Natural supplements in dermatology: What drugs do they interact with?
A review recently published in theInternational Journal of Dermatology has shown that six natural supplements commonly recommended in dermatology (nicotinic acid, polypodium leucotomos [heliocare], turmeric, horse chestnut seed extract, zinc, and N-acetylcysteine) have notable drug interactions.
For nicotinic acid, zinc, horse chestnut, and N-acetylcysteine, IBM Micromedex generated 11, 23, one, and two results, respectively. Further review of literature from PubMed identified two drug interactions with polypodium leucotomos, two with turmeric, and two more with zinc. Notable interactions included an increased risk of myopathy and rhabdomyolysis when nicotinic acid is taken by patients using statins, an increased risk of bleeding associated with horse chestnut seed, especially when used in combination with warfarin, and reduced plasma concentration in many drugs when taken with zinc.
N-acetylcysteine may interfere with concentrations of other medications used in the psychiatric setting, and polypodium leucotomos and turmeric may interfere with the CYP metabolic pathway, which may affect drugs metabolized by this pathway.
Learn how to meet patients’ desire for alternative medicine with evidence-based care inDermWorld.
DermWorld Insights and Inquiries: Olmsted syndrome patients can finally put their foot down
Greco et al explored the possibility of blocking EGFR transactivation with the inhibitor erlotinib hydrochloride to treat PPK in patients with OS due to TRPV3 mutations. This hypothesis is based on the finding that TRPV3 activation is associated with epidermal growth factor receptor (EGFR) signaling through a process of transactivation. Within three months of initiating therapy with erlotinib, hyperkeratosis, and pain disappeared. Patients were able to touch the ground with their feet, wear shoes, and walk. The offshoot of this discovery is that it may open a new therapeutic pathway for atopic dermatitis patients with intractable pruritus. Keep reading!
Derm Coding Consult: UnitedHealthcare delays Laboratory Test Registry until 2022
UnitedHealthcare (UHC) announced that it would delay the implementation of its Laboratory Test Registry for one year and will now go live Jan. 1, 2022. This registry is an effort by UHC to promote transparency. The information captured in the registry will allow the identification and alignment of specific tests with specific procedures provided in your lab. This will create a mapping of lab tests and actual procedures used to bill for those tests that UHC can reference.Learn more about this policy and how the Academy advocated for its delay.
Vaccinating patients on TNF inhibitors
A study in JAAD confirms that prophylactic vaccination is underused in psoriasis patients on tumor necrosis factor inhibitors. Results from the retrospective cohort study from 2014–2016 of 89,000 patients demonstrated that unvaccinated patients were more likely to develop infections with influenza, pneumococcal pneumonia, and varicella zoster (OR, 17.83, 1.63, and 1.57, respectively). The patients were prescribed adalimumab, etanercept, or infliximab continuously for at least six months.
Unvaccinated patients who were infected had a higher risk of hospitalization when compared to unvaccinated patients (OR, 5.29). Vaccination rates were only 35% to 40% for influenza, 3% for herpes zoster/shingles, and 11% for pneumococcal pneumonia. The study authors believe that the physician prescibing the TNF inhibitor should discuss recommendations for vaccination and either administer the vaccine or communicate with the primary care physician.
Access Academy resources related to COVID-19 vaccines, including information on getting vaccinated, advising patients about vaccination, becoming a vaccinator, coding for vaccination, and side effects of vaccines, in the Academy's Coronavirus Resource Center.
FDA’s Bad Ad Program offers CME opportunity
The U.S. Food and Drug Administration’s Bad Ad Program is designed to help physicians and other health care providers recognize potentially false or misleading prescription drug promotions while also providing them with an easy way to report them to the FDA.
As part of the Bad Ad Program, there is a one hour, self-paced online continuing education course to train health care providers on how to recognize and report potentially false or misleading drug promotions. The CE course is accredited for physicians, physician assistants, nurse practitioners, nurses, and phamacists among others. Take the Bad Ad course for 1.0 AMA PRA Category 1 Credit™.
Medicine has increasingly grappled with its own growing economy of fraud. Predatory publishers and conferences have continued to proliferate within academia’s “publish or perish” pressure cooker, aided by changes in scholarly publishing models and advances in e-phishing. Scammers have also recently turned their attention toward legitimate professional meetings, in the form of carefully crafted webpages and near-identical URLs intended to trick attendees. Read more about how to spot fakes in medicine inDermWorld.
Academy Advisory Board invites members to submit policy resolutions
The Academy’s Advisory Board 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 Advisory Board convenes every year at the AAD Annual Meeting to deliberate on issues of importance to individual practitioners and propose new policies 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. Determine who your state or local dermatology society’s Advisory Board representative is and work with them to draft a policy resolution. The resolution will ask for the Academy to take specific action relating to advocacy or a general Academy policy.
To ensure full consideration, please submit resolutions by Feb. 12. The author or Advisory Board representative of the resolution must be present during the Virtual Reference Committee Hearing on Friday, March 19 at 2 p.m. (EST) to introduce and discuss the resolution. Even if you do not submit a resolution, the Academy strongly encourages all members to attend the Virtual Reference Committee Hearing to hear the debate on proposed resolutions. The full Advisory Board will vote on the resolutions at the Virtual General Business Meeting on Sunday, March 21 at 3 p.m. (EST).
To submit a resolution, your Disclosure of Outside Interests (DOI) statement must be updated. Please submit all resolutions and/or questions regarding the process to Cierra Martin at cmartin@aad.org by Feb. 12.
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