January 16
IN THIS ISSUE / January 16, 2019
- Isotretinoin may change bacteria levels on skin of acne patients
- We want your feedback: Psoriasis draft guidelines
- Cochrane collection gathers new diagnostic test accuracy reviews for skin cancer
- New guideline available for infantile hemangioma treatment
- It’s time to use the new biopsy codes: Do you know how to use them?
- Remembering Stephen I. Katz, MD, PhD
- Academy Advisory Board invites members to submit policy resolutions
Isotretinoin may change bacteria levels on skin of acne patients
According to a study recently published in the Journal of Investigative Dermatology, an additional benefit of isotretinoin has come to light. The drug alters the bacteria on the skin of acne patients to more closely resemble the skin of people without acne, researchers report. This discovery may lead the way for bacteria-based treatments, providing a safer alternative for women of childbearing age, said lead researchers, Makedonka Mitreva, PhD, associate professor of medicine; and William H. McCoy, MD, PhD, an instructor in medicine. Learn more about the FDA’s Risk Evaluation and Mitigation Strategies safety program, which includes the iPLEDGE program.
Investigators sampled bacteria from the skin of 17 patients treated with isotretinoin. They compared this bacteria with samples from eight people who hadn’t been treated — four of whom had normal skin and four who had acne. An increase in microbe diversity was seen on the skin of the isotretinoin patients. DNA sequencing identified four types of bacteria that newly appeared with use of isotretinoin. None of these bacteria has been associated with improved acne before. Scientists believe that it may be possible to develop a similar drug to isotretinoin without the negative side effects.
Related Links:
- Acne update – Dermatology World (October 2016)
- AADA web: iPLEDGE Program
- Overusing acne antibiotics? – Dermatology World (August 2015)
- Learning Module: Acne and rosacea
- For your patients: Isotretinoin – Treatment for severe acne
Using DataDerm™ to seamlessly report for MIPS
Related Links:
- Earning a high performance bonus for MIPS: Using DataDerm™ to report – Dermatology World (November 2018)
- AADA MACRA Resource Center
- When dealing with payers, the data can speak for itself – Dermatology World Weekly (Oct. 24, 2018)
- DataDerm™ participants earned MIPS bonuses in 2017 – Dermatology World (November 2018)
- 2019 Webinar All-Access Pass
We want your feedback: Psoriasis draft guidelines
The American Academy of Dermatology is requesting feedback from AAD members about its draft guideline: Guidelines of care for the management and treatment of psoriasis with phototherapy.
Cochrane collection gathers new diagnostic test accuracy reviews for skin cancer
The Cochrane Reviews published a special collection of 11 reviews focused on the diagnosis of melanoma and non-melanoma skin cancers. This collection brings together a series of new diagnostic test accuracy systematic reviews for skin cancer, which aim to identify the most accurate approaches to diagnosis, and provide the best evidence on which clinical and policy-related decisions can be based.
The following are some of the key findings from the reviews:
- Visual inspection of a skin lesion with the naked eye alone is not enough to ensure accurate diagnosis of skin cancer.
- Dermoscopy used by specialists is better at diagnosing melanoma than visual inspection alone and may also help diagnose BCCs. (Read more about the expanding universe of dermoscopy in DW.)
- Dermoscopy could also help general practitioners correctly identify suspicious lesions that should be seen by a specialist.
- Teledermatology may be a good way to help general practitioners decide which skin lesions should be seen by a skin specialist. (Read more about teledermatology in practice in DW.)
“The greatest value of the research is to serve as a yardstick for designing future studies evaluating skin cancer diagnosis techniques on patients who are typically seen in GP and specialist settings,” said Cochrane Skin Group founder Professor Hywel Williams, MD, PhD.
Related Links:
- On target: New approaches to skin cancer treatment and prevention – Dermatology World (August 2016)
- From dysplastic nevus to missed melanoma? – Dermatology World (December 2015)
- AAD public education resource: Why see a board-certified dermatologist?
- AAD clinical guidelines of care for melanoma
- AAD product: Simulated Patient Encounter – Breaking Bad News
New guideline available for infantile hemangioma treatment
The American Academy of Pediatrics (AAP) has developed its first guideline for the management of infantile hemangiomas (IHs), published in Pediatrics at the end of December. The guideline notes that IHs may occur in as many as 5% of infants and that a considerable minority are problematic. The authors, who included dermatologist Ilona Frieden, MD, defined potentially higher risk IHs, which should prompt concern, and highlighted the importance of increased vigilance, consideration of active treatment, and specialty consultation when appropriate.
The most rapid and significant growth occurs between one and three months of age; in most cases, growth is completed by five months of age. For infants who have potentially problematic IHs, early intervention and/or referral is recommended — ideally by one month of age. Propranolol is the drug of choice when systemic treatment is indicated. Treatment is usually continued for at least six months, and is maintained until 12 months and sometimes longer. Select, small, thin, superficial IHs may be treated with topical timolol. For treatment of residual skin changes after involution, surgery and/or laser treatment are most useful.Related Links:
- Fulfilling the promise of propranolol – Dermatology World (January 2014)
- How can propranolol be used to treat infantile hemangiomas? – Dermatology World (September 2011)
- AAD product: Simulated Patient Encounter – Medication Management
It’s time to use the new biopsy codes: Do you know how to use them?
As of Jan. 1, 2019, dermatologists must now use the six new codes for skin biopsies, which have replaced the old primary and add-on codes for biopsy of the skin, 11100 and 11101. Dive into part 3 of the details in this month’s Cracking the Code column in Dermatology World.
Survey data indicated that these codes were used in distinct and inconsistent ways, so the AMA’s CPT Editorial Panel developed and approved a set of six codes — three primary and three add on — intended to be more specific about the technique and depth of the biopsy performed.
Related Links:
- Biopsy coding in 2019: Part 1 – Dermatology World (November 2018)
- Biopsy coding in 2019: Part 2 – Dermatology World (December 2018)
- Special codes for special places – Dermatology World (January 2017)
- AAD store: 2019 Coding Webinar All-Access Pass
- AAD store: 2019 Coding and Billing for Dermatology Manual
- AAD store: Principles of Documentation for Dermatology, Second Edition
Remembering Stephen I. Katz, MD, PhD
The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) is collecting expressions of condolences regarding the passing of Stephen I. Katz, MD, PhD, to share with the Katz family and the community. To contribute a remembrance, email your comments to NIAMSInfo@mail.nih.gov. Visit the NIAMS website to learn more.
Look for DW physician editor Kathryn Schwarzenberger's remembrance of Dr. Katz in the February issue of Dermatology World. Until then, read the Academy's tribute, which was featured in last week's Dermatology World Weekly. Read now.
Remember a colleague: A Tribute gift demonstrates your thoughtfulness and caring while helping to support AAD programs. Learn more and make your gift.
Academy Advisory Board invites members to submit policy resolutions
The Academy’s Advisory Board (AB) invites all Academy members as well as state, local, and specialty dermatology groups to submit proposed AAD/A policy resolutions on issues of interest and/or concern. The AB convenes every year at the AAD Annual Meeting to deliberate on issues of importance to individual physicians, and if approved, propose them to the Academy’s Board of Directors for consideration. If there is an issue of interest and/or concern, now is your opportunity to submit a resolution from which an official Academy position might arise. View the Academy’s current position statements.
To ensure full consideration, please submit your resolutions by Jan. 31. The author and/or their AB representative must be present at the Reference Committee Hearing on Friday, March 1, at 2 PM (EST) at the Academy’s Annual Meeting in Washington D.C., to introduce and discuss the resolution. The full AB will vote on the resolutions March 3. Even if you do not submit a resolution, the Academy encourages all members to attend the Reference Committee Hearing to be a part of this influential debate. Please note that before you submit a resolution, your COI statement must be updated. For general questions, or to obtain a template resolution form or submit a resolution, contact Ashley John at ajohn@aad.org.
