Eight misconceptions of photoprotection for skin of color
In a recentJAADarticle, authors address how visible light as well as UV wavelengths can damage skin, particularly its effects on those with skin of color (SOC), which is defined as having Fitzpatrick skin types IV-VI in this publication. Individuals with skin of color are susceptible to various forms of photodamage, including pigmentary disorders and malignancy. They are more likely to experience photodamage presenting as uneven skin tone, post-inflammatory hyperpigmentation, or melasma. While darker skin tones offer some degree of protection against UV-B rays, they are more likely to develop dyspigmentation induced by visible light and UV-A1.
Additionally, the authors address misconceptions surrounding the clinical presentation of photodamage in skin of color, the photoprotection provided by endogenous melanin, the response of skin of color to visible light, skin cancer risk in SOC, and sun protection recommendations in SOC. The authors conclude that SOC patients need to be informed about the impact of visible light on the risk of dyspigmentation, which is associated with a negative impact on quality of life and increased disease burden. More research is needed into novel strategies to address visible light damage, in addition to UV damage, in SOC patients.
DermWorld Insights and Inquiries: IL-36 and generalized pustular psoriasis — L’chaim!
There is no FDA-approved treatment for either localized or generalized pustular psoriasis (GPP). Fortunately, our understanding of GPP has taken a quantum leap forward over the past decade. “Sequencing studies have demonstrated that variants in IL36RN may be responsible for 19% to 41% of GPP and have also linked pathogenic variants in CARD14, AP1S3, SERPINA3, and myeloperoxidase with GPP. These discoveries have prompted a renewed effort to disentangle the pathogenesis of pustular psoriasis from plaque disease and, more specifically, to clarify the role of IL-1 family member cytokines (IL-1, IL-36) in the management of idiopathic pustular psoriasis, which still represents the majority of pustular psoriasis cases.” Keep reading!
Derm Coding Consult: Novitas revises shave removal coverage policy to include malignant skin lesions
Dermatologists in the Novitas Solutions–covered region brought up concerns about the denial of claims for removal of malignant skin lesion by shave technique (CPT codes 11300-11313). Upon review of Novitas’ Local Coverage Determination (LCD) L34938 and its associated Local Coverage Article: Billing and Coding A57113, both policy and technical guidance resource were found lacking, as no malignant skin lesion ICD-10-CM codes were included in the range of diagnosis codes that would support the medical necessity for this procedure, triggering denials for medically necessary and appropriate procedures. Learn more.
Is spironolactone use associated with risk of cancer?
A systematic review and meta-analysis published in JAMA Dermatology investigated the results of seven observational studies including 4.5 million patients to determine whether spironolactone use was associated with an increased risk of cancer.
[Spironolactone: An increasingly recognized hero in acne therapy. Read more.]
The findings indicate that no statistically significant association between spironolactone use and the risk of breast (risk ratio, 1.04), ovarian (1.52), bladder (0.89), kidney (0.96), gastric (1.02), or esophageal (1.09) cancers. Four studies did, however, suggest a potential association between spironolactone use and reduced risk of prostate cancer occurrence (0.79).
Dermatologists discuss the latest clinical guidance for managing hirsutism. Read more inDermWorld.
MIPS extreme and uncontrollable circumstances applications reopened
CMS reopened the MIPS extreme and uncontrollable circumstances (EUC) applications for the 2021 MIPS performance year in response to COVID-19. MIPS EUC applications citing COVID-19 as the triggering event can be submitted until Thursday, March 31, 2022, at 8 p.m. ET. Submit an application.
Also, 2020 Quality Payment Program (QPP) performance information is now available on Medicare Care Compare and the Provider Data Catalog (PDC). CMS is required to report MIPS-eligible clinicians’ final scores, and performance information for physicians and clinicians is displayed using measure-level star ratings, percent performance scores, and checkmarks. Medicare patients and caregivers can use the Care Compare website to search for and compare physicians, clinicians, and groups who are enrolled in Medicare. Get more information on CMS’ website.
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