Authors of an article published in JAAD compared the efficacy, recurrence rate, and patient-reported satisfaction of 10 mg versus 20 mg isotretinoin in individuals with moderate to severe seborrheic dermatitis. Disease severity was assessed using the Seborrheic Dermatitis Area Severity Index (SDASI).
The 20 mg group demonstrated greater reductions in SDASI at 12 months. Recurrence-free probability was significantly greater in the 20 mg group at all time points. Multivariate analysis identified the 20 mg dose as a protective factor against recurrence, while baseline SDASI scores did not independently predict recurrence. Both 10 mg and 20 mg isotretinoin effectively reduced disease severity in seborrheic dermatitis, but the 20 mg dose was associated with superior disease control, lower recurrence rates, and higher patient satisfaction, according to the authors.
DermWorld Insights and Inquiries: Turning our attention to melanoma risk in Turner syndrome
Turner syndrome (TS) is the most common sex chromosomal abnormality in females. It results from a deletion or the nonfunctioning of one X chromosome in females. In their excellent review of TS in dermatology, Lowenstein et al. noted that an increased number of benign nevi have been reported in TS. Other cutaneous manifestations include lymphedema and disorders associated with TS-associated autoimmunity (alopecia areata, vitiligo). Patients with Turner syndrome have an increased risk of melanoma, possibly related to the number of nevi. The use of human growth hormone may contribute to the appearance of a larger number of acquired melanocytic nevi. Keep reading!
CMS updates MUE limit for Ameluz — Effective July 1, 2025
CMS has announced a revised Medically Unlikely Edit (MUE) limit for aminolevulinic acid hydrochloride (Ameluz®). Effective July 1, 2025, the maximum allowable units per claim for Ameluz will be updated to 600 units (3 tubes) — aligning with the FDA-approved prescribing information.
HCPCS/ CPT code
Practitioner services MUE values
MUE adjudication indicator
MUE rationale
J7345
600
3 date of service edit: Clinical
Prescribing information
When reporting Ameluz under HCPCS code J7345 (aminolevulinic acid HCl for topical administration, 10 mg):
Each 2g tube of Ameluz contains 200 mg, which equates to 200 billing units.
Therefore, 3 tubes = 600 billing units, which, effective July 1, 2025, is the maximum MUE per date of service.
This update ensures coverage consistency with labeled dosing for procedures such as lesion-directed and field-directed photodynamic therapy. Be sure to review payer coverage policies to ensure your billing and documentation practices remain compliant.
If you have any questions or need support with coding or documentation, contact the Academy’s coding team at coding@aad.org.
Safety of JAK inhibitors in pregnancy, lactation
A systematic review published in JAAD summarized evidence regarding JAK inhibitors (JAKi) taken throughout pregnancy for any condition and subsequent fetal outcomes. Conditions that were treated include rheumatoid arthritis, atopic dermatitis, inflammatory bowel disease, psoriasis, psoriatic arthritis, alopecia areata, and others. JAKi were used prior to conception in 253 cases, during pregnancy in 254 cases, and after birth in four cases. One hundred sixty-nine patients used JAKi only in the first trimester, three patients through the second trimester, 82 patients through the third trimester, and two patients had nonspecific timelines.
[Dermatologists discuss the risks and benefits of performing dermatologic procedures on pregnant patients. Read more.]
According to the authors, there is little evidence on the use of JAKi in pregnancy, nevertheless, all case reports described favorable pregnancy outcomes. Data from clinical trials demonstrated similar rates of spontaneous abortion and congenital malformation to those of the general population. Congenital malformations were present in cases where patients were taking other systemic agents (e.g., methotrexate and losartan). Four studies assessed the effects of JAKi in lactation, with some evidence of transmission in breast milk, they noted. “Although healthy pregnancy outcomes are reported, JAKi have demonstrated ex-vivo transfer via human placenta and breast milk. It is currently advised to discontinue JAKi four weeks prior to conception and avoid JAKi use during pregnancy and lactation.”
Dermatologists discuss the safety of common dermatologic drugs in pregnant patients inDermWorld.
Authors of a report published in JAAD compared the efficacy of topical roflumilast 0.15% once daily and topical ruxolitinib 1.5% twice daily in patients with atopic dermatitis (AD). Across 13 trials, 4,278 patients were identified. At week four, ruxolitinib was twice as likely as roflumilast to achieve treatment success (TS: defined as IGA score 0/1 with 2-point improvement from baseline) and EASI-75. Both treatments demonstrated higher efficacy than the controls, with ruxolitinib four times more likely to achieve TS and EASI-75 and roflumilast about two times more likely to achieve TS and EASI-75. The authors suggested that topical ruxolitinib may be more effective than roflumilast in achieving TS and EASI-75 in patients with mild to moderate AD.
Dermatologists discuss the influx of new JAK inhibitors in dermatology. Read more.
CMS has published Program Year 2024 Open Payments data, along with newly submitted and updated records from 2018–2023. The Open Payments program promotes transparency by making public the financial relationships between physicians and industry (e.g., pharmaceutical and device companies). The data is available now through the Open Payments Search Tool.
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