5-FU in patients with squamous cell carcinoma in situ
A study published in JAAD investigated the outcomes of treatment with 5-fluorouracil (5-FU) 5% cream in patients with squamous cell carcinoma in situ and identified factors influencing treatment outcomes. A total of 149 cases were included in the analysis. A complete clinical response was noted in 87.9% of the cases. Tumors treated for four weeks or longer showed the highest clinical response rates. A shorter treatment duration was significantly associated with treatment failure; larger tumor size was associated with higher treatment failure rates.
DermWorld Insights and Inquiries: Living with trimethylaminuria — Research awaiting the smell of success
Trimethylaminuria (TMAU) (aka fish odor syndrome or stale fish syndrome, OMIM 602079), is a rare metabolic disorder characterized by the abnormal accumulation and excretion of trimethylamine (TMA). The accumulation of TMA results in an offensive odor resembling that of rotting fish. Existing treatment strategies are classified into the following groups: precursor intake limitation (notably foods rich in choline and carnitine), protonation of TMA (frequent washing with low pH soaps), targeting of the gut metabolism, and targeting of the enzyme FMO3 (potentially enzyme replacement or gene therapy). Patients may benefit from a multidisciplinary team of dieticians, mental health professionals, and support groups. Keep reading!
Do topical corticosteroids increase risk of pregnancy complications?
Authors of a study published in JAAD analyzed the risks of pregnancy complications with topical corticosteroid (TC) exposure in psoriasis patients. Overall, 2,409 TC-exposed and an equal number of non-TC-exposed pregnant psoriasis patients were included. TC-exposed vs. non-TC-exposed subjects had decreased risk of low maternal weight gain and no difference in the risks of other pregnancy complications. The authors found that TC-exposed and non-TC-exposed pregnant psoriasis patients did not have increased pregnancy complication risks.
High rates of potentially unnecessary topical antifungal prescribing
A research letter published in JAAD estimated outpatient topical antifungal prescribing rates and evaluated potentially unnecessary prescribing by specialty. Of nearly 16 million outpatients, 568,715 were prescribed a topical antifungal. Ketoconazole had the highest prescribing rate (10.2%) followed by clotrimazole-betamethasone (7.3%), nystatin (6.4%), and nystatin-triamcinolone (2.7%). Overall, 16% of patients prescribed an antifungal received a diagnostic test. For 51.6% of patients prescribed a topical antifungal, the prescription was categorized as potentially unnecessary.
The prescriptions were highest for those seen by primary care physicians and pediatricians and lowest for dermatologists and podiatrists. The authors found that a substantial proportion of topical antifungal prescriptions were not associated with a fungal diagnosis or diagnostic testing, highlighting opportunities to improve clinical practice in an era of emerging antifungal resistant skin infections.
Fighting fungi: Here’s what dermatologists need to know about managing dermatophytosis. Read more.
FDA issues warning letter concerning Dermo-Jet Needleless Injector
The FDA issued a warning letter to the manufacturer of the Dermo-Jet Needleless Injector, Robbins Instruments, LLC. The product is being marketed and distributed without FDA marketing clearance or approval in violation of the Federal Food, Drug, and Cosmetic Act. The Dermo-Jet includes many specific claims for use in dermatology, including in situ injections in the treatment of alopecia, psoriasis, keloids and hypertrophic scars, sclerosis, keratosis, acne, and other conditions. The FDA has requested that the manufacturer cease marketing and distribution of the injector.
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