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VIDEO: Molecular testing helps pinpoint ambiguous lesions
WAILEA, HAWAII – In a video interview, Pedram Gerami, MD, professor of dermatology, pathology, and pediatrics, Northwestern University, Chicago, discusses the use of molecular testing for melanoma and suspicious lesions.
Molecular tests are available for various components of diagnosis and prognosis of melanoma, and one of the most popular scenarios for their use is to confirm a diagnosis if a lesion is biopsied and the histopathologist “feels that the diagnosis is ambiguous by standard pathology methods,” Dr. Gerami said in a video interview at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.
On average, between 1% and 5% of cases of suspicious lesions may need molecular testing to confirm the diagnosis, he noted. Of the available options for molecular testing, FISH (fluorescence in situ hybridization) testing is the most validated in the setting of ambiguous histology, he said.
Dr. Gerami disclosed serving as a consultant and researcher for Castle Biosciences, Myriad Genetics, and DermTech.
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
WAILEA, HAWAII – In a video interview, Pedram Gerami, MD, professor of dermatology, pathology, and pediatrics, Northwestern University, Chicago, discusses the use of molecular testing for melanoma and suspicious lesions.
Molecular tests are available for various components of diagnosis and prognosis of melanoma, and one of the most popular scenarios for their use is to confirm a diagnosis if a lesion is biopsied and the histopathologist “feels that the diagnosis is ambiguous by standard pathology methods,” Dr. Gerami said in a video interview at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.
On average, between 1% and 5% of cases of suspicious lesions may need molecular testing to confirm the diagnosis, he noted. Of the available options for molecular testing, FISH (fluorescence in situ hybridization) testing is the most validated in the setting of ambiguous histology, he said.
Dr. Gerami disclosed serving as a consultant and researcher for Castle Biosciences, Myriad Genetics, and DermTech.
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
WAILEA, HAWAII – In a video interview, Pedram Gerami, MD, professor of dermatology, pathology, and pediatrics, Northwestern University, Chicago, discusses the use of molecular testing for melanoma and suspicious lesions.
Molecular tests are available for various components of diagnosis and prognosis of melanoma, and one of the most popular scenarios for their use is to confirm a diagnosis if a lesion is biopsied and the histopathologist “feels that the diagnosis is ambiguous by standard pathology methods,” Dr. Gerami said in a video interview at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.
On average, between 1% and 5% of cases of suspicious lesions may need molecular testing to confirm the diagnosis, he noted. Of the available options for molecular testing, FISH (fluorescence in situ hybridization) testing is the most validated in the setting of ambiguous histology, he said.
Dr. Gerami disclosed serving as a consultant and researcher for Castle Biosciences, Myriad Genetics, and DermTech.
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 HAWAII DERMATOLOGY SEMINAR
FDA confirms complications from intragastric balloons
Complications from overinflation and acute pancreatitis can create problems for obesity patients treated with intragastric balloons, according to a statement from the Food and Drug Administration. In a letter to health care providers published on February 9, 2017, the FDA warned of the two specific issues that have been the subject of multiple adverse event reports.
“We recommend that you closely monitor patients with these devices for these adverse events, and to submit reports to help us better understand any complications from the use of these obesity treatment devices,” the letter said.
Most of the overinflation reports involved the Orbera Intragastric Balloon System (Apollo Endosurgery) that uses a single balloon, although some reports involved the ReShape Integrated Dual Balloon System (ReShape Medical) that uses two balloons. Neither product mentions overinflation risk in its labeling. “At this moment there is not enough information to determine what is causing the balloon to overinflate,” according to the FDA letter.
A separate set of adverse event reports noted the development of acute pancreatitis caused when the balloons compressed other gastrointestinal structures. Both the Orbera and ReShape products were associated with pancreatitis, although neither lists pancreatitis as a potential complication on their labels. Pancreatitis was reported as early as 3 days after implantation, and symptoms included severe back and abdominal pain.
The FDA letter recommends that health care providers consider overinflation and pancreatitis in their differential diagnoses of obesity patients with intragastric balloons who present with the symptoms described, and to report any type of serious adverse events associated with intragastric balloons to the FDA through the MedWatch program. For more information about reporting adverse events to the FDA, visit the MedWatch site.
Complications from overinflation and acute pancreatitis can create problems for obesity patients treated with intragastric balloons, according to a statement from the Food and Drug Administration. In a letter to health care providers published on February 9, 2017, the FDA warned of the two specific issues that have been the subject of multiple adverse event reports.
“We recommend that you closely monitor patients with these devices for these adverse events, and to submit reports to help us better understand any complications from the use of these obesity treatment devices,” the letter said.
Most of the overinflation reports involved the Orbera Intragastric Balloon System (Apollo Endosurgery) that uses a single balloon, although some reports involved the ReShape Integrated Dual Balloon System (ReShape Medical) that uses two balloons. Neither product mentions overinflation risk in its labeling. “At this moment there is not enough information to determine what is causing the balloon to overinflate,” according to the FDA letter.
A separate set of adverse event reports noted the development of acute pancreatitis caused when the balloons compressed other gastrointestinal structures. Both the Orbera and ReShape products were associated with pancreatitis, although neither lists pancreatitis as a potential complication on their labels. Pancreatitis was reported as early as 3 days after implantation, and symptoms included severe back and abdominal pain.
The FDA letter recommends that health care providers consider overinflation and pancreatitis in their differential diagnoses of obesity patients with intragastric balloons who present with the symptoms described, and to report any type of serious adverse events associated with intragastric balloons to the FDA through the MedWatch program. For more information about reporting adverse events to the FDA, visit the MedWatch site.
Complications from overinflation and acute pancreatitis can create problems for obesity patients treated with intragastric balloons, according to a statement from the Food and Drug Administration. In a letter to health care providers published on February 9, 2017, the FDA warned of the two specific issues that have been the subject of multiple adverse event reports.
“We recommend that you closely monitor patients with these devices for these adverse events, and to submit reports to help us better understand any complications from the use of these obesity treatment devices,” the letter said.
Most of the overinflation reports involved the Orbera Intragastric Balloon System (Apollo Endosurgery) that uses a single balloon, although some reports involved the ReShape Integrated Dual Balloon System (ReShape Medical) that uses two balloons. Neither product mentions overinflation risk in its labeling. “At this moment there is not enough information to determine what is causing the balloon to overinflate,” according to the FDA letter.
A separate set of adverse event reports noted the development of acute pancreatitis caused when the balloons compressed other gastrointestinal structures. Both the Orbera and ReShape products were associated with pancreatitis, although neither lists pancreatitis as a potential complication on their labels. Pancreatitis was reported as early as 3 days after implantation, and symptoms included severe back and abdominal pain.
The FDA letter recommends that health care providers consider overinflation and pancreatitis in their differential diagnoses of obesity patients with intragastric balloons who present with the symptoms described, and to report any type of serious adverse events associated with intragastric balloons to the FDA through the MedWatch program. For more information about reporting adverse events to the FDA, visit the MedWatch site.
Collaborative care aids seniors’ mild depression
A collaborative care model significantly mitigated mild depression in adults aged 65 and older, compared with usual care in the short term, based on data from 705 patients. The findings were published online Feb. 21.
“There is limited research about older people with mild depressive disorders who have insufficient levels of depressive symptoms to meet diagnostic criteria (called subclinical, subthreshold, or subsyndromal depression) but also reduced quality of life and function,” wrote Simon Gilbody, PhD, of the University of York (England) and colleagues. However, subthreshold depression increases the risk of a severe depressive illness, the researchers added.
Overall, patients in the collaborative care group improved from an average score of 7.8 at baseline to 5.4 after 4 months; the usual care group improved from an average of 7.8 at baseline to 6.7 at 4 months. The difference in scores persisted at 12 months in the secondary analysis (JAMA. 2017;317:728-37. doi: 10.1001/jama.2017.0130). “For populations with case-level depression, a successful treatment outcome has been defined as 5 points on the PHQ-9,” the researchers noted. “This magnitude of benefit was not observed in either group of the trial when comparing scores before and after treatment, although this result would be anticipated given the lower baseline PHQ-9 scores in populations with subthreshold depression.’
The study participants came from 32 primary care practices in northern England; the average age was 77 years, and 58% were women.
The results were limited by several factors, including the absence of a standardized interview to diagnose depression, differences in retention and attrition between groups, and the absence of long-term follow-up, “and further research is needed to assess longer-term efficacy,” the researchers said.
Neither Dr. Gilbody nor his colleagues had financial conflicts to disclose.
The CASPER trial “provides the first evidence that collaborative care may benefit patients with subthreshold depression,” Kurt Kroenke, MD, wrote in an accompanying editorial. In addition to the improvements on the Patient Health Questionnaire and the reduction in risk of progression to threshold level depression, the findings further support the use of behavioral activation, which was the core treatment in the study, he said. “Strong evidence for the effectiveness of behavioral activation was provided by the recent COBRA trial. … and behavioral activation was found to be noninferior to cognitive-behavioral therapy for the outcome of depression,” he wrote. However, more research is needed before clinicians routinely expand treatment beyond major depression to include subthreshold depression, Dr. Kroenke noted. Key factors include the variable rate of progression from subthreshold depression to major depression, the duration and context of subthreshold depression, patient preferences, and the possible role of antidepressants, he noted. However, the CASPER findings show “new evidence that collaborative care improves outcomes for at least some patients with subthreshold depression,” Dr. Kroenke said. “Patients with persistent symptoms, functional impairment, and a desire for treatment may particularly benefit,” he added (JAMA. 2017;317:702-4).
Kurt Kroenke, MD, is affiliated with the VA Health Services Research and Development Service Center for Health Communication and Information, Regenstrief Institute and Indiana University, both in Indianapolis. He had no financial conflicts to disclose.
The CASPER trial “provides the first evidence that collaborative care may benefit patients with subthreshold depression,” Kurt Kroenke, MD, wrote in an accompanying editorial. In addition to the improvements on the Patient Health Questionnaire and the reduction in risk of progression to threshold level depression, the findings further support the use of behavioral activation, which was the core treatment in the study, he said. “Strong evidence for the effectiveness of behavioral activation was provided by the recent COBRA trial. … and behavioral activation was found to be noninferior to cognitive-behavioral therapy for the outcome of depression,” he wrote. However, more research is needed before clinicians routinely expand treatment beyond major depression to include subthreshold depression, Dr. Kroenke noted. Key factors include the variable rate of progression from subthreshold depression to major depression, the duration and context of subthreshold depression, patient preferences, and the possible role of antidepressants, he noted. However, the CASPER findings show “new evidence that collaborative care improves outcomes for at least some patients with subthreshold depression,” Dr. Kroenke said. “Patients with persistent symptoms, functional impairment, and a desire for treatment may particularly benefit,” he added (JAMA. 2017;317:702-4).
Kurt Kroenke, MD, is affiliated with the VA Health Services Research and Development Service Center for Health Communication and Information, Regenstrief Institute and Indiana University, both in Indianapolis. He had no financial conflicts to disclose.
The CASPER trial “provides the first evidence that collaborative care may benefit patients with subthreshold depression,” Kurt Kroenke, MD, wrote in an accompanying editorial. In addition to the improvements on the Patient Health Questionnaire and the reduction in risk of progression to threshold level depression, the findings further support the use of behavioral activation, which was the core treatment in the study, he said. “Strong evidence for the effectiveness of behavioral activation was provided by the recent COBRA trial. … and behavioral activation was found to be noninferior to cognitive-behavioral therapy for the outcome of depression,” he wrote. However, more research is needed before clinicians routinely expand treatment beyond major depression to include subthreshold depression, Dr. Kroenke noted. Key factors include the variable rate of progression from subthreshold depression to major depression, the duration and context of subthreshold depression, patient preferences, and the possible role of antidepressants, he noted. However, the CASPER findings show “new evidence that collaborative care improves outcomes for at least some patients with subthreshold depression,” Dr. Kroenke said. “Patients with persistent symptoms, functional impairment, and a desire for treatment may particularly benefit,” he added (JAMA. 2017;317:702-4).
Kurt Kroenke, MD, is affiliated with the VA Health Services Research and Development Service Center for Health Communication and Information, Regenstrief Institute and Indiana University, both in Indianapolis. He had no financial conflicts to disclose.
A collaborative care model significantly mitigated mild depression in adults aged 65 and older, compared with usual care in the short term, based on data from 705 patients. The findings were published online Feb. 21.
“There is limited research about older people with mild depressive disorders who have insufficient levels of depressive symptoms to meet diagnostic criteria (called subclinical, subthreshold, or subsyndromal depression) but also reduced quality of life and function,” wrote Simon Gilbody, PhD, of the University of York (England) and colleagues. However, subthreshold depression increases the risk of a severe depressive illness, the researchers added.
Overall, patients in the collaborative care group improved from an average score of 7.8 at baseline to 5.4 after 4 months; the usual care group improved from an average of 7.8 at baseline to 6.7 at 4 months. The difference in scores persisted at 12 months in the secondary analysis (JAMA. 2017;317:728-37. doi: 10.1001/jama.2017.0130). “For populations with case-level depression, a successful treatment outcome has been defined as 5 points on the PHQ-9,” the researchers noted. “This magnitude of benefit was not observed in either group of the trial when comparing scores before and after treatment, although this result would be anticipated given the lower baseline PHQ-9 scores in populations with subthreshold depression.’
The study participants came from 32 primary care practices in northern England; the average age was 77 years, and 58% were women.
The results were limited by several factors, including the absence of a standardized interview to diagnose depression, differences in retention and attrition between groups, and the absence of long-term follow-up, “and further research is needed to assess longer-term efficacy,” the researchers said.
Neither Dr. Gilbody nor his colleagues had financial conflicts to disclose.
A collaborative care model significantly mitigated mild depression in adults aged 65 and older, compared with usual care in the short term, based on data from 705 patients. The findings were published online Feb. 21.
“There is limited research about older people with mild depressive disorders who have insufficient levels of depressive symptoms to meet diagnostic criteria (called subclinical, subthreshold, or subsyndromal depression) but also reduced quality of life and function,” wrote Simon Gilbody, PhD, of the University of York (England) and colleagues. However, subthreshold depression increases the risk of a severe depressive illness, the researchers added.
Overall, patients in the collaborative care group improved from an average score of 7.8 at baseline to 5.4 after 4 months; the usual care group improved from an average of 7.8 at baseline to 6.7 at 4 months. The difference in scores persisted at 12 months in the secondary analysis (JAMA. 2017;317:728-37. doi: 10.1001/jama.2017.0130). “For populations with case-level depression, a successful treatment outcome has been defined as 5 points on the PHQ-9,” the researchers noted. “This magnitude of benefit was not observed in either group of the trial when comparing scores before and after treatment, although this result would be anticipated given the lower baseline PHQ-9 scores in populations with subthreshold depression.’
The study participants came from 32 primary care practices in northern England; the average age was 77 years, and 58% were women.
The results were limited by several factors, including the absence of a standardized interview to diagnose depression, differences in retention and attrition between groups, and the absence of long-term follow-up, “and further research is needed to assess longer-term efficacy,” the researchers said.
Neither Dr. Gilbody nor his colleagues had financial conflicts to disclose.
FROM JAMA
Key clinical point: Collaborative care reduced subthreshold depression in older adults, compared with usual care after 4 months.
Major finding: Older adults with subthreshold depression who received collaborative care had lower depression scores on the Patient Health Questionnaire than those who received usual care after 4 months (average scores 5.4 and 6.7, respectively).
Data source: A randomized trial of 705 adults aged 65 years and older with subthreshold depression.
Disclosures: The researchers had no financial conflicts to disclose.
VIDEO: Coffee break at the Hawaii Dermatology Seminar
WAILEA, HAWAII – A few attendees at the Hawaii Dermatology Seminar discussed some of the highlights of the presentations during a coffee break at the meeting.
New treatment protocols for psoriasis, details about skin disease in children, managing medication side effects, and promising data about biologics are discussed in this video, as are updates on the latest tips for treating atopic dermatitis.
The interviewees had no conflicts to disclose.
The meeting is provided by Global Academy for Medical Education/Skin Disease Education Foundation. 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
WAILEA, HAWAII – A few attendees at the Hawaii Dermatology Seminar discussed some of the highlights of the presentations during a coffee break at the meeting.
New treatment protocols for psoriasis, details about skin disease in children, managing medication side effects, and promising data about biologics are discussed in this video, as are updates on the latest tips for treating atopic dermatitis.
The interviewees had no conflicts to disclose.
The meeting is provided by Global Academy for Medical Education/Skin Disease Education Foundation. 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
WAILEA, HAWAII – A few attendees at the Hawaii Dermatology Seminar discussed some of the highlights of the presentations during a coffee break at the meeting.
New treatment protocols for psoriasis, details about skin disease in children, managing medication side effects, and promising data about biologics are discussed in this video, as are updates on the latest tips for treating atopic dermatitis.
The interviewees had no conflicts to disclose.
The meeting is provided by Global Academy for Medical Education/Skin Disease Education Foundation. 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 HAWAII DERMATOLOGY SEMINAR
VIDEO: Distinctive features define pediatric psoriasis
WAILEA, HAWAII – Plaque type psoriasis continues to be the most common type of psoriasis in children, but there are other presentations that should be considered, said Wynnis Tom, MD, a pediatric dermatologist at the University of California, San Diego, and Rady Children’s Hospital, San Diego.
“We certainly see a form of what some people would call napkin dermatitis,” or “diaper psoriasis,” affecting the diaper area in young infants, Dr. Tom said in a video interview at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.
So when a child has a more refractory diaper rash, “look around to see if there are other lesions in the surrounding area that might be more typical for psoriasis,” she noted.
“We also see a lot more guttate disease” in children with psoriasis, which is more likely to be related to infections and triggers, Dr. Tom said. The face and scalp are often affected in children, and it is important to attend to these areas early to help avoid social stigma, she added.
Dr. Tom disclosed financial relationships with companies including Celgene, Janssen, and Promius. 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
WAILEA, HAWAII – Plaque type psoriasis continues to be the most common type of psoriasis in children, but there are other presentations that should be considered, said Wynnis Tom, MD, a pediatric dermatologist at the University of California, San Diego, and Rady Children’s Hospital, San Diego.
“We certainly see a form of what some people would call napkin dermatitis,” or “diaper psoriasis,” affecting the diaper area in young infants, Dr. Tom said in a video interview at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.
So when a child has a more refractory diaper rash, “look around to see if there are other lesions in the surrounding area that might be more typical for psoriasis,” she noted.
“We also see a lot more guttate disease” in children with psoriasis, which is more likely to be related to infections and triggers, Dr. Tom said. The face and scalp are often affected in children, and it is important to attend to these areas early to help avoid social stigma, she added.
Dr. Tom disclosed financial relationships with companies including Celgene, Janssen, and Promius. 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
WAILEA, HAWAII – Plaque type psoriasis continues to be the most common type of psoriasis in children, but there are other presentations that should be considered, said Wynnis Tom, MD, a pediatric dermatologist at the University of California, San Diego, and Rady Children’s Hospital, San Diego.
“We certainly see a form of what some people would call napkin dermatitis,” or “diaper psoriasis,” affecting the diaper area in young infants, Dr. Tom said in a video interview at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.
So when a child has a more refractory diaper rash, “look around to see if there are other lesions in the surrounding area that might be more typical for psoriasis,” she noted.
“We also see a lot more guttate disease” in children with psoriasis, which is more likely to be related to infections and triggers, Dr. Tom said. The face and scalp are often affected in children, and it is important to attend to these areas early to help avoid social stigma, she added.
Dr. Tom disclosed financial relationships with companies including Celgene, Janssen, and Promius. 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 HAWAII DERMATOLOGY SEMINAR
VIDEO: Pediatric psoriasis patients prepare for biologics
WAILEA, Hawaii – The first approval of a biologic for pediatric psoriasis, and ongoing clinical trials of other biologics in children with psoriasis, are among the encouraging therapeutic developments for this patient population, Wynnis Tom, MD, said at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.
“We are incredibly excited ... as pediatric dermatologists that we’re finally seeing breakthroughs” in terms of Food and Drug Administration activity regarding the use of biologics for treating psoriasis in children, Dr. Tom said in a video interview at the seminar.
Etanercept (Enbrel) is now approved for children with psoriasis, the first biologic indicated for pediatric psoriasis, and clinical trials of other biologics that have been available for adults and nonbiologic products for pediatric psoriasis are underway, she said.
However, getting insurance coverage can still be a challenge, although having long-term efficacy and safety data helps, noted Dr. Tom of the department of dermatology and pediatrics, University of California, San Diego, and Rady Children’s Hospital, San Diego. Also helpful is sending letters to insurers on behalf of the patient, describing the patient’s quality of life, descriptions of treatments that have been unsuccessful, and even photos documenting the disease in the child, she added.
Dr. Tom disclosed ties with Promius, Celgene, and Janssen.
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
WAILEA, Hawaii – The first approval of a biologic for pediatric psoriasis, and ongoing clinical trials of other biologics in children with psoriasis, are among the encouraging therapeutic developments for this patient population, Wynnis Tom, MD, said at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.
“We are incredibly excited ... as pediatric dermatologists that we’re finally seeing breakthroughs” in terms of Food and Drug Administration activity regarding the use of biologics for treating psoriasis in children, Dr. Tom said in a video interview at the seminar.
Etanercept (Enbrel) is now approved for children with psoriasis, the first biologic indicated for pediatric psoriasis, and clinical trials of other biologics that have been available for adults and nonbiologic products for pediatric psoriasis are underway, she said.
However, getting insurance coverage can still be a challenge, although having long-term efficacy and safety data helps, noted Dr. Tom of the department of dermatology and pediatrics, University of California, San Diego, and Rady Children’s Hospital, San Diego. Also helpful is sending letters to insurers on behalf of the patient, describing the patient’s quality of life, descriptions of treatments that have been unsuccessful, and even photos documenting the disease in the child, she added.
Dr. Tom disclosed ties with Promius, Celgene, and Janssen.
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
WAILEA, Hawaii – The first approval of a biologic for pediatric psoriasis, and ongoing clinical trials of other biologics in children with psoriasis, are among the encouraging therapeutic developments for this patient population, Wynnis Tom, MD, said at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.
“We are incredibly excited ... as pediatric dermatologists that we’re finally seeing breakthroughs” in terms of Food and Drug Administration activity regarding the use of biologics for treating psoriasis in children, Dr. Tom said in a video interview at the seminar.
Etanercept (Enbrel) is now approved for children with psoriasis, the first biologic indicated for pediatric psoriasis, and clinical trials of other biologics that have been available for adults and nonbiologic products for pediatric psoriasis are underway, she said.
However, getting insurance coverage can still be a challenge, although having long-term efficacy and safety data helps, noted Dr. Tom of the department of dermatology and pediatrics, University of California, San Diego, and Rady Children’s Hospital, San Diego. Also helpful is sending letters to insurers on behalf of the patient, describing the patient’s quality of life, descriptions of treatments that have been unsuccessful, and even photos documenting the disease in the child, she added.
Dr. Tom disclosed ties with Promius, Celgene, and Janssen.
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 HAWAII DERMATOLOGY SEMINAR
VIDEO: Nonsteroidal topical expands options for pediatric AD
WAILEA, HAWAII – In an interview, pediatric dermatologist Lawrence F. Eichenfield, MD, discusses a recently approved topical therapy for atopic dermatitis, which provides a nonsteroidal option for treating the disease in young patients.
“We’re really excited to have a new topical agent” for AD, Dr. Eichenfield said in a video interview at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.
The product, crisaborole (Eucrisa), is a phosphodiesterase 4 (PDE-4) inhibitor, a new type of chemical entity “based on a different pathway of decreasing inflammation,” said Dr. Eichenfield, professor of dermatology and pediatrics at the University of California, San Diego. Crisaborole, the first new chemical entity to become available for treating AD since 2001, blocks PDE-4 and decreases cytokines, thereby reducing the inflammation in AD, he explained.
In the United States, the product is approved for the topical treatment of mild to moderate AD for patients aged 2 years and older. No serious adverse events attributed to crisaborole have been reported so far, in phase II and III studies and in a 1-year study, he said.
Dr. Eichenfield disclosed relationships with companies including Anacor/Pfizer, Genentech, Lilly, Regeneron/Sanofi, Medimetriks, and Otsuka. Crisaborole is manufactured by Anacor. 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
WAILEA, HAWAII – In an interview, pediatric dermatologist Lawrence F. Eichenfield, MD, discusses a recently approved topical therapy for atopic dermatitis, which provides a nonsteroidal option for treating the disease in young patients.
“We’re really excited to have a new topical agent” for AD, Dr. Eichenfield said in a video interview at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.
The product, crisaborole (Eucrisa), is a phosphodiesterase 4 (PDE-4) inhibitor, a new type of chemical entity “based on a different pathway of decreasing inflammation,” said Dr. Eichenfield, professor of dermatology and pediatrics at the University of California, San Diego. Crisaborole, the first new chemical entity to become available for treating AD since 2001, blocks PDE-4 and decreases cytokines, thereby reducing the inflammation in AD, he explained.
In the United States, the product is approved for the topical treatment of mild to moderate AD for patients aged 2 years and older. No serious adverse events attributed to crisaborole have been reported so far, in phase II and III studies and in a 1-year study, he said.
Dr. Eichenfield disclosed relationships with companies including Anacor/Pfizer, Genentech, Lilly, Regeneron/Sanofi, Medimetriks, and Otsuka. Crisaborole is manufactured by Anacor. 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
WAILEA, HAWAII – In an interview, pediatric dermatologist Lawrence F. Eichenfield, MD, discusses a recently approved topical therapy for atopic dermatitis, which provides a nonsteroidal option for treating the disease in young patients.
“We’re really excited to have a new topical agent” for AD, Dr. Eichenfield said in a video interview at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.
The product, crisaborole (Eucrisa), is a phosphodiesterase 4 (PDE-4) inhibitor, a new type of chemical entity “based on a different pathway of decreasing inflammation,” said Dr. Eichenfield, professor of dermatology and pediatrics at the University of California, San Diego. Crisaborole, the first new chemical entity to become available for treating AD since 2001, blocks PDE-4 and decreases cytokines, thereby reducing the inflammation in AD, he explained.
In the United States, the product is approved for the topical treatment of mild to moderate AD for patients aged 2 years and older. No serious adverse events attributed to crisaborole have been reported so far, in phase II and III studies and in a 1-year study, he said.
Dr. Eichenfield disclosed relationships with companies including Anacor/Pfizer, Genentech, Lilly, Regeneron/Sanofi, Medimetriks, and Otsuka. Crisaborole is manufactured by Anacor. 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
VIDEO: Dosing an important consideration when using neuromodulators in men
WAILEA, HAWAII – Using larger doses and avoiding overarching of the brows are among the considerations to keep in mind when using neuromodulators in men, advised Canadian dermatologist Katie Beleznay, MD.
In general, men have a very different anatomy with a different brow position, and have needs different from those of women, said Dr. Beleznay of the University of British Columbia, Vancouver.
One secret for successful injections of toxins in male patients: Dose matters. Men have stronger muscles in the face and need larger doses to overcome their muscular strength, Dr. Beleznay said in a video interview at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.
On average, “if you use 20-30 units in a female glabella, maybe you’d use 40-50, maybe even 60 units in a male patient,” she said. However, the volume depends on the strength of the muscles in the area, and some men may need less to avoid a frozen look. “You can always treat less and bring them back in a couple of weeks and add more,” especially with patients who are new to treatment, Dr. Beleznay noted.
She disclosed financial relationships with Allergan, Revance, Evolus, Galderma, and Zeltiq.
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
WAILEA, HAWAII – Using larger doses and avoiding overarching of the brows are among the considerations to keep in mind when using neuromodulators in men, advised Canadian dermatologist Katie Beleznay, MD.
In general, men have a very different anatomy with a different brow position, and have needs different from those of women, said Dr. Beleznay of the University of British Columbia, Vancouver.
One secret for successful injections of toxins in male patients: Dose matters. Men have stronger muscles in the face and need larger doses to overcome their muscular strength, Dr. Beleznay said in a video interview at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.
On average, “if you use 20-30 units in a female glabella, maybe you’d use 40-50, maybe even 60 units in a male patient,” she said. However, the volume depends on the strength of the muscles in the area, and some men may need less to avoid a frozen look. “You can always treat less and bring them back in a couple of weeks and add more,” especially with patients who are new to treatment, Dr. Beleznay noted.
She disclosed financial relationships with Allergan, Revance, Evolus, Galderma, and Zeltiq.
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
WAILEA, HAWAII – Using larger doses and avoiding overarching of the brows are among the considerations to keep in mind when using neuromodulators in men, advised Canadian dermatologist Katie Beleznay, MD.
In general, men have a very different anatomy with a different brow position, and have needs different from those of women, said Dr. Beleznay of the University of British Columbia, Vancouver.
One secret for successful injections of toxins in male patients: Dose matters. Men have stronger muscles in the face and need larger doses to overcome their muscular strength, Dr. Beleznay said in a video interview at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.
On average, “if you use 20-30 units in a female glabella, maybe you’d use 40-50, maybe even 60 units in a male patient,” she said. However, the volume depends on the strength of the muscles in the area, and some men may need less to avoid a frozen look. “You can always treat less and bring them back in a couple of weeks and add more,” especially with patients who are new to treatment, Dr. Beleznay noted.
She disclosed financial relationships with Allergan, Revance, Evolus, Galderma, and Zeltiq.
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 HAWAII DERMATOLOGY SEMINAR
VIDEO: Patient survey data yield useful information on acne and different contraceptives
WAILEA, HAWAII – A study that used patient-reported outcomes to assess the impact of different contraceptive methods on acne provided “fascinating results,” Lawrence F. Eichenfield, MD, said at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.
“Progestins are present in birth control for the birth control, but they’re not usually good for the acne,” Dr. Eichenfield said in a video interview at the meeting.
Dr. Eichenfield, professor of dermatology and pediatrics at the University of California, San Diego, and his colleagues reviewed patient reports from an Internet-based survey of more than 2,000 adolescent and young adult acne patients asking whether they were on any contraceptive, and if so, how they thought the contraceptive method affected their acne.
Overall, hormonal progestin-only IUDs and some progestin-only implants correlated with worse acne. Of the combined oral contraceptives, those on the OCs containing drospirenone performed best, he said. Also of interest, the triphasic OCs, with the progestin in three phases, had a better impact on the acne than did the dual ones, he added.
The review of patient-reported outcomes can not only inform clinicians on how they should prescribe hormonal therapy, but also raises awareness of the impact of contraceptives on acne in general, Dr. Eichenfield said.
The results were published last year (J Drugs Dermatol. 2016 Jun 1;15[6]:670-4).
Dr. Eichenfield disclosed relationships with Anacor/Pfizer, Genentech, Lilly, Regeneron/Sanofi, Medimetriks, and Otsuka.
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
WAILEA, HAWAII – A study that used patient-reported outcomes to assess the impact of different contraceptive methods on acne provided “fascinating results,” Lawrence F. Eichenfield, MD, said at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.
“Progestins are present in birth control for the birth control, but they’re not usually good for the acne,” Dr. Eichenfield said in a video interview at the meeting.
Dr. Eichenfield, professor of dermatology and pediatrics at the University of California, San Diego, and his colleagues reviewed patient reports from an Internet-based survey of more than 2,000 adolescent and young adult acne patients asking whether they were on any contraceptive, and if so, how they thought the contraceptive method affected their acne.
Overall, hormonal progestin-only IUDs and some progestin-only implants correlated with worse acne. Of the combined oral contraceptives, those on the OCs containing drospirenone performed best, he said. Also of interest, the triphasic OCs, with the progestin in three phases, had a better impact on the acne than did the dual ones, he added.
The review of patient-reported outcomes can not only inform clinicians on how they should prescribe hormonal therapy, but also raises awareness of the impact of contraceptives on acne in general, Dr. Eichenfield said.
The results were published last year (J Drugs Dermatol. 2016 Jun 1;15[6]:670-4).
Dr. Eichenfield disclosed relationships with Anacor/Pfizer, Genentech, Lilly, Regeneron/Sanofi, Medimetriks, and Otsuka.
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
WAILEA, HAWAII – A study that used patient-reported outcomes to assess the impact of different contraceptive methods on acne provided “fascinating results,” Lawrence F. Eichenfield, MD, said at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.
“Progestins are present in birth control for the birth control, but they’re not usually good for the acne,” Dr. Eichenfield said in a video interview at the meeting.
Dr. Eichenfield, professor of dermatology and pediatrics at the University of California, San Diego, and his colleagues reviewed patient reports from an Internet-based survey of more than 2,000 adolescent and young adult acne patients asking whether they were on any contraceptive, and if so, how they thought the contraceptive method affected their acne.
Overall, hormonal progestin-only IUDs and some progestin-only implants correlated with worse acne. Of the combined oral contraceptives, those on the OCs containing drospirenone performed best, he said. Also of interest, the triphasic OCs, with the progestin in three phases, had a better impact on the acne than did the dual ones, he added.
The review of patient-reported outcomes can not only inform clinicians on how they should prescribe hormonal therapy, but also raises awareness of the impact of contraceptives on acne in general, Dr. Eichenfield said.
The results were published last year (J Drugs Dermatol. 2016 Jun 1;15[6]:670-4).
Dr. Eichenfield disclosed relationships with Anacor/Pfizer, Genentech, Lilly, Regeneron/Sanofi, Medimetriks, and Otsuka.
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
EXPERT ANALYSIS FROM SDEF HAWAII DERMATOLOGY SEMINAR
Office-based survey characterizes seborrheic keratosis lesions in adults
WAILEA, HAWAII – More than half of the patients with seborrheic keratosis had more than 16 lesions, in a prospective study of 406 adults at 10 dermatology practices.
The results were presented in a poster at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.
The study population was 62% female, with an average age of 58 years. Patients were seen at 10 community dermatology clinics across the United States, where they completed questionnaires about their seborrheic keratosis.
Of those surveyed, 54% had more than 16 lesions, while 18% had 5 or fewer; another 18% had 6-10 lesions, and 10% had 11-15 lesions. The mean number of lesions by location ranged from 3.6 on the face to 26 on the upper body. Approximately 31% of patients reported picking at their lesions to cause them to fall off.
Most of those surveyed said they were either interested or somewhat interested in an office-based treatment. Female patients and patients with lesions on the head and neck were more likely to report interest in an office-based treatment.
The findings were limited by the inclusion only of patients who presented to private dermatology clinics and therefore may not generalize to the overall population of seborrheic keratosis patients.
The author of the study was James Del Rosso, MD, of Touro University, Nevada.
The study was supported by Aclaris Therapeutics. Dr. Del Rosso has received consulting fees from Aclaris.
SDEF and this news organization are owned by the same parent company.
WAILEA, HAWAII – More than half of the patients with seborrheic keratosis had more than 16 lesions, in a prospective study of 406 adults at 10 dermatology practices.
The results were presented in a poster at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.
The study population was 62% female, with an average age of 58 years. Patients were seen at 10 community dermatology clinics across the United States, where they completed questionnaires about their seborrheic keratosis.
Of those surveyed, 54% had more than 16 lesions, while 18% had 5 or fewer; another 18% had 6-10 lesions, and 10% had 11-15 lesions. The mean number of lesions by location ranged from 3.6 on the face to 26 on the upper body. Approximately 31% of patients reported picking at their lesions to cause them to fall off.
Most of those surveyed said they were either interested or somewhat interested in an office-based treatment. Female patients and patients with lesions on the head and neck were more likely to report interest in an office-based treatment.
The findings were limited by the inclusion only of patients who presented to private dermatology clinics and therefore may not generalize to the overall population of seborrheic keratosis patients.
The author of the study was James Del Rosso, MD, of Touro University, Nevada.
The study was supported by Aclaris Therapeutics. Dr. Del Rosso has received consulting fees from Aclaris.
SDEF and this news organization are owned by the same parent company.
WAILEA, HAWAII – More than half of the patients with seborrheic keratosis had more than 16 lesions, in a prospective study of 406 adults at 10 dermatology practices.
The results were presented in a poster at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.
The study population was 62% female, with an average age of 58 years. Patients were seen at 10 community dermatology clinics across the United States, where they completed questionnaires about their seborrheic keratosis.
Of those surveyed, 54% had more than 16 lesions, while 18% had 5 or fewer; another 18% had 6-10 lesions, and 10% had 11-15 lesions. The mean number of lesions by location ranged from 3.6 on the face to 26 on the upper body. Approximately 31% of patients reported picking at their lesions to cause them to fall off.
Most of those surveyed said they were either interested or somewhat interested in an office-based treatment. Female patients and patients with lesions on the head and neck were more likely to report interest in an office-based treatment.
The findings were limited by the inclusion only of patients who presented to private dermatology clinics and therefore may not generalize to the overall population of seborrheic keratosis patients.
The author of the study was James Del Rosso, MD, of Touro University, Nevada.
The study was supported by Aclaris Therapeutics. Dr. Del Rosso has received consulting fees from Aclaris.
SDEF and this news organization are owned by the same parent company.
AT SDEF HAWAII DERMATOLOGY SEMINAR