Molluscum contagiosum: 35% trichloroacetic acid vs. autoinoculation
In a randomized controlled study published in JAAD, 124 patients aged five to 60 years with five or more non-genital lesions, clinically diagnosed as molluscum contagiosum, were treated with either a single session of 35% trichloroacetic acid (TCA) or autoinoculation — a well-studied treatment method for warts. Autoinoculation was performed by repeatedly piercing a well-formed lesion with an insulin syringe.
[A novel treatment for molluscum contagiosum? Read more inDermWorld Weekly.]
At three months, complete clearance was achieved in 80% of the autoinoculation group compared with 62% of the TCA group. Additionally, recurrence at six months was lower in the autoinoculation group compared with the TCA group (3% vs. 40%). The authors hypothesize that autoinoculation may induce a cell-mediated immune response to an antigen by producing various cytokines, which down-regulates gene transcription and eradicates infected cells. According to the authors, autoinoculation shows promise in the treatment of molluscum contagiosum.
Remedies for warts abound, but high-quality studies are lacking. Read more inDermWorld.
DermWorld Insights and Inquiries: Is it a waste for dermatologists to order fecal calprotectin?
I am still haunted by my initiation to Crohn disease. My late brother Andrew, who succumbed to the illness because of a confluence of complications at 29 years old, first manifested symptoms as a child. It was a different era — his abdominal pain, fevers, and rigors that literally raised him off his bed were improperly diagnosed for years, primarily because of relative unfamiliarity with the disorder in the early 1960s. (The National Foundation for Ileitis and Colitis was founded in 1967 by Dr. Henry Janowitz, the specialist who ultimately diagnosed Andrew).
Dermatologists have a unique opportunity to recognize potential inflammatory bowel disease (IBD — Crohn disease, CD, or ulcerative colitis, UC) by the presence of specific lesions (such as granulomas in “metastatic” Crohn disease) or non-specific signs including erythema nodosum or pyoderma gangrenosum. Early identification of IBD is crucial, as it has been demonstrated that diagnostic delay is associated with poor outcomes, including increased intestinal surgery risks. Keep reading!
Physician experience with virtual scribes
According to a KLAS report, health care organizations that use virtual scribes report decreased EHR documentation time and improved clinician satisfaction. Nearly 94% of respondents reported that their firm’s services had a positive or highly positive impact on their EHR documentation time. Additionally, respondents mentioned improved patient experience, catching up on documentation, and more complete and accurate documentation.
Survey respondents also shared best practices for using virtual scribing services including ensuring that physicians are committed to training scribes, building strong partnerships between physicians and scribes, having access to backup scribes, and being prepared to deal with technology obstacles, such as connectivity and software updates.
Can scribes or dictation achieve the speed and simplicity of handwritten notes? Find out in DermWorld.
Derm Coding Consult: Cigna to delay modifier 25 policy
Representatives of Cigna recently informed the Academy that they plan to delay implementation of a recently announced policy that would require submission of office notes with claims submitted with E/M codes 99212, 99213, 99214, or 99215 and modifier 25 when a minor procedure is billed. According to Cigna, the implementation of this policy, which was set to occur on Aug. 13, 2022, has been delayed until further notice as the policy is not in compliance with clean claims laws in 24 states. Learn more about this update.
Ustekinumab for pediatric plaque psoriasis
In a retrospective chart review published in JAAD, 23 children with moderate-to-severe plaque psoriasis were treated with ustekinumab. Of these, primary responders (78.3%) had an IGA score of 0 or 1 at week 16, and secondary responders (17.4%) achieved an IGA of 0 or 1 at week 52. The proportion of patients achieving an improvement in PASI 75 were 78% at week 16 and 90% at week 52, respectively. There were no serious adverse events or discontinuation of treatment related to adverse events.
What’s new in pediatric dermatology? Experts break down diagnoses you didn’t know about 10 years ago in DermWorld.
The American Academy of Dermatology is a non-profit professional organization and does not endorse companies or products. Advertising helps support our mission.
