Intralesional acyclovir vs. quadrivalent HPV vaccine for recalcitrant warts
A study published in the Archives of Dermatological Research assessed the efficacy and safety of intralesional acyclovir versus the quadrivalent human papilloma virus (HPV) vaccine in the treatment of recalcitrant cutaneous warts. A total of 60 patients with recalcitrant warts were assigned to three groups: Group 1 received intralesional injection of acyclovir, group 2 received intralesional quadrivalent HPV vaccine, and group 3 received a saline injection. Complete clearance was observed in 40% of group 1, 80% of group 2, and no response in group 3. The authors concluded that both intralesional quadrivalent HPV vaccine and intralesional acyclovir seem to be promising, well-tolerated therapeutic options, although the HPV vaccine had statistically significant superiority over acyclovir.
Therapeutic use of the HPV vaccine shows promise as a treatment for stubborn warts. Read more.
DermWorld Insights and Inquiries: PRIDE without prejudice
Epidermal growth factor receptor inhibitors (EGFRIs) are routinely used to treat advanced malignancies with definite improvement in survival and quality of life. According to Recuero et al., “The exact mechanism leading to skin toxicity during treatment with an EGFRi is not well known, but it is undoubtedly the result of genetic modifications of the signals associated with its activation." Because EGFR is located in the basal layer of the epidermis, sebocytes, outer root sheath of hair follicles, nail matrix, dermal smooth muscle cells, and endothelial cells, having adverse effects of the skin and its appendages make sense. The constellation of common cutaneous reactions due to EGFRIs is known by the acronym PRIDE syndrome — Papulopustular rash and/or Paronychia, Regulatory changes in hair, Itching, and Dryness caused by EGFRIs. The PRIDE complex can typically be managed symptomatically without discontinuing the EFGRI regimen. Keep reading!
FDA approves delgocitinib for chronic hand eczema
The FDA has approved delgocitinib cream for the treatment of moderate-to-severe chronic hand eczema in adults who have had inadequate response to topical corticosteroids or for whom they are not advised. Using the Hand Eczema Symptom Diary (HESD), 4-point or greater reductions in pain and itch scores were assessed at week 16. In the DELTA 1 study, 49% of delgocitinib-treated patients achieved this threshold for pain vs. 28% with vehicle, and in the DELTA 2 study, the corresponding rates were 49% vs. 23%. For itch, 47% of delgocitinib patients achieved ≥4-point reduction in both trials compared to 23% and 20% in vehicle arms, respectively.
In an open-label phase 3 study (DELTA 3), clinical response was sustained among prior delgocitinib-treated patients. Patients initially randomized to vehicle cream in DELTA 1 or 2 showed significant improvement as well.
Delgocitinib was well tolerated, with the most frequent adverse events being COVID-19 and nasopharyngitis.
Efficacy of hedgehog inhibitors for advanced basal cell carcinoma
In an article published in the Journal of Drugs in Dermatology, an expert consensus panel provided guidance in using hedgehog inhibitors (HHIs) for the treatment of locally advanced basal cell carcinoma (LaBCC). A panel of eight dermatologists with expertise in the treatment of BCC reviewed the articles and developed consensus statements. A modified Delphi process was used to approve each statement, including a strength of recommendation.
The panel unanimously voted to adopt eight consensus statements and recommendations: Two were given a strength of “A,” three were given a strength of “B,” and three were given a strength of “C.” Sonidegib and vismodegib are FDA-approved HHIs that can decrease the size of laBCC tumors prior to surgical intervention or be used as primary therapy in certain circumstances. The most common adverse events include muscle spasms, alopecia, and taste alterations.
DIY cosmetic neuromodulator injection tutorials on YouTube
Authors of a study published in the Journal of Cosmetic Dermatology evaluated the quality and safety of DIY neuromodulator injection videos on YouTube based on their discussion and/or demonstration of the seven safe injecting techniques described by a pharmaceutical company’s medication guide insert.
Videos covered an average of 1.5 out of the seven guidelines. Most videos covered treatment of the frontalis (65%) and glabellar regions (59%). Most videos demonstrated injections on humans/mannequins (89%) and used sterile technique (82%). Approximately 39% of the videos lacked a discussion of complications and when to seek medical attention. Few videos included a demonstration of sharps disposal (4.7%) or a safety disclaimer within the video or description (31%). Most injectors did not state their credentials in the video (73%), while 15% were physicians and 12% were nurses.
Dermatologists discuss popular social media trends impacting the skin. Read more.
2025 APM incentive payments now available — Action may be needed
CMS is now disbursing 2025 Advanced APM Incentive Payments (3.5%) to clinicians who qualified as Qualifying APM Participants (QPs) in 2023 — including about 19% of dermatologists. No action is needed if your Medicare billing information is current, but if you haven’t received payment, check the 2025 QP Public Notice. You may need to submit the Billing Information Collection Form by Sept. 1, 2025, to receive your bonus. You can also log in to the QPP site with your HARP credentials to confirm payment amounts by NPI and organization. For full details and access to the 2025 QP Notice files, including the billing collection form, visit the QPP Resource Library and scroll down to the “2025 QP Notice for APM Incentive Payment.”
Delay in release of 2024 MIPS final scores and Targeted Review timeline
CMS has announced a delay in releasing final 2024 MIPS scores due to incomplete Medicare claims data needed for cost measure calculations. Final scores and the Targeted Review period are now expected in the fall, with 2026 payment adjustments to follow about a month later. The Targeted Review period will remain open for 30 days after payment adjustments are released. CMS will share updated timeline details as soon as they become available.
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