Treating atopic dermatitis with cognitive behavioral therapy: Does it work?
According to a study published in JAMA Dermatology, cognitive behavioral therapy (CBT) delivered via the internet appears to be effective in reducing symptoms of atopic dermatitis. The randomized clinical trial took place in a medical university in Sweden and included 102 adults with atopic dermatitis who received 12 weeks of internet-delivered CBT or a control condition that gave instructions about standard of care.
The analysis indicated that relative to the controls, the participants receiving internet-delivered CBT had a significantly larger mean weekly reduction in symptoms of atopic dermatitis as measured with the Patient-Oriented Eczema Measure, with a moderate-to-large, controlled effect after treatment. The CBT produced significantly larger reductions in itch intensity, perceived stress, sleep problems, and depression with gains sustained at 12 months.
DermWorld Insights and Inquiries: Deep learning in dermatopathology
Deep learning algorithms — deep neural networks that model the connections neurons make and analyze images in successive layers to ultimately produce a likelihood of diagnosis — can now distinguish dermoscopic images of nevus and melanoma with greater accuracy than junior and senior dermatologists. Artificial intelligence (AI) has already proven useful in tedious tasks that are prone to variability, such as counting mitoses and quantifying HER2 expression in breast cancer. Naturally, applications of AI have now extended to dermatopathology. Keep reading!
Sublingual tofacitinib for alopecia areata
In a pilot trial published in theInternational Journal of Dermatology, investigators treated 18 alopecia areata patients, who were nonresponders to cyclosporine/placebo in a preceding trial, with 5 mg of sublingual tofacitinib twice daily for 12 weeks. There was some degree of response seen in 37.5% of the patients, with SALT50 reached in 12.5%. The mean improvement in SALT score was 15.6%.
Sublingual delivery avoids hepatic first-pass metabolism, which may potentially reduce gastrointestinal side effects, and prevent drug reactions. In the pharmacokinetic analysis, the half-life of sublingual tofacitinib was found to be 11 hours, which may accommodate daily dosing rather than the twice-daily dosing of the oral formulation, which has a three-hour half-life.
While the researchers note the response rates to sublingual tofacitinib were lower than rates seen with oral treatment in observational studies, the authors suggest that this may be due to lower efficacy of the sublingual treatment or may represent difficulties in treating a cohort of severe, treatment-resistant disease. The tofacitinib group had a mean duration of current episode of alopecia areata of 7.8 years and mean scalp hair loss at baseline of 86%, with more than 70% of participants with alopecia totalis or alopecia universalis.
The Academy’s HAIR Grant Program is now accepting applications. HAIR research grants will be offered to dermatologists, researchers, and trainees in the U.S. for the completion of basic, translational, and/or clinical research projects that address gaps in hair disorders research, with a particular emphasis on hair disorders in diverse populations. Apply by Aug. 31.
Biologic psoriasis treatments and risk of nonmelanoma skin cancers
According to findings of a study published in the Journal of the European Academy of Dermatology and Venereology, patients with chronic plaque psoriasis treated with biologics did not have a significantly increased risk of developing basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) compared to patients treated with non-biologic systemic agents only.
In the biologic cohort, 70 (0.7%) patients developed only BCC during follow-up, 39 (0.4%) only SCC, and five others developed both BCC and SCC. In the non-biologic cohort, 18 patients (0.3%) developed only BCC, nine (0.2%) developed only SCC, and three developed BCC and SCC.
AAD adopts updated ACCME disclosure standards for educational presenters
The AAD provides CME to members through its accreditation by the Accreditation Council for Continuing Medical Education, and follows ACCME standards for disclosures of outside interests by those who prepare or present educational material. ACCME has recently updated its Standards for Commercial Support and renamed them the “Standards for Integrity and Independence in Accredited Continuing Education.” As a result, a few rules for educational planners and presenters are changing.
Disclosures will be required to include financial relationships over the last 24 months rather than 12 months.
The language ACCME uses to describe companies that presenters may have financial relationships with has changed from “commercial interest” to “ineligible company,” with the term “ineligible” referring to the fact that the company cannot be accredited by ACCME.
Speakers at meetings will be allowed to mention their authorship or involvement in the creation of for-profit items like textbooks, but will not be allowed to recommend the purchase of such items.
Persons who own stock in privately held “ineligible companies” will be considered owners of such companies, and thus face tighter restrictions on their planning or presentation of CME activities.
AAD members who present at meetings starting with the 2022 Annual Meeting, as well as those who participate in the development of other educational materials for 2022 and beyond, will see the updated requirements reflected in the attestation and disclosure forms they are required to complete.
AADA’s Coding Community will close permanently Aug. 2, 2021
But don’t worry! Many of your coding and reimbursement questions can be answered by visiting the Coding Resource Center in the AADA’s Practice Management Center (PMC). The PMC helps simplify administrative burdens by providing practical dermatologist-vetted tools and guidance in a number of practice management areas.
As an AAD member dermatologist, your practice management staff can now access all of the PMC content and resources they need to help your practice run smoothly and efficiently. Your staff will receive their own personal login to the AAD website, allowing them to access the information they need. Contact the AAD Member Resource Center at mrc@aad.org to set up access for your staff.
For the latest information about accurate diagnostic and procedural coding, along with reimbursement, browse the Derm Coding Consult archive.
If you still need coding assistance, AADA coding staff is here to help. Email coding@aad.org and a staff expert will respond within 48 business hours.
For inquiries that are exclusive in nature to your circumstance or practice, or require numerous email exchanges, at the discretion of AADA staff, you will be asked to either schedule a phone appointment initiated via the Member Resource Center or be referred to a qualified consultation service for additional guidance. Note: The suggested consultation services are not affiliated with or endorsed by the AAD/A.
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