Amy Pfeiffer

The Food and Drug Administration has sent warning letters to four companies that manufacture or distribute hand sanitizers carrying an unproven message that they can prevent MRSA.

The four companies are: Tec Laboratories (Staphaseptic First Aid Antiseptic/Pain Relieving Gel); JD Nelson and Associates (Safe4Hours Hand Sanitizing Lotion and Safe4Hours First Aid Antiseptic Skin Protectant); Dr. G.H. Tichenor Antiseptic Co. (Dr. Tichenor’s Antiseptic Gel); and Oh So Clean Inc., also known as CleanWell Company (Clean Well All-Natural Hand Sanitizer, Clean Well All-Natural Hand Sanitizing Wipes, and Clean Well All-Natural Antibacterial Foaming Hand Soap).

The companies have 15 days from the date of the FDA's Warning Letter (April 20) to correct product labeling, or they risk other legal action and/or product seizure.

The FDA also issued advice to consumers that they should not buy over-the-counter products that claim to prevent infection. "Consumers are being misled if they think these products you can buy in a drugstore or from other places will protect them from a potentially deadly infection," Deborah Autor, compliance director at the FDA’s Center for Drug Evaluation and Research, said in a press release.

Examples of claims found on the labels include: "Kills over 99.9% of MRSA," "helps prevent skin infections caused by MRSA and other germs," and "is effective against a broad spectrum of pathogens, including MRSA."

Any side effects believed to be caused by the use of these hand sanitizing products should be reported to MedWatch.

The Food and Drug Administration has sent warning letters to four companies that manufacture or distribute hand sanitizers carrying an unproven message that they can prevent MRSA.

The four companies are: Tec Laboratories (Staphaseptic First Aid Antiseptic/Pain Relieving Gel); JD Nelson and Associates (Safe4Hours Hand Sanitizing Lotion and Safe4Hours First Aid Antiseptic Skin Protectant); Dr. G.H. Tichenor Antiseptic Co. (Dr. Tichenor’s Antiseptic Gel); and Oh So Clean Inc., also known as CleanWell Company (Clean Well All-Natural Hand Sanitizer, Clean Well All-Natural Hand Sanitizing Wipes, and Clean Well All-Natural Antibacterial Foaming Hand Soap).

The companies have 15 days from the date of the FDA's Warning Letter (April 20) to correct product labeling, or they risk other legal action and/or product seizure.

The FDA also issued advice to consumers that they should not buy over-the-counter products that claim to prevent infection. "Consumers are being misled if they think these products you can buy in a drugstore or from other places will protect them from a potentially deadly infection," Deborah Autor, compliance director at the FDA’s Center for Drug Evaluation and Research, said in a press release.

Examples of claims found on the labels include: "Kills over 99.9% of MRSA," "helps prevent skin infections caused by MRSA and other germs," and "is effective against a broad spectrum of pathogens, including MRSA."

Any side effects believed to be caused by the use of these hand sanitizing products should be reported to MedWatch.

The Food and Drug Administration has sent warning letters to four companies that manufacture or distribute hand sanitizers carrying an unproven message that they can prevent MRSA.

The four companies are: Tec Laboratories (Staphaseptic First Aid Antiseptic/Pain Relieving Gel); JD Nelson and Associates (Safe4Hours Hand Sanitizing Lotion and Safe4Hours First Aid Antiseptic Skin Protectant); Dr. G.H. Tichenor Antiseptic Co. (Dr. Tichenor’s Antiseptic Gel); and Oh So Clean Inc., also known as CleanWell Company (Clean Well All-Natural Hand Sanitizer, Clean Well All-Natural Hand Sanitizing Wipes, and Clean Well All-Natural Antibacterial Foaming Hand Soap).

The companies have 15 days from the date of the FDA's Warning Letter (April 20) to correct product labeling, or they risk other legal action and/or product seizure.

The FDA also issued advice to consumers that they should not buy over-the-counter products that claim to prevent infection. "Consumers are being misled if they think these products you can buy in a drugstore or from other places will protect them from a potentially deadly infection," Deborah Autor, compliance director at the FDA’s Center for Drug Evaluation and Research, said in a press release.

Examples of claims found on the labels include: "Kills over 99.9% of MRSA," "helps prevent skin infections caused by MRSA and other germs," and "is effective against a broad spectrum of pathogens, including MRSA."

Any side effects believed to be caused by the use of these hand sanitizing products should be reported to MedWatch.

The Food and Drug Administration has sent warning letters to four companies that manufacture or distribute hand sanitizers carrying an unproven message that they can prevent MRSA.

The four companies are: Tec Laboratories (Staphaseptic First Aid Antiseptic/Pain Relieving Gel); JD Nelson and Associates (Safe4Hours Hand Sanitizing Lotion and Safe4Hours First Aid Antiseptic Skin Protectant); Dr. G.H. Tichenor Antiseptic Co. (Dr. Tichenor’s Antiseptic Gel); and Oh So Clean Inc., also known as CleanWell Company (Clean Well All-Natural Hand Sanitizer, Clean Well All-Natural Hand Sanitizing Wipes, and Clean Well All-Natural Antibacterial Foaming Hand Soap).

The companies have 15 days from the date of the FDA's Warning Letter (April 20) to correct product labeling, or they risk other legal action and/or product seizure.

The FDA also issued advice to consumers that they should not buy over-the-counter products that claim to prevent infection. "Consumers are being misled if they think these products you can buy in a drugstore or from other places will protect them from a potentially deadly infection," Deborah Autor, compliance director at the FDA’s Center for Drug Evaluation and Research, said in a press release.

Examples of claims found on the labels include: "Kills over 99.9% of MRSA," "helps prevent skin infections caused by MRSA and other germs," and "is effective against a broad spectrum of pathogens, including MRSA."

Any side effects believed to be caused by the use of these hand sanitizing products should be reported to MedWatch.

The Food and Drug Administration has sent warning letters to four companies that manufacture or distribute hand sanitizers carrying an unproven message that they can prevent MRSA.

The four companies are: Tec Laboratories (Staphaseptic First Aid Antiseptic/Pain Relieving Gel); JD Nelson and Associates (Safe4Hours Hand Sanitizing Lotion and Safe4Hours First Aid Antiseptic Skin Protectant); Dr. G.H. Tichenor Antiseptic Co. (Dr. Tichenor’s Antiseptic Gel); and Oh So Clean Inc., also known as CleanWell Company (Clean Well All-Natural Hand Sanitizer, Clean Well All-Natural Hand Sanitizing Wipes, and Clean Well All-Natural Antibacterial Foaming Hand Soap).

The companies have 15 days from the date of the FDA's Warning Letter (April 20) to correct product labeling, or they risk other legal action and/or product seizure.

The FDA also issued advice to consumers that they should not buy over-the-counter products that claim to prevent infection. "Consumers are being misled if they think these products you can buy in a drugstore or from other places will protect them from a potentially deadly infection," Deborah Autor, compliance director at the FDA’s Center for Drug Evaluation and Research, said in a press release.

Examples of claims found on the labels include: "Kills over 99.9% of MRSA," "helps prevent skin infections caused by MRSA and other germs," and "is effective against a broad spectrum of pathogens, including MRSA."

Any side effects believed to be caused by the use of these hand sanitizing products should be reported to MedWatch.

The Food and Drug Administration has sent warning letters to four companies that manufacture or distribute hand sanitizers carrying an unproven message that they can prevent MRSA.

The four companies are: Tec Laboratories (Staphaseptic First Aid Antiseptic/Pain Relieving Gel); JD Nelson and Associates (Safe4Hours Hand Sanitizing Lotion and Safe4Hours First Aid Antiseptic Skin Protectant); Dr. G.H. Tichenor Antiseptic Co. (Dr. Tichenor’s Antiseptic Gel); and Oh So Clean Inc., also known as CleanWell Company (Clean Well All-Natural Hand Sanitizer, Clean Well All-Natural Hand Sanitizing Wipes, and Clean Well All-Natural Antibacterial Foaming Hand Soap).

The companies have 15 days from the date of the FDA's Warning Letter (April 20) to correct product labeling, or they risk other legal action and/or product seizure.

The FDA also issued advice to consumers that they should not buy over-the-counter products that claim to prevent infection. "Consumers are being misled if they think these products you can buy in a drugstore or from other places will protect them from a potentially deadly infection," Deborah Autor, compliance director at the FDA’s Center for Drug Evaluation and Research, said in a press release.

Examples of claims found on the labels include: "Kills over 99.9% of MRSA," "helps prevent skin infections caused by MRSA and other germs," and "is effective against a broad spectrum of pathogens, including MRSA."

Any side effects believed to be caused by the use of these hand sanitizing products should be reported to MedWatch.

The Food and Drug Administration has sent warning letters to four companies that manufacture or distribute hand sanitizers carrying an unproven message that they can prevent MRSA.

The four companies are: Tec Laboratories (Staphaseptic First Aid Antiseptic/Pain Relieving Gel); JD Nelson and Associates (Safe4Hours Hand Sanitizing Lotion and Safe4Hours First Aid Antiseptic Skin Protectant); Dr. G.H. Tichenor Antiseptic Co. (Dr. Tichenor’s Antiseptic Gel); and Oh So Clean Inc., also known as CleanWell Company (Clean Well All-Natural Hand Sanitizer, Clean Well All-Natural Hand Sanitizing Wipes, and Clean Well All-Natural Antibacterial Foaming Hand Soap).

The companies have 15 days from the date of the FDA's Warning Letter (April 20) to correct product labeling, or they risk other legal action and/or product seizure.

The FDA also issued advice to consumers that they should not buy over-the-counter products that claim to prevent infection. "Consumers are being misled if they think these products you can buy in a drugstore or from other places will protect them from a potentially deadly infection," Deborah Autor, compliance director at the FDA’s Center for Drug Evaluation and Research, said in a press release.

Examples of claims found on the labels include: "Kills over 99.9% of MRSA," "helps prevent skin infections caused by MRSA and other germs," and "is effective against a broad spectrum of pathogens, including MRSA."

Any side effects believed to be caused by the use of these hand sanitizing products should be reported to MedWatch.

The Food and Drug Administration has sent warning letters to four companies that manufacture or distribute hand sanitizers carrying an unproven message that they can prevent MRSA.

The four companies are: Tec Laboratories (Staphaseptic First Aid Antiseptic/Pain Relieving Gel); JD Nelson and Associates (Safe4Hours Hand Sanitizing Lotion and Safe4Hours First Aid Antiseptic Skin Protectant); Dr. G.H. Tichenor Antiseptic Co. (Dr. Tichenor’s Antiseptic Gel); and Oh So Clean Inc., also known as CleanWell Company (Clean Well All-Natural Hand Sanitizer, Clean Well All-Natural Hand Sanitizing Wipes, and Clean Well All-Natural Antibacterial Foaming Hand Soap).

The companies have 15 days from the date of the FDA's Warning Letter (April 20) to correct product labeling, or they risk other legal action and/or product seizure.

The FDA also issued advice to consumers that they should not buy over-the-counter products that claim to prevent infection. "Consumers are being misled if they think these products you can buy in a drugstore or from other places will protect them from a potentially deadly infection," Deborah Autor, compliance director at the FDA’s Center for Drug Evaluation and Research, said in a press release.

Examples of claims found on the labels include: "Kills over 99.9% of MRSA," "helps prevent skin infections caused by MRSA and other germs," and "is effective against a broad spectrum of pathogens, including MRSA."

Any side effects believed to be caused by the use of these hand sanitizing products should be reported to MedWatch.

The Food and Drug Administration has sent warning letters to four companies that manufacture or distribute hand sanitizers carrying an unproven message that they can prevent MRSA.

The four companies are: Tec Laboratories (Staphaseptic First Aid Antiseptic/Pain Relieving Gel); JD Nelson and Associates (Safe4Hours Hand Sanitizing Lotion and Safe4Hours First Aid Antiseptic Skin Protectant); Dr. G.H. Tichenor Antiseptic Co. (Dr. Tichenor’s Antiseptic Gel); and Oh So Clean Inc., also known as CleanWell Company (Clean Well All-Natural Hand Sanitizer, Clean Well All-Natural Hand Sanitizing Wipes, and Clean Well All-Natural Antibacterial Foaming Hand Soap).

The companies have 15 days from the date of the FDA's Warning Letter (April 20) to correct product labeling, or they risk other legal action and/or product seizure.

The FDA also issued advice to consumers that they should not buy over-the-counter products that claim to prevent infection. "Consumers are being misled if they think these products you can buy in a drugstore or from other places will protect them from a potentially deadly infection," Deborah Autor, compliance director at the FDA’s Center for Drug Evaluation and Research, said in a press release.

Examples of claims found on the labels include: "Kills over 99.9% of MRSA," "helps prevent skin infections caused by MRSA and other germs," and "is effective against a broad spectrum of pathogens, including MRSA."

Any side effects believed to be caused by the use of these hand sanitizing products should be reported to MedWatch.

We asked members of the Skin & Allergy News Editorial Advisory Board to predict the highlights of the American Academy of Dermatology's Annual Meeting. Here is how they responded.

Dr. Eliot Battle Jr., director of Cultura Cosmetic Medical Spa in Washington, said "It's a new year - out with the old and in with the NEW! We are observing a changing of the guard for the upcoming AAD annual conference. New Orleans will be a showplace for our newest generation of experts to share their knowledge."

Dr. Suzanne C. Connolly, a professor emeritus of dermatology at the Mayo Clinic in Scottsdale, Ariz., said "There will be something for everyone at the AAD meeting! Whether a resident or experienced dermatologist, clinician or researcher, there are sessions that will appeal. Newly added this year is a cutting edge session in which 'hot' new material will be shared."

Dr. Roberta D. Sengelmann, in private practice in Santa Barbara, Calif., predicted highlights would include discussions about: fat melting/freezing devices and injectables; confocal microscopy for skin cancer; immunotherapy for melanoma; new fillers that cross link with light; debating vitamin D; polidochoanol for treating sclerosis; and comparing botulinum toxins.

Dr. Randall K. Roenigk, chairman of the department of dermatology at the Mayo Clinic in Rochester, Minn., pointed out a new mentor recognition program developed by the Academy's Leadership Institute. For a small donation, dermatologists were able to recognize their mentor. The Academy sent all recognized mentors a gold star to wear at the meeting, and their name will be printed on a star and on display at the wall of leadership located in Lobby E of the Ernest N. Morial Convention Center. "

"Sometimes the teachers in our residency programs don't get enough recognition for the work they do preparing our dermatologists of the future," said Dr. Roegnik. For more information on this program, visit http://www.aad.org/leadership/star.html.

Dr. Neil S. Goldberg, who is in private practice in Bronxville, N.Y., said that he hopes the AAD will address the leadership in Washington. "We have been ill served by our Washington leadership for years. From the iPLEDGE fiasco to the health care debacle, the advice we've been given and the path we've taken has been totally wrong. We needed tort reform and a Medicare/SGR fix and we got neither."

He added, "The mandatory deadline for switching to EMR is approaching and the choices we have are overpriced and under performing. We need an open source system or something where basic EMR software is cheap and accessible but we pay for upgrades and customization.  The data sets should be interchangeable and mobile, we shouldn't be tethered for life to one company and be subject to exorbitant fees for tech support. We should be aiming for a solution that works better for us not one where we have to work so hard for them."

We asked members of the Skin & Allergy News Editorial Advisory Board to predict the highlights of the American Academy of Dermatology's Annual Meeting. Here is how they responded.

Dr. Eliot Battle Jr., director of Cultura Cosmetic Medical Spa in Washington, said "It's a new year - out with the old and in with the NEW! We are observing a changing of the guard for the upcoming AAD annual conference. New Orleans will be a showplace for our newest generation of experts to share their knowledge."

Dr. Suzanne C. Connolly, a professor emeritus of dermatology at the Mayo Clinic in Scottsdale, Ariz., said "There will be something for everyone at the AAD meeting! Whether a resident or experienced dermatologist, clinician or researcher, there are sessions that will appeal. Newly added this year is a cutting edge session in which 'hot' new material will be shared."

Dr. Roberta D. Sengelmann, in private practice in Santa Barbara, Calif., predicted highlights would include discussions about: fat melting/freezing devices and injectables; confocal microscopy for skin cancer; immunotherapy for melanoma; new fillers that cross link with light; debating vitamin D; polidochoanol for treating sclerosis; and comparing botulinum toxins.

Dr. Randall K. Roenigk, chairman of the department of dermatology at the Mayo Clinic in Rochester, Minn., pointed out a new mentor recognition program developed by the Academy's Leadership Institute. For a small donation, dermatologists were able to recognize their mentor. The Academy sent all recognized mentors a gold star to wear at the meeting, and their name will be printed on a star and on display at the wall of leadership located in Lobby E of the Ernest N. Morial Convention Center. "

"Sometimes the teachers in our residency programs don't get enough recognition for the work they do preparing our dermatologists of the future," said Dr. Roegnik. For more information on this program, visit http://www.aad.org/leadership/star.html.

Dr. Neil S. Goldberg, who is in private practice in Bronxville, N.Y., said that he hopes the AAD will address the leadership in Washington. "We have been ill served by our Washington leadership for years. From the iPLEDGE fiasco to the health care debacle, the advice we've been given and the path we've taken has been totally wrong. We needed tort reform and a Medicare/SGR fix and we got neither."

He added, "The mandatory deadline for switching to EMR is approaching and the choices we have are overpriced and under performing. We need an open source system or something where basic EMR software is cheap and accessible but we pay for upgrades and customization.  The data sets should be interchangeable and mobile, we shouldn't be tethered for life to one company and be subject to exorbitant fees for tech support. We should be aiming for a solution that works better for us not one where we have to work so hard for them."

We asked members of the Skin & Allergy News Editorial Advisory Board to predict the highlights of the American Academy of Dermatology's Annual Meeting. Here is how they responded.

Dr. Eliot Battle Jr., director of Cultura Cosmetic Medical Spa in Washington, said "It's a new year - out with the old and in with the NEW! We are observing a changing of the guard for the upcoming AAD annual conference. New Orleans will be a showplace for our newest generation of experts to share their knowledge."

Dr. Suzanne C. Connolly, a professor emeritus of dermatology at the Mayo Clinic in Scottsdale, Ariz., said "There will be something for everyone at the AAD meeting! Whether a resident or experienced dermatologist, clinician or researcher, there are sessions that will appeal. Newly added this year is a cutting edge session in which 'hot' new material will be shared."

Dr. Roberta D. Sengelmann, in private practice in Santa Barbara, Calif., predicted highlights would include discussions about: fat melting/freezing devices and injectables; confocal microscopy for skin cancer; immunotherapy for melanoma; new fillers that cross link with light; debating vitamin D; polidochoanol for treating sclerosis; and comparing botulinum toxins.

Dr. Randall K. Roenigk, chairman of the department of dermatology at the Mayo Clinic in Rochester, Minn., pointed out a new mentor recognition program developed by the Academy's Leadership Institute. For a small donation, dermatologists were able to recognize their mentor. The Academy sent all recognized mentors a gold star to wear at the meeting, and their name will be printed on a star and on display at the wall of leadership located in Lobby E of the Ernest N. Morial Convention Center. "

"Sometimes the teachers in our residency programs don't get enough recognition for the work they do preparing our dermatologists of the future," said Dr. Roegnik. For more information on this program, visit http://www.aad.org/leadership/star.html.

Dr. Neil S. Goldberg, who is in private practice in Bronxville, N.Y., said that he hopes the AAD will address the leadership in Washington. "We have been ill served by our Washington leadership for years. From the iPLEDGE fiasco to the health care debacle, the advice we've been given and the path we've taken has been totally wrong. We needed tort reform and a Medicare/SGR fix and we got neither."

He added, "The mandatory deadline for switching to EMR is approaching and the choices we have are overpriced and under performing. We need an open source system or something where basic EMR software is cheap and accessible but we pay for upgrades and customization.  The data sets should be interchangeable and mobile, we shouldn't be tethered for life to one company and be subject to exorbitant fees for tech support. We should be aiming for a solution that works better for us not one where we have to work so hard for them."

Sandoz Inc. has voluntarily recalled all lots of Methotrexate Injection, after small glass flakes were found in four lots.

The glass flakes were found by Sandoz quality control, and are a result of delamination of the glass that is used to manufacture the vials, according to a statement released by Sandoz.

The manufacturer noted that lodging of the particles could lead to serious adverse events that could result in disability or death.

More information, including lot numbers, label type, and expiration date can be found on the Sandoz and Food and Drug Administration websites.

Patients should discontinue use of the product immediately.

Sandoz Inc. has voluntarily recalled all lots of Methotrexate Injection, after small glass flakes were found in four lots.

The glass flakes were found by Sandoz quality control, and are a result of delamination of the glass that is used to manufacture the vials, according to a statement released by Sandoz.

The manufacturer noted that lodging of the particles could lead to serious adverse events that could result in disability or death.

More information, including lot numbers, label type, and expiration date can be found on the Sandoz and Food and Drug Administration websites.

Patients should discontinue use of the product immediately.

Sandoz Inc. has voluntarily recalled all lots of Methotrexate Injection, after small glass flakes were found in four lots.

The glass flakes were found by Sandoz quality control, and are a result of delamination of the glass that is used to manufacture the vials, according to a statement released by Sandoz.

The manufacturer noted that lodging of the particles could lead to serious adverse events that could result in disability or death.

More information, including lot numbers, label type, and expiration date can be found on the Sandoz and Food and Drug Administration websites.

Patients should discontinue use of the product immediately.

Sandoz Inc. has voluntarily recalled all lots of Methotrexate Injection, after small glass flakes were found in four lots.

The glass flakes were found by Sandoz quality control, and are a result of delamination of the glass that is used to manufacture the vials, according to a statement released by Sandoz.

The manufacturer noted that lodging of the particles could lead to serious adverse events that could result in disability or death.

More information, including lot numbers, label type, and expiration date can be found on the Sandoz and Food and Drug Administration websites.

Patients should discontinue use of the product immediately.

Sandoz Inc. has voluntarily recalled all lots of Methotrexate Injection, after small glass flakes were found in four lots.

The glass flakes were found by Sandoz quality control, and are a result of delamination of the glass that is used to manufacture the vials, according to a statement released by Sandoz.

The manufacturer noted that lodging of the particles could lead to serious adverse events that could result in disability or death.

More information, including lot numbers, label type, and expiration date can be found on the Sandoz and Food and Drug Administration websites.

Patients should discontinue use of the product immediately.

Sandoz Inc. has voluntarily recalled all lots of Methotrexate Injection, after small glass flakes were found in four lots.

The glass flakes were found by Sandoz quality control, and are a result of delamination of the glass that is used to manufacture the vials, according to a statement released by Sandoz.

The manufacturer noted that lodging of the particles could lead to serious adverse events that could result in disability or death.

More information, including lot numbers, label type, and expiration date can be found on the Sandoz and Food and Drug Administration websites.

Patients should discontinue use of the product immediately.

SANTA MONICA, CALIF. — The ideal device for treating pigmentation disorders would reduce wrinkles, pigment, and redness in one pass with a low amount of pain and give patients a fast, easy recovery, according to Dr. E. Victor Ross.

"There's no device that does all those things, but the devices that actually selectively target blood and melanin are possibly the closest thing to it," Dr. Ross said at a cosmetic dermatology seminar sponsored by Skin Disease Education Foundation (SDEF).

Dr. Ross of the Scripps Clinic in San Diego discussed the pros and cons of using intense pulsed light (IPL) devices, pulsed dye lasers (PDL), and potassium-titanyl-phosphate (KTP) lasers for treating pigmentation disorders.

Both pigmentation and vascular disorders can be treated in one pass using IPL therapy and KTP lasers, he said. The PDL was the first "boutique laser" to treat vascular lesions, he noted. Next came the KTP laser to treat isolated vessels. When IPL treatment entered the scene, it displaced the other devices because of its versatility, but all three approaches have a role in treating blood and pigment lesions. "My favorite on a daily basis is the KTP laser," he acknowledged.

PDL treatment is fast, and if a patient doesn't mind the resulting purpura, the PDL is probably the best device for improvement of redness in a single treatment, said Dr. Ross.

The PDL remains the standard for treating port wine stains. Nevertheless, it is not possible to reduce both red and brown facial lesions with this laser, and it cannot, in one pass, treat both blood and pigment lesions.

KTP lasers can treat both small and large spots. The spot-size reduction allows for safer treatment of darker-skinned (skin types IV and V) patients with telangiectasias. In addition, the device has a good vascular-to-pigment damage ratio. When a 1- to 5-mm spot size is used, vessel reduction can be seen in real time.

"It is nice to see a blood vessel disappear as you see it, which you can't do with the IPL," said Dr. Ross. "It's just fun to do." The handpiece is also light and easy to use.

KTP therapy has higher costs, however, and tends to cause more pain than IPL treatment. After KTP treatment, edema can be severe, and overtreatment can cause pitting.

IPL therapy is raising the bar for treating pigmentation. Filtration is better with an IPL device, lamp pumping is smoother, cooling has been added to the device, and the radio frequency has been improved. Most importantly, it is safe, he said.

One of IPL's drawbacks is that the divergence of the beam means the handpiece must be held close to the skin, which may compress vessels. Also, the nonlaser properties of IPL make it difficult to focus on small spots, so it can be challenging to use on discrete lesions. Finally, with large spot treatment capability comes the potential for big side effects, Dr. Ross noted.

He disclosed being a consultant for, and receiving research grants from, Palomar. Dr. Ross also has received research support from Cutera Inc., Lumenis, Candela Corp., Ulthera Inc., and Sciton Inc.

SDEF and this news organization are both owned by Elsevier.

My favorite laser on a daily basis for treating pigmentation disorders is the KTP. DR. ROSS

SANTA MONICA, CALIF. — The ideal device for treating pigmentation disorders would reduce wrinkles, pigment, and redness in one pass with a low amount of pain and give patients a fast, easy recovery, according to Dr. E. Victor Ross.

"There's no device that does all those things, but the devices that actually selectively target blood and melanin are possibly the closest thing to it," Dr. Ross said at a cosmetic dermatology seminar sponsored by Skin Disease Education Foundation (SDEF).

Dr. Ross of the Scripps Clinic in San Diego discussed the pros and cons of using intense pulsed light (IPL) devices, pulsed dye lasers (PDL), and potassium-titanyl-phosphate (KTP) lasers for treating pigmentation disorders.

Both pigmentation and vascular disorders can be treated in one pass using IPL therapy and KTP lasers, he said. The PDL was the first "boutique laser" to treat vascular lesions, he noted. Next came the KTP laser to treat isolated vessels. When IPL treatment entered the scene, it displaced the other devices because of its versatility, but all three approaches have a role in treating blood and pigment lesions. "My favorite on a daily basis is the KTP laser," he acknowledged.

PDL treatment is fast, and if a patient doesn't mind the resulting purpura, the PDL is probably the best device for improvement of redness in a single treatment, said Dr. Ross.

The PDL remains the standard for treating port wine stains. Nevertheless, it is not possible to reduce both red and brown facial lesions with this laser, and it cannot, in one pass, treat both blood and pigment lesions.

KTP lasers can treat both small and large spots. The spot-size reduction allows for safer treatment of darker-skinned (skin types IV and V) patients with telangiectasias. In addition, the device has a good vascular-to-pigment damage ratio. When a 1- to 5-mm spot size is used, vessel reduction can be seen in real time.

"It is nice to see a blood vessel disappear as you see it, which you can't do with the IPL," said Dr. Ross. "It's just fun to do." The handpiece is also light and easy to use.

KTP therapy has higher costs, however, and tends to cause more pain than IPL treatment. After KTP treatment, edema can be severe, and overtreatment can cause pitting.

IPL therapy is raising the bar for treating pigmentation. Filtration is better with an IPL device, lamp pumping is smoother, cooling has been added to the device, and the radio frequency has been improved. Most importantly, it is safe, he said.

One of IPL's drawbacks is that the divergence of the beam means the handpiece must be held close to the skin, which may compress vessels. Also, the nonlaser properties of IPL make it difficult to focus on small spots, so it can be challenging to use on discrete lesions. Finally, with large spot treatment capability comes the potential for big side effects, Dr. Ross noted.

He disclosed being a consultant for, and receiving research grants from, Palomar. Dr. Ross also has received research support from Cutera Inc., Lumenis, Candela Corp., Ulthera Inc., and Sciton Inc.

SDEF and this news organization are both owned by Elsevier.

My favorite laser on a daily basis for treating pigmentation disorders is the KTP. DR. ROSS

SANTA MONICA, CALIF. — The ideal device for treating pigmentation disorders would reduce wrinkles, pigment, and redness in one pass with a low amount of pain and give patients a fast, easy recovery, according to Dr. E. Victor Ross.

"There's no device that does all those things, but the devices that actually selectively target blood and melanin are possibly the closest thing to it," Dr. Ross said at a cosmetic dermatology seminar sponsored by Skin Disease Education Foundation (SDEF).

Dr. Ross of the Scripps Clinic in San Diego discussed the pros and cons of using intense pulsed light (IPL) devices, pulsed dye lasers (PDL), and potassium-titanyl-phosphate (KTP) lasers for treating pigmentation disorders.

Both pigmentation and vascular disorders can be treated in one pass using IPL therapy and KTP lasers, he said. The PDL was the first "boutique laser" to treat vascular lesions, he noted. Next came the KTP laser to treat isolated vessels. When IPL treatment entered the scene, it displaced the other devices because of its versatility, but all three approaches have a role in treating blood and pigment lesions. "My favorite on a daily basis is the KTP laser," he acknowledged.

PDL treatment is fast, and if a patient doesn't mind the resulting purpura, the PDL is probably the best device for improvement of redness in a single treatment, said Dr. Ross.

The PDL remains the standard for treating port wine stains. Nevertheless, it is not possible to reduce both red and brown facial lesions with this laser, and it cannot, in one pass, treat both blood and pigment lesions.

KTP lasers can treat both small and large spots. The spot-size reduction allows for safer treatment of darker-skinned (skin types IV and V) patients with telangiectasias. In addition, the device has a good vascular-to-pigment damage ratio. When a 1- to 5-mm spot size is used, vessel reduction can be seen in real time.

"It is nice to see a blood vessel disappear as you see it, which you can't do with the IPL," said Dr. Ross. "It's just fun to do." The handpiece is also light and easy to use.

KTP therapy has higher costs, however, and tends to cause more pain than IPL treatment. After KTP treatment, edema can be severe, and overtreatment can cause pitting.

IPL therapy is raising the bar for treating pigmentation. Filtration is better with an IPL device, lamp pumping is smoother, cooling has been added to the device, and the radio frequency has been improved. Most importantly, it is safe, he said.

One of IPL's drawbacks is that the divergence of the beam means the handpiece must be held close to the skin, which may compress vessels. Also, the nonlaser properties of IPL make it difficult to focus on small spots, so it can be challenging to use on discrete lesions. Finally, with large spot treatment capability comes the potential for big side effects, Dr. Ross noted.

He disclosed being a consultant for, and receiving research grants from, Palomar. Dr. Ross also has received research support from Cutera Inc., Lumenis, Candela Corp., Ulthera Inc., and Sciton Inc.

SDEF and this news organization are both owned by Elsevier.

My favorite laser on a daily basis for treating pigmentation disorders is the KTP. DR. ROSS

SANTA MONICA, CALIF. — The key to treating pigmentary disorders is making an accurate diagnosis using a Wood's lamp and classifying the patient's condition, according to Dr. Anand Ganesan.

"One of the things that is easy to learn but is easily forgotten is how to really prepare your patients when they first walk in the door, and for you to assess how well they are going to respond to the treatments that you are offering," said Dr. Ganesan, who is a professor of dermatology at the University of California, Irvine.

Dr. Ganesan discussed the etiology, diagnosis, and treatment of pigmentary disorders, as well as the triaging of patients with these conditions, at a cosmetic dermatology seminar sponsored by Skin Disease Education Foundation (SDEF).

Melasma

About 75% of melasma patients are female, and the condition is common in darker-skinned patients, he said. The exact cause of melasma is unknown, but triggers may include sun exposure, family history, phenytoin exposure, oral contraceptives, pregnancy, and increased estrogen.

The Wood's lamp is used to determine the classification of melasma: epidermal, dermal, or mixed. "If you can categorize your patients, you can actually predict very nicely how well they are going to respond to your treatment," he said.

In white and Hispanic patients, melasma appears as a reflected darker image. In patients with skin types V or VI the color will appear a little reddish, but a change can be seen over the pigmented area.

Melasma that has an epidermal component will respond well to almost any treatment. Dermal melasma tends to respond better to laser therapies. Darker-skinned patients will respond best to hydroquinone, while lighter skin responds best to peels and lasers.

Patients with melasma need to use a broad-spectrum sunscreen (UVA and UVB coverage with an SPF of 30 or more) every day, regardless of sun exposure, because fluorescent lighting emits some UVA rays, said Dr. Ganesan.

Birth control pills, cosmetic products, and phototoxic drugs should be discontinued if they appear to help cause the melasma.

Combining topical products is more effective than using tretinoin, hydroquinone, or steroids alone, he said, adding that it is important to balance an agent's potential for irritation with its strength because increased inflammation will result in poor clinical outcomes.

For patients who cannot tolerate hydroquinone, there are some less effective alternatives: kojic acid, which can be more irritating than hydroquinone; azelaic acid; mequinol, which has been shown to have some depigmenting activity and is less effective than hydroquinone; arbutin, which is a botanically related compound that can cause depigmentation; and licorice extract, available in Ayurvedic and other commercial preparations.

Chemical peels are not effective as single agents for treating melasma but may be slightly synergistic when used with hydroquinone. Peels are operator dependent, said Dr. Ganesan, so if the clinician has extensive clinical experience with them they may be a treatment option.

Studies suggest that the Q-switched Nd:YAG and ruby lasers, used in conjunction with hydroquinone, may be effective in treating dermal or mixed melasma. Positive results also have been seen with Fraxel lasers.

Vitiligo

The underlying factor thought to cause vitiligo is melanocyte susceptibility to destruction.

As with melasma, the diagnosis should be made with a Wood's lamp, which can distinguish vitiligo from other hypopigmenting conditions. Biopsy, along with Fontana-Masson staining, can be helpful to determine if melanocytes are present, Dr. Ganesan said.

There are two types of vitiligo: segmental (unresponsive to light therapy) and generalized (responsive to light therapy). Treatment options include photo therapy, lasers, surgery, and topical solutions. Given the safety and tolerability of narrow-band UVB, it is favored over treatment with PUVA.

A 380-nm excimer laser can be used to treat small surface areas, such as those on the face, but is less effective on the hands. An excimer laser should be used aggressively with dose escalation for best treatment results, Dr. Ganesan said. Because aggressive dosing regimens can lead to increased burning, it is best for treating localized areas and for patients who seek rapid improvement.

Although the excimer laser should be avoided when treating underarms, the device works well on the eyelids, he continued. It produces less response on the hands and feet but is an option if narrow-band UVB has failed.

Surgical options for treating vitiligo include punch grafting and suction blister grafting. Punch grafting has been found very effective for treating nonactive segmental lesions. A side effect of punch grafting is cobblestoning, which can diminish over time.

Dr. Ganesan disclosed having no conflicts related to his presentation.

SDEF and this news organization are both owned by Elsevier.

'If you can categorize your patients, you can actually predict very nicely how well they are going to respond.' DR. GANESAN

Possible melasma triggers include sun exposure, phenytoin exposure, and oral contraceptives. Courtesy Dr. Wendy E. Roberts

SANTA MONICA, CALIF. — The key to treating pigmentary disorders is making an accurate diagnosis using a Wood's lamp and classifying the patient's condition, according to Dr. Anand Ganesan.

"One of the things that is easy to learn but is easily forgotten is how to really prepare your patients when they first walk in the door, and for you to assess how well they are going to respond to the treatments that you are offering," said Dr. Ganesan, who is a professor of dermatology at the University of California, Irvine.

Dr. Ganesan discussed the etiology, diagnosis, and treatment of pigmentary disorders, as well as the triaging of patients with these conditions, at a cosmetic dermatology seminar sponsored by Skin Disease Education Foundation (SDEF).

Melasma

About 75% of melasma patients are female, and the condition is common in darker-skinned patients, he said. The exact cause of melasma is unknown, but triggers may include sun exposure, family history, phenytoin exposure, oral contraceptives, pregnancy, and increased estrogen.

The Wood's lamp is used to determine the classification of melasma: epidermal, dermal, or mixed. "If you can categorize your patients, you can actually predict very nicely how well they are going to respond to your treatment," he said.

In white and Hispanic patients, melasma appears as a reflected darker image. In patients with skin types V or VI the color will appear a little reddish, but a change can be seen over the pigmented area.

Melasma that has an epidermal component will respond well to almost any treatment. Dermal melasma tends to respond better to laser therapies. Darker-skinned patients will respond best to hydroquinone, while lighter skin responds best to peels and lasers.

Patients with melasma need to use a broad-spectrum sunscreen (UVA and UVB coverage with an SPF of 30 or more) every day, regardless of sun exposure, because fluorescent lighting emits some UVA rays, said Dr. Ganesan.

Birth control pills, cosmetic products, and phototoxic drugs should be discontinued if they appear to help cause the melasma.

Combining topical products is more effective than using tretinoin, hydroquinone, or steroids alone, he said, adding that it is important to balance an agent's potential for irritation with its strength because increased inflammation will result in poor clinical outcomes.

For patients who cannot tolerate hydroquinone, there are some less effective alternatives: kojic acid, which can be more irritating than hydroquinone; azelaic acid; mequinol, which has been shown to have some depigmenting activity and is less effective than hydroquinone; arbutin, which is a botanically related compound that can cause depigmentation; and licorice extract, available in Ayurvedic and other commercial preparations.

Chemical peels are not effective as single agents for treating melasma but may be slightly synergistic when used with hydroquinone. Peels are operator dependent, said Dr. Ganesan, so if the clinician has extensive clinical experience with them they may be a treatment option.

Studies suggest that the Q-switched Nd:YAG and ruby lasers, used in conjunction with hydroquinone, may be effective in treating dermal or mixed melasma. Positive results also have been seen with Fraxel lasers.

Vitiligo

The underlying factor thought to cause vitiligo is melanocyte susceptibility to destruction.

As with melasma, the diagnosis should be made with a Wood's lamp, which can distinguish vitiligo from other hypopigmenting conditions. Biopsy, along with Fontana-Masson staining, can be helpful to determine if melanocytes are present, Dr. Ganesan said.

There are two types of vitiligo: segmental (unresponsive to light therapy) and generalized (responsive to light therapy). Treatment options include photo therapy, lasers, surgery, and topical solutions. Given the safety and tolerability of narrow-band UVB, it is favored over treatment with PUVA.

A 380-nm excimer laser can be used to treat small surface areas, such as those on the face, but is less effective on the hands. An excimer laser should be used aggressively with dose escalation for best treatment results, Dr. Ganesan said. Because aggressive dosing regimens can lead to increased burning, it is best for treating localized areas and for patients who seek rapid improvement.

Although the excimer laser should be avoided when treating underarms, the device works well on the eyelids, he continued. It produces less response on the hands and feet but is an option if narrow-band UVB has failed.

Surgical options for treating vitiligo include punch grafting and suction blister grafting. Punch grafting has been found very effective for treating nonactive segmental lesions. A side effect of punch grafting is cobblestoning, which can diminish over time.

Dr. Ganesan disclosed having no conflicts related to his presentation.

SDEF and this news organization are both owned by Elsevier.

'If you can categorize your patients, you can actually predict very nicely how well they are going to respond.' DR. GANESAN

Possible melasma triggers include sun exposure, phenytoin exposure, and oral contraceptives. Courtesy Dr. Wendy E. Roberts

SANTA MONICA, CALIF. — The key to treating pigmentary disorders is making an accurate diagnosis using a Wood's lamp and classifying the patient's condition, according to Dr. Anand Ganesan.

"One of the things that is easy to learn but is easily forgotten is how to really prepare your patients when they first walk in the door, and for you to assess how well they are going to respond to the treatments that you are offering," said Dr. Ganesan, who is a professor of dermatology at the University of California, Irvine.

Dr. Ganesan discussed the etiology, diagnosis, and treatment of pigmentary disorders, as well as the triaging of patients with these conditions, at a cosmetic dermatology seminar sponsored by Skin Disease Education Foundation (SDEF).

Melasma

About 75% of melasma patients are female, and the condition is common in darker-skinned patients, he said. The exact cause of melasma is unknown, but triggers may include sun exposure, family history, phenytoin exposure, oral contraceptives, pregnancy, and increased estrogen.

The Wood's lamp is used to determine the classification of melasma: epidermal, dermal, or mixed. "If you can categorize your patients, you can actually predict very nicely how well they are going to respond to your treatment," he said.

In white and Hispanic patients, melasma appears as a reflected darker image. In patients with skin types V or VI the color will appear a little reddish, but a change can be seen over the pigmented area.

Melasma that has an epidermal component will respond well to almost any treatment. Dermal melasma tends to respond better to laser therapies. Darker-skinned patients will respond best to hydroquinone, while lighter skin responds best to peels and lasers.

Patients with melasma need to use a broad-spectrum sunscreen (UVA and UVB coverage with an SPF of 30 or more) every day, regardless of sun exposure, because fluorescent lighting emits some UVA rays, said Dr. Ganesan.

Birth control pills, cosmetic products, and phototoxic drugs should be discontinued if they appear to help cause the melasma.

Combining topical products is more effective than using tretinoin, hydroquinone, or steroids alone, he said, adding that it is important to balance an agent's potential for irritation with its strength because increased inflammation will result in poor clinical outcomes.

For patients who cannot tolerate hydroquinone, there are some less effective alternatives: kojic acid, which can be more irritating than hydroquinone; azelaic acid; mequinol, which has been shown to have some depigmenting activity and is less effective than hydroquinone; arbutin, which is a botanically related compound that can cause depigmentation; and licorice extract, available in Ayurvedic and other commercial preparations.

Chemical peels are not effective as single agents for treating melasma but may be slightly synergistic when used with hydroquinone. Peels are operator dependent, said Dr. Ganesan, so if the clinician has extensive clinical experience with them they may be a treatment option.

Studies suggest that the Q-switched Nd:YAG and ruby lasers, used in conjunction with hydroquinone, may be effective in treating dermal or mixed melasma. Positive results also have been seen with Fraxel lasers.

Vitiligo

The underlying factor thought to cause vitiligo is melanocyte susceptibility to destruction.

As with melasma, the diagnosis should be made with a Wood's lamp, which can distinguish vitiligo from other hypopigmenting conditions. Biopsy, along with Fontana-Masson staining, can be helpful to determine if melanocytes are present, Dr. Ganesan said.

There are two types of vitiligo: segmental (unresponsive to light therapy) and generalized (responsive to light therapy). Treatment options include photo therapy, lasers, surgery, and topical solutions. Given the safety and tolerability of narrow-band UVB, it is favored over treatment with PUVA.

A 380-nm excimer laser can be used to treat small surface areas, such as those on the face, but is less effective on the hands. An excimer laser should be used aggressively with dose escalation for best treatment results, Dr. Ganesan said. Because aggressive dosing regimens can lead to increased burning, it is best for treating localized areas and for patients who seek rapid improvement.

Although the excimer laser should be avoided when treating underarms, the device works well on the eyelids, he continued. It produces less response on the hands and feet but is an option if narrow-band UVB has failed.

Surgical options for treating vitiligo include punch grafting and suction blister grafting. Punch grafting has been found very effective for treating nonactive segmental lesions. A side effect of punch grafting is cobblestoning, which can diminish over time.

Dr. Ganesan disclosed having no conflicts related to his presentation.

SDEF and this news organization are both owned by Elsevier.

'If you can categorize your patients, you can actually predict very nicely how well they are going to respond.' DR. GANESAN

Possible melasma triggers include sun exposure, phenytoin exposure, and oral contraceptives. Courtesy Dr. Wendy E. Roberts

MAUI, HAWAII — Two studies have further demonstrated the safety and efficacy of bimatoprost for increased eyelash growth.

The Food and Drug Administration approved bimatoprost for increasing eyelash growth, a side effect of the glaucoma-treating drug that was observed several years ago.

In the first study presented at the annual Hawaii dermatology seminar sponsored by Skin Disease Education Foundation, Dr. David Wirta, an ophthalmologist in private practice in Newport Beach, Calif., and colleagues, conducted a safety analysis of bimatoprost based on the aggregated profile of six double-blind, active-controlled, long-term clinical studies.

Of the 1,459 patients treated with bimatoprost 0.03% once or twice daily for glaucoma, approximately 10% reported side effects that were of mild severity and led to a low study-discontinuation rate. The most commonly reported adverse effects were conjunctival hyperemia, eye pruritus, dry eye, eyelash growth, and skin hyperpigmentation.

In the second study, Dr. Wendy W. Lee and colleagues reported that bimatoprost increased eyelash growth by 2.01 mm in treated eyes, compared with 1.13 mm in controls. The patients reported no change in visual acuity or iris discoloration. The study patients received two vials of gel suspension, one containing bimatoprost and the other containing saline. The vials' contents were each mixed with 1:1 hypromellose solution and labeled "right eye" and "left eye." The suspensions were applied to the lashes once daily, each on the designated eye, for 6 weeks. Lashes were measured with a caliper at enrollment and at 1 and 3 months, according to Dr. Lee, assistant professor of clinical ophthalmology at the University of Miami.

The new indication for bimatoprost 0.03% ophthalmic solution is for "the treatment of hypotrichosis of the eyelashes by increasing their growth including length, thickness, and darkness." It is being marketed as Latisse by Allergan Inc. SDEFand this newspaper are owned by Elsevier.

MAUI, HAWAII — Two studies have further demonstrated the safety and efficacy of bimatoprost for increased eyelash growth.

The Food and Drug Administration approved bimatoprost for increasing eyelash growth, a side effect of the glaucoma-treating drug that was observed several years ago.

In the first study presented at the annual Hawaii dermatology seminar sponsored by Skin Disease Education Foundation, Dr. David Wirta, an ophthalmologist in private practice in Newport Beach, Calif., and colleagues, conducted a safety analysis of bimatoprost based on the aggregated profile of six double-blind, active-controlled, long-term clinical studies.

Of the 1,459 patients treated with bimatoprost 0.03% once or twice daily for glaucoma, approximately 10% reported side effects that were of mild severity and led to a low study-discontinuation rate. The most commonly reported adverse effects were conjunctival hyperemia, eye pruritus, dry eye, eyelash growth, and skin hyperpigmentation.

In the second study, Dr. Wendy W. Lee and colleagues reported that bimatoprost increased eyelash growth by 2.01 mm in treated eyes, compared with 1.13 mm in controls. The patients reported no change in visual acuity or iris discoloration. The study patients received two vials of gel suspension, one containing bimatoprost and the other containing saline. The vials' contents were each mixed with 1:1 hypromellose solution and labeled "right eye" and "left eye." The suspensions were applied to the lashes once daily, each on the designated eye, for 6 weeks. Lashes were measured with a caliper at enrollment and at 1 and 3 months, according to Dr. Lee, assistant professor of clinical ophthalmology at the University of Miami.

The new indication for bimatoprost 0.03% ophthalmic solution is for "the treatment of hypotrichosis of the eyelashes by increasing their growth including length, thickness, and darkness." It is being marketed as Latisse by Allergan Inc. SDEFand this newspaper are owned by Elsevier.

MAUI, HAWAII — Two studies have further demonstrated the safety and efficacy of bimatoprost for increased eyelash growth.

The Food and Drug Administration approved bimatoprost for increasing eyelash growth, a side effect of the glaucoma-treating drug that was observed several years ago.

In the first study presented at the annual Hawaii dermatology seminar sponsored by Skin Disease Education Foundation, Dr. David Wirta, an ophthalmologist in private practice in Newport Beach, Calif., and colleagues, conducted a safety analysis of bimatoprost based on the aggregated profile of six double-blind, active-controlled, long-term clinical studies.

Of the 1,459 patients treated with bimatoprost 0.03% once or twice daily for glaucoma, approximately 10% reported side effects that were of mild severity and led to a low study-discontinuation rate. The most commonly reported adverse effects were conjunctival hyperemia, eye pruritus, dry eye, eyelash growth, and skin hyperpigmentation.

In the second study, Dr. Wendy W. Lee and colleagues reported that bimatoprost increased eyelash growth by 2.01 mm in treated eyes, compared with 1.13 mm in controls. The patients reported no change in visual acuity or iris discoloration. The study patients received two vials of gel suspension, one containing bimatoprost and the other containing saline. The vials' contents were each mixed with 1:1 hypromellose solution and labeled "right eye" and "left eye." The suspensions were applied to the lashes once daily, each on the designated eye, for 6 weeks. Lashes were measured with a caliper at enrollment and at 1 and 3 months, according to Dr. Lee, assistant professor of clinical ophthalmology at the University of Miami.

The new indication for bimatoprost 0.03% ophthalmic solution is for "the treatment of hypotrichosis of the eyelashes by increasing their growth including length, thickness, and darkness." It is being marketed as Latisse by Allergan Inc. SDEFand this newspaper are owned by Elsevier.

WASHINGTON — Vaccinating all toddlers against hepatitis A reduced the overall viral incidence by 95% in one Israeli community, Dr. Beth P. Bell said at the annual Interscience Conference on Antimicrobial Agents and Chemotherapy.

In an investigation led by Dr. Ron Dagan of the Soroka University Medical Center, Be'er Sheva, Israel, the community began vaccinating children aged 18–24 months in 1999. By 2002–2004, the annual incidence of hepatitis A was 2.2–2.5 cases per 100,000 people, which represents a 95% decline in viral incidence relative to prevaccinated levels (JAMA 2005;294:202–10).

This outcome is the result of herd immunity, said Dr. Bell of the Centers for Disease Control and Prevention's Division of Viral Hepatitis in Atlanta.

“What we've learned about what happens in communities when you use hepatitis A vaccine among children is that there's evidence of considerable cohort effects both among unvaccinated children and also among adults. Early results indicate impressive overall public health impact with quite modest vaccination coverage,” said Dr. Bell, who presented the results on behalf of Dr. Dagan.

The 1− to 4-year-old age group, the population at the highest risk of contracting hepatitis A, saw the greatest decline in incidence, with a 98.2% drop, compared with the prevaccinated period.

In addition, the findings indicate that hepatitis A disparities that existed between the Jewish and non-Jewish populations have been almost completely eliminated after the universal vaccination protocol was introduced.

WASHINGTON — Vaccinating all toddlers against hepatitis A reduced the overall viral incidence by 95% in one Israeli community, Dr. Beth P. Bell said at the annual Interscience Conference on Antimicrobial Agents and Chemotherapy.

In an investigation led by Dr. Ron Dagan of the Soroka University Medical Center, Be'er Sheva, Israel, the community began vaccinating children aged 18–24 months in 1999. By 2002–2004, the annual incidence of hepatitis A was 2.2–2.5 cases per 100,000 people, which represents a 95% decline in viral incidence relative to prevaccinated levels (JAMA 2005;294:202–10).

This outcome is the result of herd immunity, said Dr. Bell of the Centers for Disease Control and Prevention's Division of Viral Hepatitis in Atlanta.

“What we've learned about what happens in communities when you use hepatitis A vaccine among children is that there's evidence of considerable cohort effects both among unvaccinated children and also among adults. Early results indicate impressive overall public health impact with quite modest vaccination coverage,” said Dr. Bell, who presented the results on behalf of Dr. Dagan.

The 1− to 4-year-old age group, the population at the highest risk of contracting hepatitis A, saw the greatest decline in incidence, with a 98.2% drop, compared with the prevaccinated period.

In addition, the findings indicate that hepatitis A disparities that existed between the Jewish and non-Jewish populations have been almost completely eliminated after the universal vaccination protocol was introduced.

WASHINGTON — Vaccinating all toddlers against hepatitis A reduced the overall viral incidence by 95% in one Israeli community, Dr. Beth P. Bell said at the annual Interscience Conference on Antimicrobial Agents and Chemotherapy.

In an investigation led by Dr. Ron Dagan of the Soroka University Medical Center, Be'er Sheva, Israel, the community began vaccinating children aged 18–24 months in 1999. By 2002–2004, the annual incidence of hepatitis A was 2.2–2.5 cases per 100,000 people, which represents a 95% decline in viral incidence relative to prevaccinated levels (JAMA 2005;294:202–10).

This outcome is the result of herd immunity, said Dr. Bell of the Centers for Disease Control and Prevention's Division of Viral Hepatitis in Atlanta.

“What we've learned about what happens in communities when you use hepatitis A vaccine among children is that there's evidence of considerable cohort effects both among unvaccinated children and also among adults. Early results indicate impressive overall public health impact with quite modest vaccination coverage,” said Dr. Bell, who presented the results on behalf of Dr. Dagan.

The 1− to 4-year-old age group, the population at the highest risk of contracting hepatitis A, saw the greatest decline in incidence, with a 98.2% drop, compared with the prevaccinated period.

In addition, the findings indicate that hepatitis A disparities that existed between the Jewish and non-Jewish populations have been almost completely eliminated after the universal vaccination protocol was introduced.