May 30
IN THIS ISSUE / MAY 30, 2018
- FDA issues warning on unapproved sunscreen pills
- May Access Hero: Karen Edison, MD
- Study: AI detects skin cancer better than dermatologists
- BCBS Michigan rescinds modifier 25 reimbursement reduction policy
- Medical school enrollment is up, but can residency slots keep pace?
- FDA approves new biologic for psoriasis
- 2019 committee appointment application now open
FDA issues warning on unapproved sunscreen pills
The U.S. Food and Drug Administration (FDA) has issued warning letters to several companies that have been illegally marketing pills labeled as dietary supplements that prevent sunburn, reduce skin aging caused by UV rays, or protect against skin cancer. “These companies were instructed to correct all violations associated with their products and were advised to review product websites and product labeling to ensure that the claims they are making don’t violate federal law,” said FDA Commissioner Scott Gottlieb, MD, in a statement. “There’s no pill or capsule that can replace your sunscreen.”
Supplements aside, there are several sunscreen ingredients that are not approved for use in the United States. Read more about these ingredients and where things stand in the approval pipeline in Dermatology World.
Related Links:
- Do European sunscreens outperform those in the U.S.? – Dermatology World (October 2017)
- Are teens tanning less? Signs point to progress, but work remains – Dermatology World (May 2018)
- The use of Polypodium leucotomos extract as an adjunctive agent to decrease the effects of UVB on the skin – Dermatology World (December 2017)
- What do you ask your skin cancer patients at follow up visits? – Dermatology World (July 2017)
- AADA product: Simulated Patient Encounter – Medication Management
May Access Hero: Karen Edison, MD
After participating in Derm ECHO with board-certified dermatologist Karen Edison, MD, family physician Robert Pierce, MD, started having older male patients take their shirts off during physicals. Learn how this practice helped save a patient’s life.
Each month, the Academy highlights members’ diverse efforts to expand access to dermatology. Submit your story at SkinSerious.org.
Related Links:
- Access granted: Improving access for referrals – Dermatology World (October 2017)
- Lending a hand: Physicians discuss the rewards and challenges of caring for the underserved – Dermatology World (December 2015)
- Can better access to dermatologists improve melanoma prognosis? – Dermatology World (February 2015)
Study: AI detects skin cancer better than dermatologists
According to a study published in Annals of Oncology, a machine trained to detect skin cancer missed fewer melanomas and misdiagnosed benign nevi as malignant less often than 58 dermatologists. Researchers in the United States, Germany, and France trained a deep learning convolutional neural network (CNN) to identify skin cancer by showing it more than 100,000 images of malignant melanomas and benign nevi.
Despite the CNN’s performance, the study authors stated, “This CNN may serve physicians involved in skin cancer screening as an aid in their decision whether to biopsy a lesion or not. Most dermatologists already use digital dermoscopy systems to image and store lesions for documentation and follow-up. The CNN can then easily and rapidly evaluate the stored image for an ‘expert opinion’ on the probability of melanoma. We are currently planning prospective studies to assess the real-life impact of the CNN for physicians and patients.” Additionally, the authors note several limitations. For example, the dermatologists were in an artificial setting where they knew they were not making “life or death” decisions. Additionally, “the test sets did not include the full range of skin lesions; there were fewer validated images from non-Caucasian skin types and genetic backgrounds; and the fact that doctors may not always follow the recommendation of a CNN they don’t trust.”
Should dermatologists fear machine learning, or are concerns over their impending obsolescence unwarranted? Read more in Dermatology World.
Related Links:
- Deep neural networks for skin cancer classifications – Dermatology World (April 2017)
- The future of dermatology practice settings – Dermatology World (September 2016)
- Breaking the glass? Digital pathology makes waves in dermatology – Dermatology World (April 2016)
BCBS Michigan rescinds modifier 25 reimbursement reduction policy
As a result of significant advocacy efforts by the Michigan Dermatological Society, the American Academy of Dermatology Association (AADA), and the Michigan State Medical Society, Blue Cross Blue Shield Michigan has announced that it will rescind its proposed policy to reduce reimbursement for evaluation and management services by 20% when billed with a modifier 25. The policy was scheduled to go into effect on July 1.
The AADA will continue its advocacy efforts in other states with known modifier 25 reduction policies. Read more about the Academy’s attempts to rein in this policy, and other payer policies, in Dermatology World.
Related Links:
- To 25 or not? Part one – Dermatology World (June 2013)
- To 25 or not? Part two – Dermatology World (July 2013)
- AADA product: 2018 Coding and Billing for Dermatology
- AADA product: On-demand webinar - Getting to know Modifier 25
- Digital Derm Coding Consult pro
Medical school enrollment is up, but can residency slots keep pace?
According to results from the American Association of Medical Colleges’ 2017 Medical School Enrollment Survey, first-year enrollment in U.S. medical schools has increased 29% since 2002. While the uptick in medical school enrollments may be good news, given the potential physician workforce shortage, 44% of medical school deans indicated that they are concerned that there will not be enough graduate medical education (GME) slots available for the influx of students.
The availability of GME opportunities at the state and national level has been a growing concern for medical schools across the country. Read more about this issue in Dermatology World.
Related Links:
- Strength in numbers: Funding for GME – Dermatology World (August 2015)
- AAD/A position statement: Graduate Medical Education
FDA approves new biologic for psoriasis
The FDA has approved a label extension for certolizumab pegol (CIMZIA) to include the indication of adults with moderate-to-severe plaque psoriasis. The drug was previously approved for use in psoriatic arthritis, rheumatoid arthritis, ankylosing spondylitis, and Crohn’s disease. According to a press release, “The approval makes CIMZIA the first Fc-free, PEGylated anti-TNF treatment option for this indication.”
While biologics may be a boon for psoriasis patients, are they effective for patients with scalp psoriasis? Read more about scalp psoriasis and other conditions that can cause itchy scalp in Dermatology World.
Related Links:
- Taking aim at psoriasis – Dermatology World (November 2017)
- What do you ask your psoriasis patients at follow-up visits? – Dermatology World (September 2017)
- What advice should dermatologists give psoriasis patients about CV risk? – Dermatology World (March 2017)
- Which topicals work for scalp psoriasis? – Dermatology World (June 2016)
- Academy resource: Practical Approaches to Assessing Psoriasis and Psoriatic Arthritis Patients in Clinic
Every year, hundreds of dermatologists serve the Academy through its organizational governance structure and through other service opportunities. The Appointment Selection Committee, chaired by George J. Hruza, MD, MBA, has begun accepting applications to fill 2019 open appointments. Applications must be submitted by June 30, 2018. Members who are selected to serve will be contacted in the winter. Letters of recommendation are highly suggested but are not required.
Learn more about the specific committees and task forces, committee member responsibilities, and other opportunities, in the CCTF Resources-Governance Handbook.
