April 3
IN THIS ISSUE / April 3, 2019
- Can the elimination diet hurt pediatric atopic dermatitis patients?
- DW Insights and Inquiries: Tofacitinib – a JAK inhibitor of all trades
- Unity in dermatology starts with putting patients first
- Acne risk in transgender men treated with testosterone
- Ixekizumab sustains plaque psoriasis improvements, quality of life for one year
- American Academy of Dermatology announces Interim Executive Director
Can the elimination diet hurt pediatric atopic dermatitis patients?
Eliminating foods to control atopic dermatitis (AD) in children may do more harm than good, according to a review of the topic presented at the 2019 AAD Annual Meeting. There are good data showing that excluding foods in unselected patients with AD offers no benefit, said Peter Lio, MD, a clinical assistant professor of dermatology and pediatrics at Northwestern’s Feinberg School of Medicine.
While the severity of AD correlates with food allergy — with as many as one-third of moderate to severe patients with AD having food allergies — Dr. Lio does not believe food allergy causes AD. In fact, 80% of patients do not experience a worsening of their AD due to food allergy. While appeasing a parent who wants to try elimination diet can be tempting, Dr. Lio said, “One must be cautious. In addition to risks of malnutrition in the most extreme cases, food elimination diets can place patients at increased risk of developing anaphylactic reactions to foods.”
Recently, new data has demonstrated that some food allergies (peanuts, for example), may be caused by AD. This means that treating AD and maintaining the skin barrier could reduce the incidence of food allergy. “I think it is key to do the things that have the highest impact and are most reliable — excellent skin care, avoiding known allergens, appropriate topical medications, etc. — as opposed to speculating on whether or not nightshades are making things slightly worse,” he said.
Get the latest information on how new treatments have changed atopic dermatitis treatment in Dermatology World.
Related Content:
- Atopic dermatitis: Up in smoke! – DW Insights and Inquiries (February 2017)
- Should systemic steroids be avoided in atopic dermatitis? – Dermatology World (July 2018)
- Is atopic dermatitis actually a systemic inflammatory disorder? – Dermatology World (May 2017)
- Academy clinical guidelines: Atopic dermatitis
DW Insights and Inquiries: A JAK inhibitor of all trades
The Janus kinase inhibitors are taking the dermatologic therapeutic world by storm — at least in the literature. By now, most dermatologists are familiar with studies that have demonstrated efficacy in alopecia areata, vitiligo, psoriasis, psoriatic arthritis, and atopic dermatitis.
This commentary will focus on tofacitinib and potential new indications for the drug. Tofacitinib is currently approved for rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis. It is available in 5 mg pills or as 11 mg extended release tablets. My experience using the drug is limited to only one patient — a woman in her 60s with devastating atopic dermatitis and rheumatoid arthritis, recalcitrant to multiple immunosuppressive therapies (she could not afford dupilumab). She demonstrated a remarkable response to tofacitinib within weeks — her radiant smile obviated the need for a SCORAD assessment. Keep reading!
Unity in dermatology starts with putting patients first
Unity of the specialty, an AAD strategic goal challenging all dermatologists to work together as one voice impacting all of dermatology, can only be achieved when patients are at the center. Seemal R. Desai, MD, highlights strides the Academy is making to meet the diverse needs of dermatologists. Also shedding light on mentorship, Dr. Desai uncovers how unity among dermatologists from varying practice types and demographics protects the specialty in this Dermatology World Weekly interview. Keep reading!
Acne risk in transgender men treated with testosterone
Research has shown that testosterone therapy increases the development of acne. If a transgender man begins to develop acne, it may be possible to personalize his testosterone therapy depending on transition goals, priorities, and other risk factors, according to a recent JAAD study.
Researchers performed an analysis of 55 transgender patients that were more than 18 years of age and who had been receiving testosterone therapy for at least two years. None of the transgender men had a history of acne before receiving testosterone. Acne was reported in 9% of the transgender men after three months of therapy, 18% after six months of treatment, and 38% of participants after 24 months of therapy. Acne was significantly associated with serum testosterone levels greater than 630 ng/dL.
Learn more about the cultural and medical competencies of providing care for transgender patients in Dermatology World.
Related Content:
- How cultural competency can improve care outcomes – Dermatology World (March 2019)
- Cultural and medical competencies of caring for lesbian, gay, and bisexual patients – Dermatology World (November 2017)
- How to address implicit bias in health care hiring – Dermatology World (October 2018)
- JAAD quiz: Dermatologic care for lesbian, gay, bisexual, and transgender persons
Ixekizumab sustains plaque psoriasis improvements, quality of life for one year
An analysis of plaque psoriasis patients showed that a majority of patients treated with ixekizumab (Taltz®) achieved clear skin within three months, reported MD Magazine. The new data, presented at the Academy’s 2019 Annual meeting, showed real-world disease severity and quality of life improvements with the drug at three-month intervals over the first year of treatment.
By one month, more than half of the patients (59%) had achieved clear or nearly clear skin. At three months, 74% had achieved clear or nearly clear skin. At 12 months, 63% of patients still reported scores of 0 or 1 for sPGA and 82% achieved BSA ≤ 1%. Nearly 67% of patients indicated that psoriasis had “no effect” on their life at 12 months. Another 15% of patients reported the disease as having only a “small effect” on their life.
Related Content:
- Taking aim at psoriasis – Dermatology World (November 2017)
- For your patients: Psoriasis Resource Center
- Which topicals work for scalp psoriasis – Dermatology World (June 2016)
- What lies beneath – Dermatology World (August 2012)
- AAD product: Psoriasis and Psoriatic Arthritis patient pamphlet
American Academy of Dermatology announces Interim Executive Director
The American Academy of Dermatology announced on March 29 that it has named Interim Executive Director Irvin (Irv) Bomberger, consultant with Transition Management Consulting, Inc, to replace Elaine Weiss, who announced her resignation from the Academy earlier this year.
Ms. Weiss will leave the Academy on April 5 to become the Executive Director of the Society of Thoracic Surgeons. “I want to thank Elaine Weiss for doing an outstanding job as the Academy's executive director,” said Academy President George Hruza, MD, MBA. “During her tenure, she strengthened our professional staff and oversaw the development of a number of new programs essential for the Academy’s and dermatology’s future. These include an updated strategic plan, DataDerm™, and the forthcoming visionary quality innovation center. Her impact on the Academy will be felt for years to come. I wish her well in her future endeavors.”
Mr. Bomberger has more than three decades of experience in all facets of non-profit association management, including holding executive director positions at the American Orthopaedic Society for Sports Medicine (AOSSM) and Society of Gynecologic Oncologists (SGO), as well as director-level work at the American Medical Association (AMA). Mr. Bomberger will begin his assignment on April 10.
The AAD’s Board of Directors continues a formal search for a permanent Executive Director and CEO for the Academy.
