
• Cortexolone 17a-propionate (CB-03-01) 1% cream, a topical antiandrogen.
A 4% gel formulation of SB204 once a day was compared with a vehicle, also applied topically once a day, in a pair of phase 3 randomized, multicenter pivotal trials of 2,639 patients aged 9 years and older with moderate to severe acne, Dr. Stein Gold said. At 12 weeks, the absolute change in number of noninflammatory lesions among those treated with SB204 was a reduction by 15.4 vs. 13.4 among those treated with a vehicle in one study (P = .03) and by 14.9 vs. 12.3 with a vehicle in the other study (P = .001). The absolute change in the number of inflammatory lesions among those using SB204 in the first study was not significantly different from those seen among patients using the vehicle (a reduction of 12.1 vs. 11.1, respectively) but was significant in the second study (a reduction of 12.9 vs. 10.6 for vehicle; P less than .001).
No new safety signals were observed and treatment was “generally safe and well tolerated,” with fewer than 2% of patients discontinuing treatment because of treatment-emergent adverse events, she noted.
In a phase 2 study, those treated with a 4% formulation of SB204 had a significant reduction in inflammatory and noninflammatory lesions at 12 weeks, with mild local irritation as the main adverse effect, she said (J. Drugs Dermatol. 2016 Dec 1;15[12]:1496-527). The treatment was generally safe and well tolerated, said Dr. Stein Gold, one of the study authors.
In a phase 2 randomized, multicenter, double-blind study of 108 patients with moderate or severe acne, she continued, those treated with DRM01 7.5% applied to the face twice a day for 12 weeks, those treated with DRM01 showed significant improvement across all efficacy measures at 12 weeks, including a significantly greater reduction in both inflammatory and noninflammatory lesions, and on measures of investigator’s global assessment – after 12 weeks of twice-daily treatment. Treatment was well tolerated, and no serious adverse events related to the treatment were reported, Dr. Stein Gold said.
(In October, the manufacturer, Dermira, announced that patient enrollment in two phase 3 trials of DRM01– now known as olumacostat glasaretil – in patients aged 9 years and older with facial acne had been completed.)
Phase 3 studies of cortexolone 17a-propionate (CB-03-01) 1% cream are underway, Dr. Stein Gold said.
Dr. Stein Gold disclosed relationships with multiple companies including Galderma, Leo, Novan, Valeant, Dermira, Novartis, Celgene, Allergan, Foamix, Promius, Anacor, and Medimetriks.
SDEF and this news organization are owned by the same parent company.
In the future, topical agents that target sebum production could play a greater role in acne management.
Linda F. Stein Gold, MD, director of dermatology research at the Henry Ford Health System in Detroit highlighted several studies of these investigational therapies in a presentation on acne at the Skin Disease Education Foundation’s annual Las Vegas Dermatology Seminar.
• SB204, a topical agent that releases nitric oxide.
• DRM01, a topical sebum inhibitor that inhibits acetyl coenzyme-A carboxylase, an enzyme involved in the synthesis of fatty acids.
• Cortexolone 17a-propionate (CB-03-01) 1% cream, a topical antiandrogen.
A 4% gel formulation of SB204 once a day was compared with a vehicle, also applied topically once a day, in a pair of phase 3 randomized, multicenter pivotal trials of 2,639 patients aged 9 years and older with moderate to severe acne, Dr. Stein Gold said. At 12 weeks, the absolute change in number of noninflammatory lesions among those treated with SB204 was a reduction by 15.4 vs. 13.4 among those treated with a vehicle in one study (P = .03) and by 14.9 vs. 12.3 with a vehicle in the other study (P = .001). The absolute change in the number of inflammatory lesions among those using SB204 in the first study was not significantly different from those seen among patients using the vehicle (a reduction of 12.1 vs. 11.1, respectively) but was significant in the second study (a reduction of 12.9 vs. 10.6 for vehicle; P less than .001).
No new safety signals were observed and treatment was “generally safe and well tolerated,” with fewer than 2% of patients discontinuing treatment because of treatment-emergent adverse events, she noted.
In a phase 2 study, those treated with a 4% formulation of SB204 had a significant reduction in inflammatory and noninflammatory lesions at 12 weeks, with mild local irritation as the main adverse effect, she said (J. Drugs Dermatol. 2016 Dec 1;15[12]:1496-527). The treatment was generally safe and well tolerated, said Dr. Stein Gold, one of the study authors.
In a phase 2 randomized, multicenter, double-blind study of 108 patients with moderate or severe acne, she continued, those treated with DRM01 7.5% applied to the face twice a day for 12 weeks, those treated with DRM01 showed significant improvement across all efficacy measures at 12 weeks, including a significantly greater reduction in both inflammatory and noninflammatory lesions, and on measures of investigator’s global assessment – after 12 weeks of twice-daily treatment. Treatment was well tolerated, and no serious adverse events related to the treatment were reported, Dr. Stein Gold said.
(In October, the manufacturer, Dermira, announced that patient enrollment in two phase 3 trials of DRM01– now known as olumacostat glasaretil – in patients aged 9 years and older with facial acne had been completed.)
Phase 3 studies of cortexolone 17a-propionate (CB-03-01) 1% cream are underway, Dr. Stein Gold said.
Dr. Stein Gold disclosed relationships with multiple companies including Galderma, Leo, Novan, Valeant, Dermira, Novartis, Celgene, Allergan, Foamix, Promius, Anacor, and Medimetriks.
SDEF and this news organization are owned by the same parent company.
AT SDEF LAS VEGAS DERMATOLOGY SEMINAR
VIDEO: Various treatments for acne in clinical trials
LAS VEGAS – “It’s an exciting time in the treatment of acne,” Linda F. Stein Gold, MD, said in a video interview at Skin Disease Education Foundation’s annual Las Vegas dermatology seminar.
In the interview, Dr. Stein Gold, director of dermatology research at the Henry Ford Health System in Detroit, discussed several new developments in the field of acne, including a once-daily oral antibiotic, sarecycline, and topical minocycline drugs in different stages in the research pipeline.
Scarring can occur with any degree of acne severity, but new data suggest that patients struggling with scars may benefit from a fixed combination of adapalene gel 0.3% and benzoyl peroxide gel 2.5%, Dr. Stein Gold noted.
She disclosed relationships with multiple companies including Allergan, Anacor, Celgene, Dermira, Foamix, Galderma, LEO, Medimetriks, Novan, Novartis, Promius, Sol-gel, and Valeant.
SDEF and this news organization are owned by the same parent company.
LAS VEGAS – “It’s an exciting time in the treatment of acne,” Linda F. Stein Gold, MD, said in a video interview at Skin Disease Education Foundation’s annual Las Vegas dermatology seminar.
In the interview, Dr. Stein Gold, director of dermatology research at the Henry Ford Health System in Detroit, discussed several new developments in the field of acne, including a once-daily oral antibiotic, sarecycline, and topical minocycline drugs in different stages in the research pipeline.
Scarring can occur with any degree of acne severity, but new data suggest that patients struggling with scars may benefit from a fixed combination of adapalene gel 0.3% and benzoyl peroxide gel 2.5%, Dr. Stein Gold noted.
She disclosed relationships with multiple companies including Allergan, Anacor, Celgene, Dermira, Foamix, Galderma, LEO, Medimetriks, Novan, Novartis, Promius, Sol-gel, and Valeant.
SDEF and this news organization are owned by the same parent company.
LAS VEGAS – “It’s an exciting time in the treatment of acne,” Linda F. Stein Gold, MD, said in a video interview at Skin Disease Education Foundation’s annual Las Vegas dermatology seminar.
In the interview, Dr. Stein Gold, director of dermatology research at the Henry Ford Health System in Detroit, discussed several new developments in the field of acne, including a once-daily oral antibiotic, sarecycline, and topical minocycline drugs in different stages in the research pipeline.
Scarring can occur with any degree of acne severity, but new data suggest that patients struggling with scars may benefit from a fixed combination of adapalene gel 0.3% and benzoyl peroxide gel 2.5%, Dr. Stein Gold noted.
She disclosed relationships with multiple companies including Allergan, Anacor, Celgene, Dermira, Foamix, Galderma, LEO, Medimetriks, Novan, Novartis, Promius, Sol-gel, and Valeant.
SDEF and this news organization are owned by the same parent company.
AT SDEF LAS VEGAS DERMATOLOGY SEMINAR
Don’t overlook all options for ocular rosacea
Managing ocular rosacea often includes a combination of oral and topical treatments, and some patients find relief with natural strategies such as warm compresses and eyelid massage, Julie C. Harper, MD, said at the Skin Disease Education Foundation’s annual Las Vegas Dermatology Seminar.
Ocular rosacea can present in several forms, including sties on the eyelids, blepharitis with chalazia and telangiectasia, and “meibomian inspissation visible as pale streaks perpendicular to the lid margin,” according to a 2016 review article she cited (Clin Dermatol. 2016 Mar-Apr;34[2]:146-50).
The most common symptoms at baseline were burning, stinging, and light sensitivity. At baseline, all the cyclosporine-treated patients had burning, stinging, and light sensitivity, which dropped to 21%, 47%, and 10.5% of the patients, respectively, after 3 months of twice-daily topical treatment. In the study, all patients also were administering artificial eye drops daily.
The patients treated with doxycycline also showed improvement in these three symptoms after 3 months of treatment, but not to the same degree: At 3 months, 74% still had burning and stinging, from 100% at baseline. Almost 95% had light sensitivity at baseline, dropping to 21% after 3 months of treatment.
When treating patients with ocular rosacea, “the greatest challenge is that we don’t have any medications that are Food and Drug Administration–approved for this indication,” Dr. Harper said in an interview.
In the interview, she provided the following pearl: “Always ask about eye involvement in rosacea patients; they won’t volunteer information because they think it is unrelated. Teach patients about lid care (lid massage and artificial tears). This is analogous to good skin care in cutaneous rosacea.”
Dr. Harper disclosed serving as a speaker/adviser for Allergan, Bayer, and Galderma, and receiving research support from Bayer. SDEF and this news organization are owned by the same parent company.
Managing ocular rosacea often includes a combination of oral and topical treatments, and some patients find relief with natural strategies such as warm compresses and eyelid massage, Julie C. Harper, MD, said at the Skin Disease Education Foundation’s annual Las Vegas Dermatology Seminar.
Ocular rosacea can present in several forms, including sties on the eyelids, blepharitis with chalazia and telangiectasia, and “meibomian inspissation visible as pale streaks perpendicular to the lid margin,” according to a 2016 review article she cited (Clin Dermatol. 2016 Mar-Apr;34[2]:146-50).
The most common symptoms at baseline were burning, stinging, and light sensitivity. At baseline, all the cyclosporine-treated patients had burning, stinging, and light sensitivity, which dropped to 21%, 47%, and 10.5% of the patients, respectively, after 3 months of twice-daily topical treatment. In the study, all patients also were administering artificial eye drops daily.
The patients treated with doxycycline also showed improvement in these three symptoms after 3 months of treatment, but not to the same degree: At 3 months, 74% still had burning and stinging, from 100% at baseline. Almost 95% had light sensitivity at baseline, dropping to 21% after 3 months of treatment.
When treating patients with ocular rosacea, “the greatest challenge is that we don’t have any medications that are Food and Drug Administration–approved for this indication,” Dr. Harper said in an interview.
In the interview, she provided the following pearl: “Always ask about eye involvement in rosacea patients; they won’t volunteer information because they think it is unrelated. Teach patients about lid care (lid massage and artificial tears). This is analogous to good skin care in cutaneous rosacea.”
Dr. Harper disclosed serving as a speaker/adviser for Allergan, Bayer, and Galderma, and receiving research support from Bayer. SDEF and this news organization are owned by the same parent company.
Managing ocular rosacea often includes a combination of oral and topical treatments, and some patients find relief with natural strategies such as warm compresses and eyelid massage, Julie C. Harper, MD, said at the Skin Disease Education Foundation’s annual Las Vegas Dermatology Seminar.
Ocular rosacea can present in several forms, including sties on the eyelids, blepharitis with chalazia and telangiectasia, and “meibomian inspissation visible as pale streaks perpendicular to the lid margin,” according to a 2016 review article she cited (Clin Dermatol. 2016 Mar-Apr;34[2]:146-50).
The most common symptoms at baseline were burning, stinging, and light sensitivity. At baseline, all the cyclosporine-treated patients had burning, stinging, and light sensitivity, which dropped to 21%, 47%, and 10.5% of the patients, respectively, after 3 months of twice-daily topical treatment. In the study, all patients also were administering artificial eye drops daily.
The patients treated with doxycycline also showed improvement in these three symptoms after 3 months of treatment, but not to the same degree: At 3 months, 74% still had burning and stinging, from 100% at baseline. Almost 95% had light sensitivity at baseline, dropping to 21% after 3 months of treatment.
When treating patients with ocular rosacea, “the greatest challenge is that we don’t have any medications that are Food and Drug Administration–approved for this indication,” Dr. Harper said in an interview.
In the interview, she provided the following pearl: “Always ask about eye involvement in rosacea patients; they won’t volunteer information because they think it is unrelated. Teach patients about lid care (lid massage and artificial tears). This is analogous to good skin care in cutaneous rosacea.”
Dr. Harper disclosed serving as a speaker/adviser for Allergan, Bayer, and Galderma, and receiving research support from Bayer. SDEF and this news organization are owned by the same parent company.
AT SDEF LAS VEGAS DERMATOLOGY SEMINAR
Analysis indicates coprescribing of tetracyclines, isotretinoin is low
LAS VEGAS – Coprescribing isotretinoin and tetracycline antibiotics among dermatologists and nondermatologists was low, according to a study that analyzed 11 years of ambulatory medical data.
The findings were presented in a poster at the Skin Disease Education Foundation’s annual Las Vegas Dermatology Seminar.
“Patients with an inadequate response to tetracyclines or severe cases of acne may require isotretinoin,” wrote Brooke Vasicek, MD, of Loyola University Chicago in Maywood, Ill., and colleagues. However, since the combined use of tetracyclines and isotretinoin puts patients at risk of pseudotumor cerebri, which may lead to blindness, “concurrent use of these medications must be avoided,” they explained.
To assess the frequency of isotretinoin/tetracycline coprescribing, they reviewed data from the National Ambulatory Medical Care Survey collected during 2003-2013 and estimated the number of prescriptions for isotretinoin and/or tetracycline. The dataset included 51,980,042 visits to dermatologists for acne and 29,063,717 visits to nondermatologists.
Of the dermatologists in the survey data, 13.6% reported prescribing isotretinoin (compared with 1.6% of nondermatologists), 29.2% reported prescribing tetracycline (compared with 22.9% of nondermatologists), and 0.40% reported concurrently prescribing both medications (compared with .025% of nondermatologists).
Dermatologists were significantly more likely to mention isotretinoin than nondermatologists, but mention of tetracycline was not significantly different among specialties. “Acne severity and level of comfort because of specialty-based training may be at play in the isotretinoin prescribing pattern differences between dermatologists and nondermatologists,” the researchers noted. The increased pseudotumor cerebri risk associated with combining the medications “is well known among dermatologists, hence, patient exposure is likely very uncommon,” they added.
The results were limited by the cross-sectional nature of the study and possible sampling bias associated with the data collection source, they said.
The researchers had no financial conflicts to disclose.
SDEF and this news organization are owned by the same parent company.
LAS VEGAS – Coprescribing isotretinoin and tetracycline antibiotics among dermatologists and nondermatologists was low, according to a study that analyzed 11 years of ambulatory medical data.
The findings were presented in a poster at the Skin Disease Education Foundation’s annual Las Vegas Dermatology Seminar.
“Patients with an inadequate response to tetracyclines or severe cases of acne may require isotretinoin,” wrote Brooke Vasicek, MD, of Loyola University Chicago in Maywood, Ill., and colleagues. However, since the combined use of tetracyclines and isotretinoin puts patients at risk of pseudotumor cerebri, which may lead to blindness, “concurrent use of these medications must be avoided,” they explained.
To assess the frequency of isotretinoin/tetracycline coprescribing, they reviewed data from the National Ambulatory Medical Care Survey collected during 2003-2013 and estimated the number of prescriptions for isotretinoin and/or tetracycline. The dataset included 51,980,042 visits to dermatologists for acne and 29,063,717 visits to nondermatologists.
Of the dermatologists in the survey data, 13.6% reported prescribing isotretinoin (compared with 1.6% of nondermatologists), 29.2% reported prescribing tetracycline (compared with 22.9% of nondermatologists), and 0.40% reported concurrently prescribing both medications (compared with .025% of nondermatologists).
Dermatologists were significantly more likely to mention isotretinoin than nondermatologists, but mention of tetracycline was not significantly different among specialties. “Acne severity and level of comfort because of specialty-based training may be at play in the isotretinoin prescribing pattern differences between dermatologists and nondermatologists,” the researchers noted. The increased pseudotumor cerebri risk associated with combining the medications “is well known among dermatologists, hence, patient exposure is likely very uncommon,” they added.
The results were limited by the cross-sectional nature of the study and possible sampling bias associated with the data collection source, they said.
The researchers had no financial conflicts to disclose.
SDEF and this news organization are owned by the same parent company.
LAS VEGAS – Coprescribing isotretinoin and tetracycline antibiotics among dermatologists and nondermatologists was low, according to a study that analyzed 11 years of ambulatory medical data.
The findings were presented in a poster at the Skin Disease Education Foundation’s annual Las Vegas Dermatology Seminar.
“Patients with an inadequate response to tetracyclines or severe cases of acne may require isotretinoin,” wrote Brooke Vasicek, MD, of Loyola University Chicago in Maywood, Ill., and colleagues. However, since the combined use of tetracyclines and isotretinoin puts patients at risk of pseudotumor cerebri, which may lead to blindness, “concurrent use of these medications must be avoided,” they explained.
To assess the frequency of isotretinoin/tetracycline coprescribing, they reviewed data from the National Ambulatory Medical Care Survey collected during 2003-2013 and estimated the number of prescriptions for isotretinoin and/or tetracycline. The dataset included 51,980,042 visits to dermatologists for acne and 29,063,717 visits to nondermatologists.
Of the dermatologists in the survey data, 13.6% reported prescribing isotretinoin (compared with 1.6% of nondermatologists), 29.2% reported prescribing tetracycline (compared with 22.9% of nondermatologists), and 0.40% reported concurrently prescribing both medications (compared with .025% of nondermatologists).
Dermatologists were significantly more likely to mention isotretinoin than nondermatologists, but mention of tetracycline was not significantly different among specialties. “Acne severity and level of comfort because of specialty-based training may be at play in the isotretinoin prescribing pattern differences between dermatologists and nondermatologists,” the researchers noted. The increased pseudotumor cerebri risk associated with combining the medications “is well known among dermatologists, hence, patient exposure is likely very uncommon,” they added.
The results were limited by the cross-sectional nature of the study and possible sampling bias associated with the data collection source, they said.
The researchers had no financial conflicts to disclose.
SDEF and this news organization are owned by the same parent company.
AT SDEF LAS VEGAS DERMATOLOGY SEMINAR
Key clinical point: Most clinicians understand the risk of pseudotumor cerebri associated with concurrent use of tetracyclines and isotretinoin.
Major finding: Very few dermatologists (0.40%) and nondermatologists (0.025%) mentioned both tetracycline and isotretinoin at a clinical visit for acne.
Data source: The data for this cross-sectional study came from the National Ambulatory Medical Care Survey from 2003 to 2013 and included 51,980,042 acne visits to dermatologists and 29,063,717 acne visits to nondermatologists.
Disclosures: The researchers had no financial conflicts to disclose.
Nondermatologists more likely to prescribe nystatin for dermatophyte infections, survey finds
LAS VEGAS – Nondermatologists were 11 times more likely than dermatologists to prescribe nystatin for dermatophyte infections, according to a study that analyzed 12 years of ambulatory-care data in the United States.
The findings were presented in a poster at the Skin Disease Education Foundation’s annual Las Vegas Dermatology Seminar.
“Although it is effective for the treatment of cutaneous or mucocutaneous candidiasis, the topical polyene nystatin, however, is clinically ineffective in the treatment of dermatophyte infection,” wrote Jeave Reserva, MD, of the division of dermatology at Loyola University Health System in Illinois, and colleagues.
In their analysis, the researchers used 12 years of data from two separate surveys – the National Ambulatory Medical Care Surveys and the National Hospital Ambulatory Medical Care Survey–Emergency Department – collected between 2003 and 2014, as well as 9 years of data from the National Hospital Ambulatory Medical Care Survey–Outpatient Department collected between 2003 and 2011. They reviewed data from 48.4 million ambulatory-care visits for dermatophyte infections, including 1,459,184 visits in which nystatin was prescribed. Overall, nondermatologists were significantly more likely than dermatologists to prescribe nystatin. The researchers also found that, after controlling for race, gender, and insurance status, male or black patients were significantly more likely to have positive tinea infections.
Nondermatologists were 11.08 times more likely to prescribe nystatin for dermatophytosis, compared with dermatologists (P = .02), the researchers found.
Although the number of visits does not reflect disease prevalence, the results suggest that health care disparities affect patients presenting with dermatophytosis, the researchers said. “Nondermatologists may benefit from additional provider education on the diagnosis and appropriate treatment of dermatophyte infections,” they concluded.
The researchers had no financial conflicts to disclose; no funding source was listed.
SDEF and this news organization are owned by the same parent company.
LAS VEGAS – Nondermatologists were 11 times more likely than dermatologists to prescribe nystatin for dermatophyte infections, according to a study that analyzed 12 years of ambulatory-care data in the United States.
The findings were presented in a poster at the Skin Disease Education Foundation’s annual Las Vegas Dermatology Seminar.
“Although it is effective for the treatment of cutaneous or mucocutaneous candidiasis, the topical polyene nystatin, however, is clinically ineffective in the treatment of dermatophyte infection,” wrote Jeave Reserva, MD, of the division of dermatology at Loyola University Health System in Illinois, and colleagues.
In their analysis, the researchers used 12 years of data from two separate surveys – the National Ambulatory Medical Care Surveys and the National Hospital Ambulatory Medical Care Survey–Emergency Department – collected between 2003 and 2014, as well as 9 years of data from the National Hospital Ambulatory Medical Care Survey–Outpatient Department collected between 2003 and 2011. They reviewed data from 48.4 million ambulatory-care visits for dermatophyte infections, including 1,459,184 visits in which nystatin was prescribed. Overall, nondermatologists were significantly more likely than dermatologists to prescribe nystatin. The researchers also found that, after controlling for race, gender, and insurance status, male or black patients were significantly more likely to have positive tinea infections.
Nondermatologists were 11.08 times more likely to prescribe nystatin for dermatophytosis, compared with dermatologists (P = .02), the researchers found.
Although the number of visits does not reflect disease prevalence, the results suggest that health care disparities affect patients presenting with dermatophytosis, the researchers said. “Nondermatologists may benefit from additional provider education on the diagnosis and appropriate treatment of dermatophyte infections,” they concluded.
The researchers had no financial conflicts to disclose; no funding source was listed.
SDEF and this news organization are owned by the same parent company.
LAS VEGAS – Nondermatologists were 11 times more likely than dermatologists to prescribe nystatin for dermatophyte infections, according to a study that analyzed 12 years of ambulatory-care data in the United States.
The findings were presented in a poster at the Skin Disease Education Foundation’s annual Las Vegas Dermatology Seminar.
“Although it is effective for the treatment of cutaneous or mucocutaneous candidiasis, the topical polyene nystatin, however, is clinically ineffective in the treatment of dermatophyte infection,” wrote Jeave Reserva, MD, of the division of dermatology at Loyola University Health System in Illinois, and colleagues.
In their analysis, the researchers used 12 years of data from two separate surveys – the National Ambulatory Medical Care Surveys and the National Hospital Ambulatory Medical Care Survey–Emergency Department – collected between 2003 and 2014, as well as 9 years of data from the National Hospital Ambulatory Medical Care Survey–Outpatient Department collected between 2003 and 2011. They reviewed data from 48.4 million ambulatory-care visits for dermatophyte infections, including 1,459,184 visits in which nystatin was prescribed. Overall, nondermatologists were significantly more likely than dermatologists to prescribe nystatin. The researchers also found that, after controlling for race, gender, and insurance status, male or black patients were significantly more likely to have positive tinea infections.
Nondermatologists were 11.08 times more likely to prescribe nystatin for dermatophytosis, compared with dermatologists (P = .02), the researchers found.
Although the number of visits does not reflect disease prevalence, the results suggest that health care disparities affect patients presenting with dermatophytosis, the researchers said. “Nondermatologists may benefit from additional provider education on the diagnosis and appropriate treatment of dermatophyte infections,” they concluded.
The researchers had no financial conflicts to disclose; no funding source was listed.
SDEF and this news organization are owned by the same parent company.
AT SDEF LAS VEGAS DERMATOLOGY SEMINAR
Key clinical point: Nondermatologists may not be aware that nystatin is not effective for treating dermatophyte infections.
Major finding: Nondermatologists were 11.08 times more likely than dermatologists to prescribe nystatin for dermatophyte infections.
Data source: The data came from the National Ambulatory Medical Care Survey, National Hospital Ambulatory Medical Care Survey–Emergency Department, and National Hospital Ambulatory Medical Care Survey–Outpatient Department and included 1,459,184 visits between 2003 and 2014 in which nystatin was prescribed.
Disclosures: The researchers had no financial conflicts to disclose.
Infections, psoriasis, facial fillers heat up Las Vegas Dermatology Seminar
Updates on vaccines and infections, as well as the latest acne treatments and the Psoriasis Forum are among the hot topics at Skin Disease Education Foundation’s annual Las Vegas Dermatology Seminar.
The meeting is cochaired by Linda F. Stein Gold, MD, of Henry Ford Health System in Detroit, Mich., Christopher B. Zachary, MD, of the University of California, Irvine, and Joseph F. Fowler Jr., MD, of the University of Louisville (Ky).
Dr. Stein Gold, along with Julie Harper, MD, will direct a rosacea forum on Thursday to review the latest information on pathology and treatment. The day’s acne forum will include details on sebum-reduction products in the pipeline, as well as data on benzoyl peroxide.
The psoriasis forum on Friday will feature “long-term information on the safety of current drugs,” and also look ahead to more data on IL-23 inhibitors, Dr. Fowler said in an interview.
Aesthetic dermatology highlights from Saturday’s scheduled presentations include Dr. Zachary’s review of options for facial rejuvenation and what clinicians need to know about body contouring. Kristin M. Kelly, MD, of the University of California, Irvine, will discuss devices and how they can be best used to modulate scarring, and Howard Steinman, MD, who is in private practice in Irving, Tex., will share tips on “avoiding the danger zones” when using toxins and fillers.
SDEF and this news organization are owned by the same parent company.
Updates on vaccines and infections, as well as the latest acne treatments and the Psoriasis Forum are among the hot topics at Skin Disease Education Foundation’s annual Las Vegas Dermatology Seminar.
The meeting is cochaired by Linda F. Stein Gold, MD, of Henry Ford Health System in Detroit, Mich., Christopher B. Zachary, MD, of the University of California, Irvine, and Joseph F. Fowler Jr., MD, of the University of Louisville (Ky).
Dr. Stein Gold, along with Julie Harper, MD, will direct a rosacea forum on Thursday to review the latest information on pathology and treatment. The day’s acne forum will include details on sebum-reduction products in the pipeline, as well as data on benzoyl peroxide.
The psoriasis forum on Friday will feature “long-term information on the safety of current drugs,” and also look ahead to more data on IL-23 inhibitors, Dr. Fowler said in an interview.
Aesthetic dermatology highlights from Saturday’s scheduled presentations include Dr. Zachary’s review of options for facial rejuvenation and what clinicians need to know about body contouring. Kristin M. Kelly, MD, of the University of California, Irvine, will discuss devices and how they can be best used to modulate scarring, and Howard Steinman, MD, who is in private practice in Irving, Tex., will share tips on “avoiding the danger zones” when using toxins and fillers.
SDEF and this news organization are owned by the same parent company.
Updates on vaccines and infections, as well as the latest acne treatments and the Psoriasis Forum are among the hot topics at Skin Disease Education Foundation’s annual Las Vegas Dermatology Seminar.
The meeting is cochaired by Linda F. Stein Gold, MD, of Henry Ford Health System in Detroit, Mich., Christopher B. Zachary, MD, of the University of California, Irvine, and Joseph F. Fowler Jr., MD, of the University of Louisville (Ky).
Dr. Stein Gold, along with Julie Harper, MD, will direct a rosacea forum on Thursday to review the latest information on pathology and treatment. The day’s acne forum will include details on sebum-reduction products in the pipeline, as well as data on benzoyl peroxide.
The psoriasis forum on Friday will feature “long-term information on the safety of current drugs,” and also look ahead to more data on IL-23 inhibitors, Dr. Fowler said in an interview.
Aesthetic dermatology highlights from Saturday’s scheduled presentations include Dr. Zachary’s review of options for facial rejuvenation and what clinicians need to know about body contouring. Kristin M. Kelly, MD, of the University of California, Irvine, will discuss devices and how they can be best used to modulate scarring, and Howard Steinman, MD, who is in private practice in Irving, Tex., will share tips on “avoiding the danger zones” when using toxins and fillers.
SDEF and this news organization are owned by the same parent company.