A guide to managing coronavirus in dermatology clinics
A recent JAAD paper in press outlines patient safety measures for outpatient dermatology clinics during the coronavirus outbreak. The paper authors discuss precautions taken at the dermatology outpatient clinic at the West China Hospital of Sichuan University, such as physical precautions (masks), running the clinic for only critical patients, and offering free teledermatology consultations.
In addition to the JAAD paper, dermatologists thinking about keeping their practices safe may wish to consult a list of products verified to fight COVID-19. The list from the Center for Biocide Chemistries is included in the CDC’s recommended resources.
Read more about the cultural factors at play in the re-emergence of infectious disease in Dermatology World.
DW Insights and Inquiries: The 2020 vision for nemolizumab in atopic dermatitis
Over the past decade, I have noticed an inversion of the ratio of patients with severe psoriasis versus atopic dermatitis (AD) in my practice. The biologic revolution has clearly favored those afflicted with psoriasis; although dupilumab has improved the lives of many patients suffering from AD, biologic therapy for the disorder is in its relative infancy.
The onset of acute AD skin lesions is characterized by large increases in TH 2/TH 22-related cytokines and chemokines with some TH 17-related signals. Subsequently, intensification of these axes as well as TH 1 augmentation orchestrates the chronic phenotype. Based on these findings, new topical agents, such as JAK (Janus kinase) inhibitors (notably ruxolitinib) and the aryl hydrocarbon receptor modulating agent tapinarof appear promising. Systemic agents, including the oral JAK inhibitors, histamine 4 receptor antagonists, the IL-13 antagonists lebrikizumab and tralokinumab, and the IL-31RA antagonist nemolizumab are on the horizon for advancing the therapeutic armamentarium for AD. This commentary focuses on nemolizumab. Keep reading!
Feedback requested: AAD/NPF draft guidelines for the management and treatment of psoriasis with topical therapy, complementary and alternative medicine modalities for psoriasis severity measures
The American Academy of Dermatology is requesting feedback from members about its draft “Joint AAD-NPF Guidelines of care for the management and treatment of psoriasis with topical therapy, complementary and alternative medicine modalities for psoriasis severity measures.” AAD members are encouraged to provide comments on the draft guidelines before the comment period closes on March 18.
Guidelines serve as decision-making and educational aids for clinical practice to support and improve quality dermatologic care and are used as the framework for quality measurement, reimbursement decisions, advocacy efforts, public messaging, and the identification of research gaps. When finalized, these evidence-based guidelines will be submitted for publication in the Journal of the American Academy of Dermatology and will be considered current for five years from the date of publication.
Brand-name prescription drug prices up 159% since 2007
According to a recent paper in JAMA, from 2007 to 2018, the list prices for brand-name prescription drugs increased by 159% and net prices increased by 60% in the United States. However, the study found that discounts increased from 40% in 2007 to 76% in 2018 in Medicaid, and increased from 23% to 51% with other payers, offsetting 62% of increases in list prices for drugs.
The authors conducted a retrospective descriptive study utilizing pricing data from the investment firm SSR Health of more than 600 drugs. They estimated net prices by compiling company-reported sales for each product and number of units sold in the U.S. All told, the authors indicated that, “Although discounts partially offset list price increases of branded products from 2007 to 2018, there was still a substantial increase in net prices over this period.”
Read more about the factors that can keep physicians out of the loop on current drug prices and costs to patients in Dermatology World.
JAAD research finds new link between vitiligo and autoimmune diseases
Research published in JAAD highlights new associations between vitiligo and multiple autoimmune diseases such as hypothyroidism and rheumatoid arthritis.
This study evaluated data from almost 1,500 vitiligo patients with different ethnic backgrounds over the course of a decade. In addition to confirming a link to autoimmune diseases, researchers identified new associations with several other serious health conditions, including multiple sclerosis, lymphoma, and a bleeding disorder known as ITP. The results also showed that these autoimmune disease rates varied by race/ethnicity and gender.
Read more about the link between vitiligo, autoimmunity, and cancer in DW Insights and Inquiries.
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