Tazarotene vs. imiquimod in patients with plane warts
A randomized clinical trial published in Clinical and Experimental Dermatology assessed the effectiveness of tazarotene 0.1% gel versus imiquimod 5% cream in the treatment of patients with plane warts. Both treatment groups showed significant improvements compared with baseline and placebo. The group treated with imiquimod 5% showed complete clearance in 50% of cases, partial response in 15%, and no response in 35%. Tazarotene 0.1% gel showed complete clearance in 40% of cases, partial response in 40%, and no response in 20%. No significant difference was observed between the two treatments. The authors concluded that tazarotene appears to be as effective and tolerable as imiquimod in treating patients with plane warts and may be better suited for those with darker skin phototypes by reducing the risk of hypopigmentation.
DermWorld Insights and Inquiries: Fire ant stings: From pain to gain — The therapeutic potential of solenopsin
Fire ant stings are nasty. Lesions usually occur on the lower extremities after the disruption of a nest, causing a large number of ants to swarm and attack. The most common presentation is a wheal and flare accompanied by pain and itch. McConnell et al. first isolated the fire ant venom from Solenopsis saevissima as an alkaloid (trans-2-methyl-6-n-undecylpiperidine), which they named solenopsin. Despite its pathogenicity, potential beneficial therapeutic uses of the venom include treating malaria, Chagas disease, and malignancies. Focusing on dermatology, topical solenopsin analogs may be potentially valuable in atopic dermatitis and psoriasis, primarily by restoring impaired barrier function. I find it perplexing (but fascinating) that a venom that can cause so much pain and itch can be considered as an anti-inflammatory agent. Keep reading!
Efficacy of treatment with botulinum toxin in patients with rosacea
An article published in the International Journal of Dermatology assessed the efficacy of treatment with intradermal botulinum toxin in patients with rosacea. A total of 33 patients received injections in areas affected by rosacea on day one and, if necessary, on day 14, with a maximum dose of 70 units of botulinum toxin per patient. The patients were followed for up to 90 days. More than 90% of the patients showed improvements in clinical signs of rosacea. The patients also reported improvements in quality of life and self-esteem.
Consensus guidelines for the use of methotrexate in patients with inflammatory skin disease
An executive summary published in JAAD highlighted the guidelines developed by an expert committee on the use of methotrexate in pediatric patients with inflammatory skin diseases. Treatment with methotrexate is indicated for pediatric patients with morphea, psoriasis, dermatomyositis, atopic dermatitis, lupus, sarcoidosis, and alopecia areata as well as the prevention of neutralizing antibodies associated with biologic therapy. Weight-based dosing is recommended, with a maximum dose of 1 mg/kg up to 25 mg/week. Methotrexate administered via the parenteral route likely has better bioavailability and efficacy, according to the authors.
Is low-dose methotrexate associated with a higher risk of melanoma development? Read more.
Vaccination recommendations for adults with psoriasis, psoriatic arthritis
An article published in JAAD developed consensus statements regarding vaccination for adults receiving biologics and oral therapies for psoriasis and/or psoriatic arthritis. Patients receiving non-live vaccines can continue most oral and biologic agents without interruption or dose modification. It is recommended to consider delaying use of methotrexate for two weeks after vaccination with non-live vaccines. For live vaccines, the authors recommend discontinuing most biologic agents for two to three half-lives before vaccination and deferring the next dose until two to four weeks after vaccination. The exceptions are apremilast and acitretin, which can be continued without modification.
CMS has opened the Final Score Preview period for the Merit-based Incentive Payment System (MIPS). Authorized representatives of practices, virtual groups, and APM Entities can now sign into the Quality Payment Program (QPP) website to preview 2023 MIPS final scores. The Final Score Preview includes performance category-level scores and weights, bonus points, measure-level performance data and scores, and activity-level scores. The Final Score preview does not include payment adjustment information or patient-level reports.
The MIPS Final Score Preview period is available until final performance feedback, including payment adjustments, is released in August 2024.
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