According to a study published Acta Dermato-Venereologica, 1,001 adolescents or young adults with truncal acne found that most patients reported current or recent facial acne. Stress (46%), a diet high in lipids (33%), and sleeplessness (27%) were considered to be triggers of truncal acne. Despite nearly 70% of all respondents reporting severe or very severe truncal acne, only 45% consulted a health care professional and 28% searched the internet or social networks for information about truncal acne.
Over two-thirds of respondents thought constantly of their condition, and over one-third of the respondents reported that truncal acne severely affected their quality of life. Women reported that truncal acne affected their lives significantly more than men. The authors conclude that the self-perceived impact of truncal acne in adolescents and young adults highlights the need for information as well as reinforced medical and psychological care.
DermWorld Insights and Inquiries: Teatime for radiation dermatitis (and beyond)
I am biased — as a coffee lover, I only believe articles demonstrating coffee’s benefits, while finding flaws in any study deriding its use. I can be more objective about tea — especially green tea — a staple of Chinese herbal medicine. As a dermatologist, however, all of us might become enamored with the potential use of topical epigallocatechin-3-gallate (EGCG), a polyphenol, which is the most abundant catechin found in green tea leaves (Camellia sinensis). EGCG sounds like a miracle drug with antioxidant, anti-inflammatory, antimicrobial, anti-angiogenic, and anticarcinogenic properties. A major reason for its limited topical use in dermatology is because the molecule is unstable, especially when retained at high temperatures and pH. Zhao et al sought to determine if topical EGCG solution can reduce the incidence of radiation-induced dermatitis in patients undergoing radiotherapy after breast cancer surgery. Keep reading!
Comorbidities of keloid and hypertrophic scars
Authors of a study published in JAMA Dermatology evaluated what diseases people with keloid and hypertrophic scars are at risk of developing. This cross-sectional UK Biobank study of 972 people with excessive scarring and 229,106 controls identified associations of excessive scarring with atopic dermatitis and hypertension (odds ratio 1.68), with evidence that associations may vary by ethnicity. Analyses within ethnic groups revealed associations with hypertension in Black participants (odd ratio 2.05), and with vitamin D deficiency in Asian participants (odds ratio 2.24). Musculoskeletal disease and pain symptoms were the most common non-dermatologic associations.
A poster presented at the 2023 AAD Annual Meeting evaluated misconceptions about biosimilars in the dermatology community. The first poster reviewed the biosimilar approval process to clarify misconceptions that dermatologists have about biosimilars. The poster authors identified studies on the molecular design, preclinical and clinical testing requirements, and approval processes of biosimilars. They described how the complexity of biologics means that even batches of originator biologics (not biosimilars) can vary during preclinical testing.
[What is keeping biosimilars out of reach and when will they be available? Find out in DermWorld.]
While clinical testing is less stringent for a biosimilar compared with the originator product, the purpose of the clinical testing is to confirm the safety and efficacy of the biosimilar. Then, the use of extrapolation allows for biosimilars to be approved for all indications of the originator product without further testing.
[14 questions patients ask their dermatologists about biosimilars. Read more.]
“Physicians who recognize that biologics are too complex to duplicate, and who desire indication-specific clinical data on biosimilars, might be satisfied knowing biosimilars provide more evidence of similarity than we have for different batches of the innovator product,” the authors concluded.
Biosimilar substitution laws passed in 50 states, but details vary. Read more in DermWorld.
Physicians should remain vigilant in identifying, preventing mpox
According to a letter issued by the California Department of Public Health, while the rate of mpox has declined since its peak in August 2022, mpox transmission has continued. Physicians and other clinicians are being cautioned to remain vigilant in mpox prevention, recognition, and testing, especially during this summer season as people gather for events, including Pride Month in June.
When combined with other prevention measures, vaccination is the most effective way to reduce transmission of mpox virus and prevent disease, hospitalization, and death. Those at risk are being encouraged to get two doses of the vaccine at least 28 days apart or administration of the second dose as soon as possible after that. Boosters are not recommended at this time. Physicians should particularly counsel those with HIV, those taking HIV pre-/post-exposure prophylaxis (PrEP) or Doxy-PEP, or those with a history of STIs to be vaccinated.
Physicians are also being urged to maintain a high level of suspicion and a low threshold for testing individuals with signs and symptoms consistent with mpox. Consider mpox on the differential diagnosis for patients presenting with diffuse or localized rashes, including mpox. Mpox may present with a variety of skin lesions and may be confused with syphilis, herpes, molluscum contagiosum, shingles, chickenpox, scabies, allergic skin rashes, drug eruptions, and other skin conditions. Novel presentations of mpox should be considered.
[AMA releases new codes for monkeypox virus testing and vaccination.]
Specimens should be obtained from lesions with suspicion for mpox and tested for both mpox and sexually transmitted infections. Review the acceptable specimen requirements for your laboratory of choice as they may vary based on the laboratory. Many local public health and commercial laboratories now provide mpox testing services. Serologic testing is not routinely used for the diagnosis of mpox and is only reserved for unique situations. View steps to sample lesions for mpox on the CDC’s website.
All suspected or confirmed cases of mpox should be reported to your local health department as soon as possible.
View the Academy's Mpox resource center for information on recognizing and treating mpox.
AADA leaders advocate for dermatology and Medicare payment reform
On June 6, AADA President Terry Cronin, MD, FAAD; SkinPAC Board of Advisors Chair Bill Hanke, MD, FAAD; AADA President-Elect Seemal Desai, MD, FAAD; AADA Council on Government Affairs and Health Policy Chair Bruce Brod, MD, FAAD, and past president George Hruza, MD, FAAD, traveled to Washington to represent dermatologists in meetings with key members of Congress and congressional staff to urge support for Medicare physician payment reform, patient access to dermatological care, prior authorization reform, and creating guidance for step therapy. These leaders were part of SkinPAC’s participation in the National Republican Congressional Committee's physician-led event called the House Call on the Mall.
AADA President Terry Cronin, MD, FAAD engages with Rep. Larry Bucshon, MD (R-IN).
Drs. Cronin, Hanke, Desai, Brod and Hruza participated in events with Rep. Michael Burgess, MD (R-TX), Rep. Brett Guthrie (R-KY), and Sen. Roger Marshall, MD (R-KS). In addition, they had separate meetings with Reps. Greg Murphy, MD (R-NC), John Joyce, MD, FAAD (R-PA), Vern Buchanan (R-FL), Lori Chavez-DeRemer (R-OR), Larry Bucshon, MD (R-IN), Brian Fitzpatrick (R-PA), and Ami Bera, MD (D-CA), where our AADA leaders stressed the need for Congress to stop Medicare payment cuts and enact legislation like H.R. 2474.
Watch for AADA survey on new telemedicine service code sets
Soon, the AADA will issue an important survey for the newly approved Current Procedural Terminology codes for telemedicine services. The CPT Panel approved seventeen codes, including those for new and established patient audio-visual and new and established audio-only services. AADA members will have the option to choose which codes you will survey based on your experience and knowledge of each service. The AADA encourages all members to complete the survey if they are familiar with the work required to perform the service.
The data from the survey will be used in recommending relative value units for the new CPT codes for the physician/qualified health care professional work of these important codes to the Centers for Medicare & Medicaid Services. The survey will be sent by AADA Health Policy and Regulatory Advocacy Manager Becky Dolan from BDolan@aad.org.
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