Are topical AK treatments associated with increased risk of SCC?
Authors of a study published in the Journal of Cutaneous Medicine and Surgery used the FDA Adverse Event Reporting System (FAERS) to query the association between topical medications used for the treatment of AK and the development of SCC. Analyses were performed in FAERS using data from 2012 to 2020.
[What’s new in treating actinic keratosis? Find out in DermWorld.]
A statistically significant reporting odds ratio (ROR) signal for SCC was found for ingenol mebutate and a smaller signal was also found for imiquimod. When compared to imiquimod directly, ingenol mebutate had a statistically significant ROR for SCC (1.27, 5.05). No signal was found for 5-fluorouracil or diclofenac.
DermWorld Insights and Inquiries: A seasoned approach to treating the ‘salt and pepper’ dyspigmentation of systemic sclerosis
It only takes a nanosecond for a dermatologist to recognize the “salt and pepper” dyspigmentation (SPD) of systemic sclerosis (SSc), but a lifetime to understand and manage it. Of all the cutaneous signs of SSc (sclerodactyly, telangiectasias, calcinosis, digital ulcerations), SPD may be among the most emotionally disconcerting for the patient. SPD is one of the earliest cutaneous findings in SSc and may be the sole dermatologic manifestation, although it may be found in sclerotic skin. Although the exact pathogenesis of SPD is unknown, it is reasonable to compare it to vitiligo, due to autoimmune T-cell-mediated melanocyte injury. Theoretically, with that analogy, this disturbing dyspigmentation should be at least partially responsive to therapeutic measures. Keep reading!
What role does diet play in rosacea?
With conflicting information regarding whether certain foods or supplements may alleviate or trigger rosacea symptoms, authors of a review published in the Journal of Clinical and Aesthetic Dermatology sought to provide an up-to-date review of the evidence on the relationship between diet and rosacea.
The review found that omega-3 fatty acids, probiotics and prebiotics, and dairy were shown to have potential benefits for patients. Spicy foods, alcohol, fatty foods, histamine (dried fruits, shellfish, aged cheese, avocados, processed meats) and cinnamaldehyde (chocolate, citrus fruits, tomatoes) may potentially trigger rosacea symptoms. While several types of foods appear to be associated with exacerbation of rosacea, there are no recommendations that can be applied to all patients, the authors conclude.
Researchers describe various treatments currently available to manage rosacea. Read more.
Media highlights dermatologists taking action to integrate skin of color into medical training
The work of dermatologists to ensure darker skin tones are represented in medical training and textbooks was given nationwide publicity in USA Today. In addition to pointing out the current training deficits for skin of color, including access to images, featured dermatologists discuss how this deficit has led to research gaps on skin of color treatments.
Images of skin of color in dermatology textbooks have ranged from 4% to 19%. According to articles published in JAAD, between 2006 to 2020, only one of six dermatology textbooks saw an increase in images of dark brown or Black skin, and half of textbooks lacked images of dark-skinned patients with common conditions like acne and psoriasis.
[What content are the AAD and member correspondents sharing to shape public perception of the specialty? Take a look!]
Dermatologists featured in the article include Jenna Lester, MD, FAAD, who started the Skin of Color Program at the University of California, San Francisco; Nada Elbuluk, MD, FAAD, who founded the USC Skin of Color Center and the Pigmentary Disorders Clinic and created Project IMPACT at VisualDx; Roopal Kundu, MD, FAAD, who has helped lead the call to get medical student trainees and faculty involved in reviewing training curricula for a “bottom-up” approach to structural change; Neelam Vashi, MD, FAAD, founder of the Boston University Center for Ethnic Skin and author of the textbook Dermatoanthropology of Ethnic Skin and Hair; and Candrice Heath, MD, FAAD, a faculty scholar at Temple University Lewis Katz School of Medicine.
In a retrospective multicenter study published in the Journal of the European Academy of Dermatology and Venereology, study authors reviewed the management and outcomes of drug reaction with eosinophilia and systemic systems (DRESS) in 141 patients. Morbilliform eruption (78%) was the most common symptom, followed by facial oedema (71.6%), and erythroderma (42%). Based on systemic involvement, 32% of patients had severe DRESS. Anticonvulsants (24%) and sulphonamides (22%) were the most common medications causing the reaction.
In all, 73% of the patients were treated with systemic glucocorticoids and 25.5% received topical corticosteroids as monotherapy. The overall mortality rate was 7.1%, with older age, kidney involvement, and admission to ICU as independent predictors of mortality. Relapse of DRESS and delayed autoimmune sequelae occurred in 8.5% and 12.1% of patients, respectively.
End of COVID-19 public health emergency planned for May 11
The Biden Administration announced on Monday that the COVID-19 public health emergency (PHE), which has been in place since January 2020, will end on May 11, 2023. This announcement will end pandemic-related flexibilities in health care and shift payment for COVID-related care to insurers and away from the government.
AADA practice management staff are assessing the impact of this change on dermatology. Look for updates in DermWorld Weekly and on AAD.org as the end date for the PHE approaches regarding steps dermatologists should take to minimize disruptions.
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