In a study published in the Journal of Cutaneous Medicine and Surgery, the authors sought to determine whether the antiviral drug acyclovir may be a potential therapeutic option for cutaneous warts. Authors found a high statistically significant difference between the treatment and control groups.
Thirty-one patients with warts were treated with 70 mg/mL of intralesional injections of acyclovir (19 patients) or saline (12 patients) as a control into the base of each wart at two-week intervals for a maximum of five sessions. The most common type of wart treated was common warts (45.1%) followed by plantar warts (41.9%) and periungual warts (12.9%). Complete and partial clearance was seen in 52.6% and 36.8% of patients treated with acyclovir, respectively. Partial response was noted in 16.7% and no response in 83.3% of patients treated with saline.
Remedies for warts abound, but high-quality studies are lacking. Read more inDermWorld.
DermWorld Insights and Inquiries: Biotin supplementation for hair and nail health — Does it pass the test?
When patients ask me about biotin supplementation for their hair or nails, the usual question is what dose they should take, not whether or not it has any value. High dose over-the-counter biotin supplements (≥ 5 mg/day, which is 166 times the dietary recommendation of 30 μg/day) are promoted for hair and nail growth. Among U.S. adults, the prevalence of self-reported biotin has increased greatly, particularly among women and older adults, with 7.4% of women older than 60 years taking at least 1 mg daily and 2.3% using at least 5 mg daily. Indeed, a Google search of “biotin supplementation for hair and nails” revealed 5,670,000 results. This commentary will be structured in a question-and-answer format. Keep reading!
DermWorld Young Physician Focus: Making progress
I was talking to a patient during a cosmetic procedure this past week about her daughter, who is also a patient of mine. She mentioned her daughter is gay and asked if I was aware. I replied no (truthfully, I did not recall meeting her daughter…we all have that moment of racking our brains trying to remember a patient we’ve met once or twice). The patient candidly spoke to me about how she was not disappointed when her daughter came out, but was worried for her, as life continues to be more difficult for gay couples. I attempted to inject a “but look how far we’ve come” silver lining, but knew deep down that she was right. Read more from DermWorld Young Physician Advisor Jenna O'Neill, MD, FAAD.
AADA urges iPLEDGE sponsors to delay new platform implementation
Recently, the AADA celebrated the FDA’s decision to reclassify patients into two risk categories: those who can become pregnant and those who cannot become pregnant. For years, the Academy has been working closely with the FDA to make the iPLEDGE program less burdensome for patients while maintaining patient safety. This action was a direct result of AADA advocacy efforts.
While the AADA was pleased with this update, additional changes have been made to the iPLEDGE program. On Dec. 13, 2021, iPLEDGE sponsors will implement a new platform for physicians, patients, and pharmacies to engage with the program. The rapid rollout of this new system will create challenges for dermatologists and their patients, potentially impeding or delaying patient access to isotretinoin.
The transition will require practices to update workflows, and practices could potentially need to purchase new hardware, such as mobile tablets that can be used to complete requirements in the exam room. Also, changes that disallow enrollment until after a negative pregnancy test, rather than allowing applications to be submitted pending a negative test, create the need for an additional patient appointment.
The AADA did not advocate for this new system and associated program changes but has shared the specialty’s concerns in implementing these new changes with the program sponsors and the administrator. The rollout could demand significant changes in workflow for physicians, which will be burdensome to achieve in such a short time frame.
The FDA listened to the AADA before, and we will continue to advocate on behalf of the specialty and patients to ensure a balanced implementation of the new iPLEDGE system updates.
Pityriasis rubra pilaris-like eruption after mRNA COVID-19 vaccine
In a letter published in Clinical and Experimental Dermatology, the authors describe a case of pityriasis rubra pilaris (PRP)-like eruption occurring in a healthy 51-year-old man following administration of the Pfizer-BioNTech mRNA COVID-19 vaccine. The condition worsened after the second dose of the vaccine.
An erythematous scaly rash in the groin and overlying the knees was seen three days after his first vaccine dose and was treated by his primary care physician with topicals for psoriasis with some improvement. A few days after receiving his second vaccine dose, he developed worsening erythematous, scaly plaques on the scalp, arms, and thighs with sparing of the periumbilical area affecting a body surface area of 60%. A biopsy showed histologic features consistent with PRP. Treatment with acitretin and topical mometasone resulted in some improvement.
Access Academy resources related to COVID-19 vaccines, including information on side effects and rules about requiring employee vaccinations.
All individual MIPS clinicians to receive automatic extreme and uncontrollable circumstances exemption
CMS announced that it will apply the automatic extreme and uncontrollable circumstances (EUC) policy to all individually eligible MIPS-eligible clinicians for the 2021 performance year due to the continued COVID-19 public health emergency. This EUC policy only applies to clinicians who are eligible to participate in MIPS as individuals — not groups, virtual groups, or alternative payment model entities. For more information, view the Quality Payment Program COVID-19 Response webpage.
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