Is there an association between metformin use and the risk of nonmelanoma skin cancer?
A retrospective case-control study published in the Journal of Drugs in Dermatology assessed the use of treatment with metformin in reducing the risk of nonmelanoma skin cancers, specifically squamous cell carcinoma (SCC) and basal cell carcinoma (BCC). The results showed that metformin use was associated with a decreased risk of BCC across all sex and ethnicity groups and a significantly lower risk of SCC; however, this decrease was not significantly associated with SCC reduction in African American patients.
[Is metformin effective for dermatologic conditions? Read more.]
The authors said their findings indicate a potential protective effect of metformin against skin cancer, particularly in patients with skin of color, although further research is needed to confirm this role.
DermWorld Insights and Inquiries: Making a pitch for the C-reactive protein/albumin ratio
As a clinician, when concerned about an inflammatory process, I will order an erythrocyte sedimentation rate (ESR), which may be elevated in many disorders, including arthritis, vasculitis, infections, inflammatory bowel disease, and certain malignancies. An ESR may also be used to monitor an existing condition, but it will not explain the source of inflammation; I find its real value in reassuring patients that their normal ESR makes active inflammation unlikely. The purpose of this commentary is to introduce a new measure that is increasingly appearing in the medical literature, including dermatology — the C-reactive protein/albumin ratio (CAR). CAR is a new measure for assessing disease severity and prognosis in inflammatory and neoplastic disorders. Dermatologists will increasingly encounter the CAR in daily practice. Keep reading!
Suicidal behaviors among patients with psoriasis treated with biologics
A study published in JAAD assessed the rates of suicidal and self-injurious behaviors (SSIBs) among patients with psoriasis or psoriatic arthritis treated with biologics. The results showed that certain biologics, notably brodalumab and infliximab, were associated with elevated odds of SSIBs. There was no significant difference in the rates of concurrent mental disorders across patients receiving different biologics, suggesting drug-specific SSIB risks. The authors recommended having awareness of potential psychiatric AEs with the use of biologics in treating psoriasis or PsA, guiding toward more personalized and comprehensive treatment strategies, especially for those with pre-existing psychiatric conditions.
As biologic therapies expand indications to children and adolescents, what do dermatologists need to know about balancing the risks and benefits? Read more.
Long-term effectiveness, reasons for discontinuation of dupilumab in atopic dermatitis
A five-year cohort study published in JAMA Dermatology evaluated the effectiveness and causes for discontinuation of dupilumab in patients with atopic dermatitis of all ages. Most patients maintained controlled symptoms, with a significant proportion of patients (70.5%) extending their dupilumab dosing intervals every three to four weeks. After five years of treatment, the mean Eczema Area and Severity Index and the Numeric Rating Scale for pruritus were 2.7 and 3.5, respectively. Nearly 24% of patients discontinued treatment, primarily owing to adverse events (7.6%) or ineffectiveness (6.6%), and 3.2% restarted therapy and regained response.
Occupational contact dermatitis among firefighters
A review published in Dermatitis provided evidence-based preventive measures to protect the dermatologic health of firefighters. Firefighters may face occupational contact dermatitis from various exposures, including personal protective equipment, firefighting agents, and smoke residues, which can cause irritant contact dermatitis, allergic contact dermatitis, and contact urticaria.
[Danger in the workplace: Occupational associations of skin cancer. Read more.]
Common allergens included tris (2,3-dibromopropyl) phosphate, nitrile, metals, and UV-sensitive agents (such as thioureas). The authors recommended identifying and avoiding known allergens, proper decontamination, and gentle skin care practices to help reduce risks.
CMS announces automatic MIPS exception for California wildfires
CMS announced that the MIPS automatic Extreme and Uncontrollable Circumstances (EUC) policy will apply to MIPS-eligible clinicians in designated California wildfire-affected counties for 2024 and 2025, automatically reweighting all performance categories to 0% and resulting in a neutral payment adjustment for 2026 and 2027. However, submitting data for two or more categories will override reweighting and impact payment. Groups, subgroups, virtual groups, and APM entities are not included but can apply for reweighting. More details are available in the 2024 and 2025 MIPS Automatic EUC Policy Fact Sheets.
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