March 27
IN THIS ISSUE / March 27, 2019
- Academy forms task force to address FDA proposed rule on sunscreen monograph, ingredients
- DW Insights and Inquiries: Biting my nails worrying about atypical presentations of nail unit melanomas
- Real-time patient data transforms the practice and improves care
- Joint position statement educates policymakers on safe in-office preparation of buffered lidocaine by dermatologists
- Patient Care Heroes: Carrie Kovarik, MD, and Keith Hamilton, MD
Academy forms task force to address FDA proposed rule on sunscreen monograph, ingredients
Earlier this month, Academy President George Hruza, MD, MBA, formed an ad-hoc task force of photoprotection, skin cancer, and environmental experts to provide additional assessment of sunscreen ingredients, including considering the U.S. Food and Drug Administration’s (FDA) proposed rule on the sunscreen monograph and the environmental impact of certain sunscreen ingredients.
The task force will contribute to the development of comments on the proposed rule; facilitate discussion between industry and the FDA; and reassess the environmental impact of certain sunscreen ingredients and make recommendations.
Additionally, the task force — together with the AADA Regulatory Policy Committee — have created FAQs on sunscreen ingredients as well as the FDA’s proposed rule on the final monograph.
Related Content:
- Breaking down the FDA’s new sunscreen proposal – Dermatology World Weekly (Feb. 27, 2019)
- Profiling sunscreen ingredients not approved for use in the U.S. – Dermatology World (May 2016)
- Say Yes to Sun Protection infographic
- What are the environmental effects of oxybenzone and other sunscreen ingredients? – Dermatology World (October 2018)
- How to Select a Sunscreen infographic
I recently encountered a patient who expressed his disappointment in me, complaining that I was too slow to diagnose a lentigo maligna in a facial solar lentigo that we had been following. How could I miss a melanoma? I explained that it probably won’t be the last time — indeed, this is what provokes insomnia in dermatologists. Lesions like his don’t worry me too much. I’m aware of the concern, and when clinically worrisome, such lesions will be biopsied. What discomforts me are those lesions when the diagnosis of melanoma is not entertained at all — this may be especially true from some melanomas of the nail unit.
This commentary was prompted by the eye-opening article by Gatica-Torres et al, who evaluated nail clippings from the left great toenail to rule out onychomycosis. Clinically the nail displayed a yellow streak consistent with a dermatophytoma — there were no features to suggest a nail unit melanoma. Histologically, the PAS stain confirmed the presence of fungi. The dermatopathologists also appreciated intervening round spaces, some of which appeared to have enlarged nuclei. An S-100 stain identified the nuclei as remnant melanocytes. A Melan-A stain, however, was negative. Because of these findings, a subsequent biopsy of the nail unit and matrix demonstrated a nail unit melanoma in situ and onychomycosis. The authors aptly concluded that nail malignancies may coexist with onychomycosis — it is essential that dermatopathologists examine nail clippings with that lesson in mind. Keep reading!
Real-time patient data transforms the practice and improves care
“Without participation from all dermatologists representing all practice models, we won’t have the richness in the data to effectively examine differences in care that are specific to certain patient populations,” said Marta J. Van Beek, MD, MPH, secretary-treasurer for the AAD Board of Directors. Excited about the new strategic plan and evaluating findings from DataDerm, Dr. Van Beek opens up about what the clinical data registry means for improved patient care, dermatologists, and the future of the specialty. Keep reading!
“We know what we do is safe, effective, and improves patient care and access,” said AAD Board of Directors member Seemal R. Desai, MD, chair of the AADA Compounding Workgroup. “However, these sentiments haven’t necessarily been spelled out, in black and white, for policymakers.” The joint position statement about safe in-office preparation of buffered lidocaine, adopted by AADA and sister societies, demonstrates that safety to policymakers, who, without specialty knowledge or skill, are not familiar with the step-by-step approach dermatologists take to safely prepare buffered lidocaine in a clinical setting. Keep reading!
Patient Care Heroes: Carrie Kovarik, MD and Keith Hamilton, MD
When a local patient was admitted with suspected leprosy, Dr. Hamilton knew he needed a second opinion. Learn how Drs. Kovarik and Hamilton worked together to treat a tricky leprosy case.
Each month, the Academy highlights members’ efforts to treat serious skin disease, work with other physicians as part of a health care team and expand access to dermatology. Submit your story at SkinSerious.org.
