Recommendations for follow-up of patients with nonmelanoma skin cancer
Authors of a systematic review published in JAMA Dermatology analyzed the recommendations of 14 clinical guidelines to assess the variability in surveillance recommendations for patients with nonmelanoma skin cancers. There was little consensus on the recommended follow-up frequency and duration for patients treated for SCC or BCC. Most guidelines suggested at least annual visits and close follow-up for higher-risk tumors.
Most guidelines stratified their recommendations by recurrence risk. For low-risk BCC and guidelines that did not stratify by risk, follow-up recommendations ranged from every six to 12 months. For high-risk BCC, one guideline suggested follow-up every three months, while four guidelines recommended every six months. For low-risk SCC, five guidelines recommended annual follow-up; three guidelines, every six months; and one guideline, every three months. For high-risk SCC, recommendations included a range of follow-up frequencies, spanning every three months (5 guidelines), four months (1 guideline), six months (6 guidelines), or annually (4 guidelines).
DermWorld Insights and Inquiries: Xylazine (“Tranq”) — The potential for loss of life and limb
Xylazine (street name “Tranq”) is a non-narcotic drug synthesized in 1962 by Bayer that is used as a sedative, analgesic, and muscle relaxant in animals. Dermatologists must be cognizant of the severe skin ulcers that may complicate xylazine administration. Chronic injections of xylazine have been associated with skin ulcers and abscesses. Lesions may develop over various body parts irrespective of the intravenous injection sites reported. The presumed mechanism is thought to be the direct vasoconstricting effect on local blood vessels and resultant decreased skin perfusion. Additionally, hypotension, bradycardia, and respiratory depression, may lead to lower tissue cutaneous oxygenation. Complications include severe soft tissue infections (abscesses, cellulitis), skin ulceration, and impaired wound healing. Keep reading!
Using apremilast off-label in dermatologic disorders
A total of 68 articles were included in a review of off-label dermatologic uses of apremilast published in Clinical and Experimental Dermatology. Currently, apremilast, an orally administered PDE-4 inhibitor, has been approved by the FDA for psoriatic arthritis, plaque psoriasis, and Behçet disease. Randomized controlled trial data show that apremilast was the most useful therapy for treating atopic dermatitis and hidradenitis suppurativa, with less efficacy noted when treating alopecia areata and vitiligo. Case series were reviewed for its use in other dermatologic conditions, including recurrent lichen planus, chronic pruritus, rosacea, and pityriasis rubra pilaris. The authors conclude that apremilast, either alone or in combination with other drugs, may be a useful therapy in several chronic inflammatory skin diseases recalcitrant to conventional therapies.
Deucravacitinib vs. apremilast for plaque psoriasis. Read more in DermWorld Weekly.
In a study published in the Journal of Drugs in Dermatology, authors examine how skin laser surgery is discussed on Instagram as well as assess whether laser surgery is accurately portrayed. On April 7, 2022, the hashtag #lasersurgery had 26,691 total posts on Instagram. All posts were created by physicians in a doctor’s office setting versus a medispa. Dermatology was the most frequently cited specialty (80%) followed by oculoplastic surgery (8%), plastic surgery (6%), dentistry (4%), and family medicine (2%).
[Digital marketing for dermatologists 101: Basics to help build the perfect practice website. Read more inDermWorld.]
Post content consisted primarily of before and after pictures (88%) and addressed topics including acne scarring, keloids, photodamage, port wine stain, telangiectasias, brown spots, and more. Laser-induced complications and laser safety considerations were only addressed in 14% and 6% of posts, respectively.
Digital marketing for dermatologists 102: Use these essentials to get started with social media — or take your online presence to the next level. Read more inDermWorld.
In a recent letter published in JAMA, authors characterize physicians serving in U.S. federal and state legislatures in 2022. Legislator data was accessed from a commercial data service firm that compiles demographic and occupational data on government officials. As of July 7, 2022, there were 17 federal physician legislators (3.1%) and 86 state physician legislators (1.1%).
The proportions of federal physician legislators vs. nonphysician federal legislators who were male were 88% vs. 71%; white, 88% vs. 75%; older than 55 years, 88% vs. 69%; and Republican, 82% vs. 48%. The proportions of state physician legislators vs. their nonphysician colleagues who were male were 73% vs. 68%; white, 80% vs. 79%; and Republican, 57% vs. 53%. There were no Black federal and four Black state physician legislators (5%) compared with 5% of physicians overall. Asian physicians, who are 17% of the physician population, composed 6% and 5% of federal and state physician legislators, respectively. Surgeons composed 12% of federal and 17% of state physician legislators vs. 7.4% of the overall physician population.
The MIPS 2022 performance year is quickly coming to an end on Dec. 31. Are you ready to submit your data to avoid the penalty or get an incentive? Be sure you have met the criteria for each of the performance categories you are participating in or that you have sought an exemption if applicable.
CMS has opened the Doctors and Clinicians Preview Period to provide physicians and clinicians the opportunity to review their 2021 Quality Payment Program performance information before it’s publicly reported on Medicare Care Compare and in the Provider Data Catalog (PDC). The preview period closes Dec. 20, 2022, at 8 p.m. ET. For assistance with accessing the QPP website or obtaining your HARP user role, contact the QPP Service Center at QPP@cms.hhs.gov.
Also, be sure to attest to whether or not you have completed your required self-assessment for the High Priority Practices Safety Assurance Factors for EHR Resilience (SAFER) Guides measure. You must attest either “yes” or “no” as both are acceptable; however, leaving this blank will result in a zero score. Learn more by reviewing the CMS MIPS SAFER Guides Factsheet.
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