Is isotretinoin linked to psychiatric events for acne patients?
An article published in JAAD identified psychiatric adverse events (AEs) associated with higher reporting frequencies with isotretinoin use and assessed the positive signals to identify which psychiatric AEs need priority monitoring.
[Neuropsychiatric diagnoses after isotretinoin initiation in pediatric acne patients. Read more.]
Among thousands of isotretinoin-related psychiatric AEs reported by 12,312 patients, a total of 96 positive signals for psychiatric AEs were identified. The most frequently reported psychiatric AEs were depression (47.5%), suicidal ideation (17.7%), anxiety (15.0%), and altered mood (11.7%). The frequency of psychiatric AEs reported by patients who used isotretinoin was higher than those who did not use isotretinoin. Patients with acne versus patients without acne presented more important signals and had a higher relative frequency of psychiatric AEs.
DermWorld Insights and Inquiries: The not-so-full body skin examination
It is not my imagination. With every passing year, an increasing number of new patients schedule an appointment for a full (or total) body skin examination (FBSE) to be checked (or, as some patients say, “scanned”) for skin cancer (keratinocyte carcinoma, melanoma, Merkel cell carcinoma, or others). I cannot fathom the number of FBSEs I perform daily on follow-up patients with a history of cutaneous malignancy. Are we over-diagnosing skin cancers that otherwise would not have caused any harm? Are FBSEs a proper use of a dermatologist’s time? Is the FBSE worth the societal economic cost? These are critical questions each deserving their own commentary. Keep reading!
What every dermatologist should know about measles
An editorial published in JAAD highlighted the clinical presentations of measles that dermatologists should be aware of. The authors noted that measles follows a distinct progression through three phases. The prodromal phase consists of four to six days of fever, cough, coryza, and conjunctivitis. Koplik spots, small white lesions on the buccal mucosa, may appear one to two days prior to the cutaneous eruption. The eruptive phase beings with the emergence of a coalescent, erythematous, maculopapular rash, which begins along the hairline and spreads caudally with palmoplantar sparing. During the final phase, convalescence, the rash resolves and may desquamate. The authors emphasized that prompt identification of measles is crucial for early isolation and public health intervention.
Is there a risk of major cardiovascular events following nicotinamide exposure?
Authors of a study in JAMA Dermatology examined whether nicotinamide use results in an increased risk of major adverse cardiovascular events (MACE). In the first cohort, 1,228 patients were exposed to nicotinamide and 253 were unexposed; in a second cohort, 4,063 were exposed and 7,564 were not. A total of 5,291 had exposure to nicotinamide. There was no difference in the cumulative incidence of MACE after nicotinamide exposure in either cohort.
Are nutritional supplements aimed at skin care helpful, harmful, or simply a placebo for patients? Read more.
Fractional CO2 laser for early treatment of surgical scars
Authors of a study published in the Journal of Cosmetic Dermatology investigated the efficacy of ablative CO2 fractional laser in treating surgical scars. In the meta-analysis, there were nine trials completed within one month following surgery and three trials that were performed for scars more than three months following surgery.
[Experts discuss current approaches to scar management. Read more.]
Compared with the control groups, fractional CO2 laser treatment at or within one month following surgery significantly reduced postoperative scars. Compared with groups receiving treatments initiated more than three months following surgery, fractional CO2 laser treatment at or within one month following surgery also significantly reduced postoperative scars. Post-operative scars were not significantly improved with fractional CO2 laser treatment initiated more than three months following surgery.
10 things your patients should know before having laser treatment for scars. Read more.
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