August 28
IN THIS ISSUE / August 28, 2019
- Dupilumab shows positive results for younger atopic dermatitis patients
- DW Insights and Inquiries: Finding joy in pediatric phototherapy
- FDA, UMD seek feedback on compounded drug use
- California, New York ban discrimination against natural hair
- Grants available for technology-based teaching applications
Dupilumab shows positive results for younger atopic dermatitis patients
According to new phase 3 trial data, dupilumab may be efficacious and safe for treating atopic dermatitis (AD) in children ages 6 to 11 years old, reports MD Magazine. The new data showed significant improvement in children with severe AD for overall disease severity, skin clearing, itching, and quality of life when adding dupilumab to topical corticosteroids. Patients receiving dupilumab every four weeks improved on average 82% weekly from baseline EASI scores. Patients on bi-weekly treatments improved on average 78% per week, and placebo patients improved 49%. The application for the new indication will be submitted to the FDA later this year.
Read more about emerging treatments for AD patients in Dermatology World.
Related content:
- Should dermatologists be anti-antihistamine for atopic dermatitis? – DW Insights and Inquiries (July 2019)
- Should systemic steroids be avoided in atopic dermatitis? – Dermatology World (July 2018)
- Can IL-31 inhibition reduce atopic dermatitis itch? – Dermatology World (June 2017)
- Academy clinical guidelines: Atopic dermatitis
- AAD product: Dialogues in Dermatology podcast subscription
DW Insights and Inquiries: Finding joy in pediatric phototherapy
This commentary is dedicated to Joy, a bright, rambunctious, delightful bundle of energy with (formerly) recalcitrant atopic dermatitis, who taught me a great deal about phototherapy in children.
The cutaneous effects of ultraviolet (UV) light are by immunosuppressive, immunomodulating, and anti-inflammatory activities. Mechanisms of action include targeting of immunomodulation via apoptosis of inflammatory cells, inhibition of Langerhans cells, and alteration of cytokine production. Additionally, UV has an antimicrobial effect reducing the colonization of Staphylococcus aureus, due to its anti-inflammatory effect and improvement of the skin barrier. Other mechanisms could be due to the effects of Vitamin D metabolism and suppression of TH2 cytokines.
The most commonly utilized form of phototherapy is narrowband UVB (NBUVB) because of its wide availability and lower risk of adverse effects. In children NBUVB is generally considered second-line therapy for patients with atopic dermatitis (AD), psoriasis, pitryriasis lichenoides chronica, prurigo nodularis, and vitiligo, who have had inadequate responses to standard topical agents such as steroids and calcineurin inhibitors. Eustace et al performed a retrospective review of 75 patients aged 3 to 17 years (mean 10.6 years; 35 male and 40 female) who received phototherapy. Forty-eight (64%) patients had AD and 21 (28%) had psoriasis. Seventy received NBUVB treatment and five received hand and foot psoralen with ultraviolet A (PUVA) treatment. All patients with AD were treated with NBUVB and four (8.3%) were also treated with hand PUVA. After phototherapy, 76% had documented clear to almost clear skin. At the 12-month follow-up, 52% of the patients with AD remained clear. All 21 patients with psoriasis underwent NBUVB phototherapy. The clearance rate after phototherapy was 86%. At the 12-month follow-up, 43% of the patients with psoriasis remained clear. Keep reading!
FDA, UMD seek feedback on compounded drug use
In collaboration with the FDA, the University of Maryland Center of Excellence in Regulatory Science and Innovation (M-CERSI) is conducting four anonymous surveys to better understand how compounded drugs containing bulk drug substances are used in clinical practice.
Protecting dermatologists’ access to compounded drugs is a top advocacy priority for the AADA. Quality data will help the Academy effectively advocate for the specialty and its patients.
The chart below displays the substances that the FDA and M-CERSI have identified for review with the link to the survey at the bottom of each column. Dermatologists are encouraged to participate in each survey. The deadline for response is Oct. 18, 2019.
| Survey 1 | Survey 2 | Survey 3 | Survey 4 |
| Alpha lipoic acid (ALA) | Coal tar | Amphotericin B | Aluminum chloride |
| Ascorbyl palmitate | Dexamethasone acetate | Boric acid | Benzocaine |
| Coenzyme Q10 | Inositol | Cantharidin | Dibucaine |
| Estriol | Precipitated sulfur | Ciclopirox olamine | Dyclonine |
| Glycolic acid | Progesterone | Clinquinol | Edetate disodium (EDTA) |
| Hydroquinone | Reduced I-glutathione | Deoxy-d-glucose | Lidocaine |
| Malic acid | Triamcinolone | Diiodohydroxyquinoline | Menthol |
| Methylcobalamin | Triamcinolone diacetate | Diphenylcyclopropenone (DPCP) | Pramoxine |
| Trichloroacetic acid | Urea | Podophyllum | Tetracaine |
| Vitamin A | Zinc pyrithione | Podophyllum resin | Tranilast |
| Zinc sulfate | Quinacrine | ||
| Squaric acid dibutyl ester (SADBE) | |||
| Take survey 1 | Take survey 2 | Take survey 3 | Take survey 4 |
Related content:
- Where will dermatology land after USP publishes its updated Chapter 797 standards for sterile compounding? – Dermatology World (May 2019)
- The essentials of in-office compounding – Dermatology World (June 2018)
- The compounding conundrum – Dermatology World (March 2018)
- AADA compounding toolkit
California, New York ban discrimination against natural hair
On July 3, California became the first state to ban discrimination against natural hairstyles, including afros, braids, twists, and locks. California state Sen. Holly J. Mitchell (D-Los Angeles) introduced the CROWN Act (Create a Respectful and Open Workplace for Natural Hair), associating hair as an extension of race, which is legally protected. The bill (SB 188) passed the Senate with a 37-0 vote, and California’s state assembly voted 69-0 to pass the bill, which was then signed by Gov. Gavin Newsom.
New York became the second state to ban natural hair discrimination, which was signed into law by Gov. Andrew Cuomo on July 12. The New York bill amends previous legislation to expand the definitions of race to include “traits historically associated with race, including but not limited to hair texture and protective hairstyles.” A bill (NJ S3945) has been introduced into the New Jersey Legislature that would ban discrimination based on hair in the workplace, housing, and public schools.
Related content:
- The history of African Americans in medicine and the diversity challenges that remain – Dermatology World (February 2018)
- Hairdressers’ dermatologic odyssey: From dye to death prevention – DW Insights and Inquiries (December 2017)
- Bridging the cultural divide – Dermatology World (October 2014)
- For the public: African-American hair – Tips for everyday care
Grants available for technology-based teaching applications
The AAD’s Sulzberger Institute for Dermatologic Education Committee is seeking grant proposals for technology-based teaching applications that further education in dermatology and dermatologic surgery. There is a two-stage application process. In the first stage, applicants will submit an online Letter of Intent (LOI). If the LOI is selected by the committee, the applicant will be invited to move forward to the second stage and submit a full proposal. The deadline to submit the LOI is Sept. 20, 2019.
Applicants will be notified in late fall 2019 if their LOI was accepted and if a full proposal will be requested by the committee.
