A study published in Dermatology and Therapy explored which biologic agents had the highest clinical benefits for complete skin clearance after 52 weeks. The study included 14 studies of 18 clinical trials. The comparisons were based on the area under the curve for PASI 100 and PASI 90 responses in patients with moderate-to-severe psoriasis.
IL-17 and IL-23 inhibitors demonstrated greater clinical benefits compared with IL-12/23 and TNF inhibitors. For complete skin clearance, the highest cumulative clinical benefits after one year were exhibited by ixekizumab, risankizumab, and brodalumab. For almost-complete skin clearance, the biologics with the highest cumulative benefits were risankizumab, ixekizumab, and brodalumab. TNF inhibitors had the lowest cumulative benefits over a year of treatment.
What’s coming down the psoriasis pipeline? Learn more about emerging treatments in DermWorld.
DermWorld Insights and Inquiries: One Toker over the line — Clarifying Toker cell hyperplasia in Zuska disease and its relationship to hidradenitis suppurativa
Don’t fret. I had never heard of Zuska disease (ZD) either until I read the article by Torre-Castro et al discussing the “tricky association” of Toker cell hyperplasia (TCH) in ZD. Why should you care? Because it is likely that you have seen — and will continue to see — patients with this disorder and should be aware of this potentially problematic association.
ZD (aka mammillary fistula [MF]) was first reported by Zuska et al in 1951, who described a case series of five women (with his wife as the index patient) in what were previously considered nontuberculous breast fistulae. The presumption was that lactiferous ducts became obstructed by squamous metaplasia, resulting in subareolar breast abscesses. The mean age of presentation of ZD is 47 years and smoking is strongly associated with the disease. A rare complication of ZD is squamous cell carcinoma of the breast. Keep reading!
DermWorld Young Physician Focus: Re-examining itch
I have always thought it significant that dermatology is one of the few fields of medicine in which most of the diseases we treat are on display to the world. Unlike high blood pressure or diabetes, for example, psoriasis and eczema often cannot be hidden. This undesired visibility can have a profound effect on the mental health of our patients. But what if a patient’s dermatologic condition is one that cannot be seen, yet still destroys their quality of life? This can be just as damaging — a patient struggling with a condition that can’t be seen or diagnosed on physical exam, but still affects every minute of their lives. Read more from DermWorld Young Physician Advisor Bridget McIlwee, DO, FAAD.
Are specific body sites prone to surgical site infections
In Dermatologic Surgery, authors reviewed 18 studies with 33 eligible surgical wounds. The overall infection rate was 4.1%. Surgical sites on the lips had the highest rates of infection. The lower extremities, ears, and hands also demonstrated high rate of infection while the trunk had the lowest risk for infection.
What can dermatologists learn from quality efforts in surgery. Read more in DermWorld.
Last week, just shy of its April 16 expiration, the Biden administration renewed the COVID-19 public health emergency (PHE) for an additional 90 days. The extension means that all telehealth and other waivers and flexibilities that have been implemented since the beginning of the PHE will remain in effect until mid-July. The Department of Health and Human Services (HHS) said that it will give states 60-days notice prior to termination or expiration of the PHE.
The non-physician dermatology workforce
Authors of a JAADresearch letter described the overall volume, demographics, and practice affiliations of non-physician clinicians (NPCs) practicing dermatology in the United States. The authors identified 5,448 NPCs practicing dermatology in the U.S. Of these, 69% were physician assistants and 31% were nurse practitioners. Most had less than 15 years of clinical experience (69%), were female (84.7%), practiced in metropolitan areas (93%), and had private practice (84%). The South had the highest NPC density with 53 NPCs per 100 dermatologists.
Read about actions that need to be taken to ease the looming physician workforce shortage in DermWorld.
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