Risk of breast, gynecologic malignancies in women using spironolactone for dermatologic conditions?
A retrospective cohort study published in JAAD assessed the risk of developing breast and gynecologic tumors among women prescribed spironolactone for acne, hair loss, and/or hirsutism. A total of 420 and 3,272 women with and without spironolactone exposure were included in the study with a median dose of 100 mg (range: 25-224 mg). Among patients with a benign tumor, malignant tumor, or breast or uterine cancers, spironolactone exposure was not a risk factor. Daily dose of the medication did not impact tumor development risk. In addition, the authors found that spironolactone use was not associated with increased risk for other cancer types, including prostate, bladder, kidney, gastric, or esophageal.
Read about potassium monitoring in women on spironolactone inDermWorld Weekly.
DermWorld Insights and Inquiries: Reassuring patients with sclerosing lymphangitis of the penis that they will not get shafted
Over the past decade of using our electronic medical record, I must have clicked on the word “reassurance” thousands of times for anxious patients with lesions of no biological concern. Today you will calm patients who are worried about seborrheic keratoses, epidermoid cysts, lipomas, sebaceous hyperplasia, etc., who have suffered through sleepless nights, convinced they had an aggressive malignancy. Men with new-onset genital lesions are often wracked with fear, guilt, and embarrassment as they anticipate learning they have a sexually transmitted disease or cancer. I have only diagnosed sclerosing lymphangitis of the penis (SLP) a few times — the term “reassurance” does not do justice to the palpable sense of relief men exhibit once they understand that this is a benign, self-limited disorder. Keep reading!
FDA approves roflumilast cream for atopic dermatitis
The FDA has approved roflumilast cream 0.15%, a PDE4 inhibitor, for the treatment of individuals aged 6 years and older with moderate-to-severe atopic dermatitis (AD). Trial data from the INTEGUMENT studies found that roflumilast cream administered once per day led to rapid clearance of patients’ AD and major reductions in itch within only 24 hours. In a long-term, open label study, 66.2% of participants had been successful in achieving a 75% improvement in Eczema Area and Severity Index by the 56-week mark.
Neoadjuvant nivolumab and ipilimumab for resectable stage III melanoma
A phase III clinical trial published in The New England Journal of Medicine assessed event-free survival for patients who were randomized to undergo surgery and then receive adjuvant nivolumab or to receive neoadjuvant ipilimumab plus nivolumab and then undergo surgery. The estimated 12-month, event-free survival rate was 83.7% in the neoadjuvant cohort versus 57.2% in the adjuvant cohort. The difference in the average survival time was approximately eight months. This study found that patients with resectable stage III melanoma had a longer event-free survival time when treated with neoadjuvant ipilimumab plus nivolumab followed by surgery when compared with those who underwent surgery first and then received adjuvant nivolumab.
DermWorld highlights some of the common (and not-so-common) skin complications associated with ICIs and shares expert tips for management. Read more.
A study published in JAMA Network Open sought to determine whether virtual scribes have an association with changes in physicians’ EHR use patterns. Use of virtual scribes was associated with significant decreases in total EHR time, time on notes, and pajama time (5:30 p.m. to 7:00 a.m. on weekdays and nonscheduled weekends and holidays), all per appointment. Practicing in a medical specialty, greater baseline EHR time, and greater decreases in note contribution by the physician were associated with significant decreases in total EHR time upon scribe use. The authors concluded that use of virtual scribes may be beneficial for reducing physicians’ time spent on using EHRs.
Can scribes or dictation achieve the speed and simplicity of handwritten notes — and give doctors their nights back? Read more.
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