Patients are using YouTube to get information on isotretinoin. Here’s what you need to know.
In a recent JAAD article, authors explored the quality of medical information in the 50 most-viewed YouTube videos pertaining to isotretinoin for the treatment of acne vulgaris. The researchers found that most videos had fair (54%) or poor (32%) quality of medical information. Additionally, the popularity of the video was not associated with the quality of medical information. Poor-quality videos had a higher average number of views than good-quality videos. Only three of the 50 videos were uploaded by a medical professional.
In the videos, dry skin (74%) and dry lips (58%) were the most common side effects reported, followed by sunburn/photosensitivity (28%), depression (26%), joint pain (24%), and mood lability (22%). Lab monitoring was mentioned in 44% of the videos and the iPLEDGE program was mentioned in 8% of the videos. Having an awareness of the information patients have been exposed to allows dermatologists to be more prepared to provide counsel to those who may have been exposed to misinformation.
Is routine lab monitoring for isotretinoin patients necessary? Find out in DW Weekly.
DW Insights and Inquiries: Getting steamed over vaping
It is not surprising that vaping can display cutaneous manifestations. While there are documented reports of burn injuries with vaping devices, there are many anecdotal reports of additional reactions to vaping products. Hua et al reviewed online e-cigarette forums searching for health effects and reported symptoms. Almost 14% of users reported dermatologic symptoms including dermatitis, burns, acne, boils, bumps, and blisters.
Based on this conclusion, Visconti and Ashack performed a literature review identifying the dermatologic conditions associated with the use of e-cigarettes. There has been an increase in reports of contact dermatitis associated with e-cigarette use, including reports of itchy erythematous scaly eruptions typically on the hands. These patients were subsequently found to have a nickel allergy; the devices were found to be positive on a dimethylglyoxime (DMG) nickel spot test.
Many electronic cigarettes are powered by lithium-containing batteries. Over a two-year period, an estimated 2,035 individuals presented with explosion and burn injuries from e-cigarettes, which was 40 times more than the previous six years combined. Tobacco smoking is associated with many different oral mucosal lesions (OML) and research shows that e-cigarettes present similarly. A recent study found that three specific OMLs are more prevalent in e-cigarette users: nicotine stomatitis, hyperplastic candidiasis, and black hairy tongue. Keep reading!
Derm Coding Consult: A New Year’s reminder on preventive services
One of the most frequently asked questions at the beginning of each new year is in regard to preventive skin screenings of asymptomatic patients. For the current year, the U.S. Preventive Services Task Force (USPSTF) has made no changes to its previous 2016 recommendation, which in turn upheld its 2009 recommendation to not include preventive skin screenings in their Level A or Level B preventive services listing. Once this question has been answered, the next question that is asked usually has to do with appropriate coding for these visits.
What is the USPSTF and what do its skin cancer counseling recommendations mean for the specialty and its patients? Find out in Dermatology World.
Are your patients at risk? Potent topical corticosteroids sold OTC
According to an undercover investigation published in JAAD, patients are using prescription-strength topical corticosteroids (TCs) without a prescription, putting them at risk of adverse effects. A sample of 80 stores specializing in foreign imports across 13 cities were evaluated. Cities in the study include Chicago, San Francisco, Minneapolis, Washington, D.C., New York City, and smaller cities like Madison, Wisconsin, and Durham, North Carolina. Of the 80 stores sampled, 45% sold at least one prescription-strength topical corticosteroid without a prescription, and 30 distinct prescription-strength TC preparations were identified.
At the stores, the average price of high-potency TCs was $6.90/30g for clobetasol propionate 0.05% and $10.02/30g for betamethasone dipropionate 0.05%. According to GoodRx, U.S. market prices are $195.27/30g and $91.37, respectively. The study’s findings emphasize the importance of asking patients about products as well as physically examining them. Additionally, the study authors recommend that dermatologists inform patients that the only over-the-counter TCs safe for use are hydrocortisone acetate ≤1%.
As a dermatologist a few years removed from general medical training, I often feel like an “imposter” physician. I haven’t donned a stethoscope in years, and I only maintain my ACLS certification in the event that I’m called to respond to an emergency on an airplane. Like the Liam Neeson movie line, I have “a very particular set of skills,” and beyond dermatology I consider myself somewhat useless.
I do feel, however, that it is important to examine the whole patient, and have diagnosed an underlying disease based on a patient’s skin findings on several occasions. Dermatology is a practice in pattern recognition — for example, diagnosing a young male with primary syphilis even though I had never actually seen a case in person. I suppose the endless Kodachromes of mostly obsolete infections during residency should be credited with that catch!Read more from DW Young Physician Advisor Jenna O’Neill, MD.
How do physicians run for office? The AMA’s workshop will guide you.
Ever wonder how physicians get elected to Congress or state legislatures? Considering a run for office for yourself? The American Medical Association’s AMPAC Candidate Workshop will teach you how to run a winning political campaign. The workshop is designed to help you make the leap from the exam room to the campaign trail and give you the skills and strategic approach you will need to make a run for public office. Get answers to your questions, and determine if running for public office is for you.
2020 QPP resources available in the Resource Library
CMS has posted new Quality Payment Program (QPP) resources to the QPP Resource Library to help physicians understand how to participate in the 2020 performance period. Resources include 2020 MIPS Quick Start Guides, data validation criteria, quality benchmarks, and more. Access CMS’ 2020 QPP resources.
For more information and resources for 2019 MIPS reporting, visit the Academy’s MIPS reporting resource center. If you’re reporting using DataDerm™, the 2019 MIPS Reporting Module can still be purchased by calling the Academy’s Member Resource Center at 866-503-SKIN (7546).
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