Potassium monitoring among female acne patients treated with spironolactone
A study published in JAAD assessed the trends in potassium monitoring among females with acne receiving spironolactone. The results showed that 73% of the patients had their potassium levels checked within 180 days of starting spironolactone, with only 5.5% undergoing monitoring within the suggested one-week period. The majority of patients who underwent potassium level monitoring were aged 45 years or older. The study results highlighted that among those with potassium monitoring, the testing is rarely performed within a few weeks of starting the treatment. Although there is no consensus on potassium level monitoring, it is still standard of care to perform routine monitoring for patients on spironolactone, especially those older than 45 years old, with several comorbidities, or with a concern for drug-drug interactions.
Not the usual suspects. Read more about drugs you never thought you’d use in dermatology inDermWorld.
DermWorld Insights and Inquiries: Taking a hard look at eosinophilic fasciitis on its golden anniversary
In 1974, Dr. Lawrence E. Shulman identified two male patients (aged 53 and 19 years old) with a scleroderma-like illness that he subsequently published as “Diffuse fasciitis with hyperglobulinemia and eosinophilia: A new syndrome?” Both had a peripheral eosinophilia and biopsies demonstrated thickening of the fascia between the subcutis and muscle. “The pathogenesis of this diffuse fasciitis is obscure, although unusual physical exertion antedated the onset of the illness in each case.” The illness is now known as eosinophilic fasciitis (EF) or by the eponym Shulman syndrome. Although much has been learned about the clinical manifestations, pathogenesis, and management of EF during the past half century, Dr. Shulman’s adjective “obscure” in comprehending EF is still apt. Keep reading!
Allergic contact dermatitis in patients with lichen planopilaris, frontal fibrosing alopecia
A study published in Dermatitis found that patients with lichen planopilaris (LLP) and/or frontal fibrosing alopecia (FFA) had a higher likelihood of positive patch test reactions. This review included seven studies with 255 patients and 16,450 controls. The authors found a 2.82-fold increased risk for at least one positive patch test reaction compared with controls. Significant allergens included nickel sulfate hexahydrate, methyldibromo glutaronitrile, balsam of Peru, benzoyl peroxide, and linalool hydroperoxide. Allergen avoidance and patch testing could be beneficial for this patient population, the authors noted.
Dermatologist hair experts share insights of what may play a role in causing in frontal fibrosing alopecia and central centrifugal cicatricial alopecia. Read more.
Laser and light-based therapies for hirsutism in patients with PCOS
A systematic review published in JAMA Dermatology assessed the effectiveness of laser and light-based hair reduction therapies for treating hirsutism in women with polycystic ovary syndrome (PCOS). Alexandrite laser treatment was associated with significant improvements in hirsutism severity and psychological outcomes, especially with high-fluence application. The alexandrite laser also appeared more effected than intense pulsed light. Combining the use of diode laser with metformin or combined oral contraceptive pills was more effective than diode laser alone and adding metformin to intense pulsed light showed better results than intense pulsed light alone. The authors conclude that hirsutism may be treated effectively with laser and light-based therapies and even more effective with the addition of pharmacologic agents in patients with PCOS.
Dermatologists discuss the latest clinical guidance for managing hirsutism. Read more in DermWorld.
Now available: 2023 MIPS performance feedback, targeted review request
CMS has released Merit-based Incentive Payment System (MIPS) performance feedback and final scores for the 2023 performance year and associated MIPS payment adjustment information for the 2025 payment year. Sign in to the QPP website to access your feedback.
CMS is accepting 2023 MIPS targeted review requests until Oct. 11, 2024, at 8 p.m. ET. You can request a targeted review if you believe there is calculation error with your MIPS payment adjustment factor. Learn more with the 2023 Targeted Review User Guide.
MIPS EUC policy for Texas clinicians
CMS announced that the MIPS automatic Extreme and Uncontrollable Circumstances (EUC) policy will apply to MIPS eligible clinicians in designated affected counties in Texas. This decision was made in response to the FEMA disaster declaration due to Hurricane Beryl. MIPS eligible clinicians in the specified counties will have all performance categories reweighted to 0% for the 2024 period, resulting in a neutral payment adjustment for 2026.
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