June 19
IN THIS ISSUE / June 19, 2019
- Do hidradenitis suppurativa patients have a greater comorbidity burden than psoriasis patients?
- DW Insights and Inquiries: The newest frontier for biologics and psoriasis may be adherence
- Complimentary webinar: FDA’s proposed sunscreen rule — what safety data is the FDA looking for and why?
- Private equity by the numbers
- Media personality Michael Smerconish will offer keynote at 2019 AADA Legislative Conference
- 2020 committee appointment application now open
Do hidradenitis suppurativa patients have a greater comorbidity burden than psoriasis patients?
According to a recent study published in JAMA Dermatology, hidradenitis suppurativa (HS) patients had significantly higher average comorbidity scores than those with psoriasis and the controls.
A cross-sectional analysis was conducted on HS patients, psoriasis patients, and controls. The primary outcome was the mean Charlson Comorbidity Index (CCI) score. The overall mean CCI score was highest among the HS patients (1.95) followed by the psoriasis patients (1.47), and then the control (0.95). Nearly 14% of HS patients had a mean score of five or greater. The most common comorbidities among HS patients were chronic pulmonary disease (40%), diabetes with chronic complications (24%), and mild liver disease (12%). HS patients with a CCI score of five or greater had nearly five times the risk of five-year mortality compared to HS patients with a score of zero.
Read a Dermatology World interview with Alexander Egeberg, MD, PhD, about his publication “Risk of Major Adverse Cardiovascular Events and All-Cause Mortality in Patients With Hidradenitis Suppurativa.”
Related Content:
- Intralesional triamcinolone for HS and thoughts on confirmation bias – DW Insights and Inquiries (December 2016)
- Connecting the dots: Experts profile the link between metabolic syndrome and dermatologic disease – Dermatology World (June 2016)
- HS and socioeconomic status: Food for thought – DW Insights and Inquiries (October 2016)
- A negative comorbidity study: Putting comorbidities in perspective – DW Insights and Inquiries (July 2016)
- For your patients: All about HS
DW Insights and Inquiries: The newest frontier for biologics and psoriasis may be adherence
My first job as an attending dermatologist was heading the psoriasis day care center at the Albert Einstein College of Medicine in 1983. The challenges of treating severe psoriasis with the Goeckerman regimen, PUVA, methotrexate, etc., made the concept of a PASI 100 virtually unfathomable. Thirty-six years later, while not the norm for all patients, it is achievable for many. Patients who used to require intensive visits, now smile, with relatively few adverse reactions, get their TB status checked, and visit every six months. I am in awe of these advances.
Adherence has always been an important issue for psoriatic patients. Regarding topical therapy, a survey of 79 Portuguese patients with psoriasis suggested that a simple dosing regimen of an agent with good moisturizing properties in a vehicle formulated to provide fast absorption was essential. Other important attributes to the topical product — which promote adherence — are leaving a minimum residue, not staining clothing, and allowing the patient to get dressed shortly after applying the medication.
Assuming there are no contraindications to using biologics for psoriatic patients (chronic infections such as tuberculosis, hepatitis B, HIV; concurrent malignancies, notably lymphoproliferative disorders; simultaneous use of other immunosuppressive agents, etc.), there are still hurdles to get patients started on biologics. Prohibitive costs and insurance authorization lead the list. Just as important, however, is overcoming the fear factor. “Dr. Heymann, my next door neighbor’s aunt’s son-in-law’s cousin’s college roommate got an infection from it — I don’t want to use them!” No matter how hard I try to put this in perspective — “You have a greater risk dying in a car accident coming to this appointment!” — I have several patients who absolutely refuse to use biologics; the perceived risk, despite published safety studies and my regaling success stories, is just too great for them. Keep reading!
A lot has been written about the FDA’s proposed rule on the OTC sunscreen final monograph and the recent JAMA study on sunscreen absorption. You and your patients may be left wondering why the FDA wants more data on sunscreen ingredients that have been on the market for some time.
In this exclusive Academy member webinar, E. Dennis Bashaw, PharmD, senior advisor for science, with the FDA’s Office of Clinical Pharmacology, will address:
- What safety data is being required and why
- What studies are required by FDA to make a determination of “generally regarded as safe and effective” for ingredients on the sunscreen OTC final monograph
- Any audience questions
Date: Tuesday, June 25, 2019
Time: 11 a.m. CT / 12 p.m. ET
Cost: Free to Academy members
Register for the webinar! Registration closes Monday, June 24 at 5 p.m. CT.
As with all “hot” topics, there are two sides to the debate over the role of private equity in dermatology. I have certainly borne witness to some lively conversations around this issue on social media. While some argue that consolidation breeds efficiency, and that private equity provides an alternative pathway to practicing medicine in a health care environment that seems increasingly hostile to solo or small practices, many of us have increasing concerns over the future of our specialty if the trend toward the corporatization of dermatology continues. Read more from Dr. Jacks.
Media personality Michael Smerconish will offer keynote at 2019 AADA Legislative Conference
The AADA has announced that Michael A. Smerconish, the host of The Michael Smerconish Program on SiriusXM Channel 124 and CNN’s Smerconish on Saturday mornings, will serve as the keynote speaker for the 2019 AADA Legislative Conference, Sept. 8-10, in Washington, D.C. Smerconish has also been a guest on several television programs including: the NBC Today Show, Colbert Report, O’Reilly Factor, Larry King Live, The View, and Real Time With Bill Maher. Smerconish is also a noteworthy newspaper columnist and author of six books, two of which are New York Times best sellers. The AADA Legislative Conference is the specialty’s premier event focused on legislative, regulatory, and political issues affecting dermatology.
Related Content:
- Facts at your Fingertips: Dermatology heads to Capitol Hill – Dermatology World (October 2018)
- Doing our part to make a difference – Dermatology World (June 2019)
- AADA 2019 advocacy priorities
2020 committee appointment application now open
Every year, hundreds of dermatologists serve the Academy through its organizational governance structure and through other service opportunities. The Appointment Selection Committee, chaired by Bruce H. Thiers, MD, has begun accepting applications to fill 2020 open appointments. Applications must be submitted by June 30, 2019. Members who are selected to serve will be contacted in the winter. Letters of recommendation are highly suggested but not required.
Learn more about the specific committees and task forces, committee member responsibilities, and other opportunities in the Governance Handbook.
