May 29

IN THIS ISSUE / May 29, 2019

Academy issues statement on sunscreen safety

In response to the Environmental Working Group’s (EWG) review, the Academy issued a statement reminding the public that sunscreen remains an important way to protect yourself from the sun’s harmful ultraviolet rays. The EWG finds that two-thirds of sunscreens on the market do not meet safety or efficacy standards. The EWG and dermatologists say, however, that the findings do not mean people should stop using sunscreen.

AAD President George Hruza, MD, MBA, noted that “Recent accounts of the FDA’s proposed sunscreen rule in the news incorrectly suggest that many sunscreens currently on the market do not meet safety requirements of the FDA. In fact, only two ingredients were proposed to be unsafe — PABA and trolamine salicylate — and these are no longer available in the U.S.”

After decades of use, there have been no reported data of systemic internal side effects from the use of sunscreen. The FDA has asked for more data on certain ingredients to find out to what extent the skin absorbs these ingredients and if absorbing sunscreen has any effects on the skin or body. This does not mean that the FDA is expressing concern about sunscreen ingredients, nor have they concluded that any of the sunscreen ingredients sold in the U.S. are unsafe, Dr. Hruza said.

“As dermatologists, we know that unprotected exposure to the sun’s dangerous ultraviolet rays is the most preventable risk factor for skin cancer, including melanoma, the deadliest form. Sunscreen can help protect the public from harmful UV rays — making it a vital tool in the fight against skin cancer,” Dr. Hruza affirmed.

Read previous DW Weekly coverage about the FDA’s proposed rule that outlines the final monograph for OTC sunscreen products and the results of a JAMA study that supports the FDA’s call for additional data.

“Dr. Heymann, I’ve noticed a number of these spots appearing lately.”

“They’re called cherry angiomas — totally benign.”

“Why I am getting them?”

“Maturity.”

“You mean I’m getting old!”

“I did not say that — you did!”

“I don’t like them. Can you take them off?”

“Easily, especially with the laser. It would be considered a cosmetic procedure.”

“You mean Medicare won’t pay for it?”

“Correct.”

“Forget it — I’ll live with them.”

I imagine this conversation occurs daily in every dermatologist’s office. Of all the cutaneous entities I have never thought much about, cherry angiomas (CAs, aka senile angioma, Campbell de Morgan spot) top the list. Keep reading!

AccessDerm: Serving the underserved

With just a few minutes a day and a smartphone, dermatologists have the potential to make a significant impact in their community by using the Academy’s volunteer teledermatology platform, AccessDerm. Dermatology World Weekly speaks with Cory Simpson, MD, about why he uses AccessDerm, how it works, and why others should get involved.

Related Content:

Anthem enforces modifier 25 denials

As previously announced, effective May 1, 2019, Anthem began denying reimbursement when evaluation and management (E/M) services are billed with a modifier 25 on the day of a related procedure when there is a recent service or procedure for the same or similar diagnosis on record.

Prior to this policy going into effect, the AADA sent a letter to Anthem indicating that it is unclear how the policy will impact dermatologists and the physician community and is requesting the payer to delay enforcement of this policy.

Despite the AADA’s concerns, Anthem began enforcing this policy and practices are reporting denials for medically necessary follow-up encounters. If your practice has received denials because of this policy please email coding@aad.org.

Learn more about modifier 25 (and others) in the Academy’s Coding Resource Center.

Join the AADA and U.S. Representative David Joyce (R-Ohio) who, along with leaders of the Congressional Skin Cancer Caucus, have introduced H. Res. 323 to urge state and local lawmakers to lift bans on sunscreen in schools, encourage development of policies that increase access to sunscreen, and support efforts to educate children and parents about sun-safe behavior.

Need to restock educational pamphlets? Get 10% off patient education pamphlets for Skin Cancer Awareness Month. Use code PAMDW19.

Kaposi sarcoma treatment gets Breakthrough Therapy designation

The Food and Drug Administration (FDA) has granted Breakthrough Therapy designation to pomalidomide (Pomalyst^®), a thalidomide analogue, for the treatment of patients with Kaposi sarcoma. Breakthrough Therapy is a process designed to expedite the development and review of drugs that are intended to treat a serious condition and preliminary clinical evidence indicates that the drug may demonstrate substantial improvement over available therapy.

Pomalidomide is being investigated as a potential treatment for patients with HIV-positive Kaposi sarcoma who have previously received systemic chemotherapy as well as in patients with HIV-negative Kaposi sarcoma. There are currently no FDA-approved treatments for HIV-positive patients who are refractory or intolerant of systemic chemotherapy.

Read Dr. Heymann’s analysis of new pitfalls in the diagnosis of Kaposi sarcoma in DW Insights and Inquiries.

The only thing bothering her, other than the idea that she had cancer, was a terrible rash. It had gone from itchy to sore and blistering. Her arms were a deep crimson. Her face felt tight and tender. Her hands were nearly purple and hugely swollen. Was it leukemia, or something else?

Read coverage of this story in The New York Times.

Academy Advisory Board invites members to submit policy resolutions

Do you have an issue of interest or area of concern? Now is your opportunity to submit a resolution from which an official Academy position might arise. Even if you do not have experience drafting resolutions, we encourage you to contact Academy staff or members of the Advisory Board Executive Committee with ideas, and they will help guide you through the submission process.

To ensure consideration, all resolutions must be submitted by June 5. The author and/or their AB representative must submit an updated conflict of interest and a statement of support with their resolution for consideration by the full Advisory Board. The statement should state the reasons why the Advisory Board should adopt the resolution. The full Advisory Board will consider the submitted comments and resolutions and vote this summer.

Established Academy position statements can be found on the Academy’s website.