September 11
IN THIS ISSUE / September 11, 2019
- How often do dermatologists prescribe off-label medications?
- DW Insights and Inquiries: Shingles and the battle of the bulge
- Feedback requested: AAD/NPF draft guidelines for the management of psoriasis with non-biologics
- Deadline approaching to submit a 2018 MIPS targeted review request
- FDA expands approval of two topical psoriasis therapies to pediatric patients
- Grants available for technology-based teaching applications
How often do dermatologists prescribe off-label medications?

An analysis of dermatologic diagnoses and treatments was conducted between 2006 and 2015 to classify prescribed drugs as on-label or off-label for their corresponding diagnoses. The analysis, accepted for publication in JAAD, found that off-label prescribing was particularly frequent for uncommon skin diseases such as hidradenitis suppurativa (45%), bullous pemphigoid (43%), and systemic lupus erythematosus (58%) while the frequency of off-label prescriptions for herpes zoster was 0.9%.
Off-label prescribing was also significant for common conditions including acne and rosacea (20% and 33%, respectively). Prescribing behaviors were similar among dermatologists and non-dermatologists, with the exception of HS, for which dermatologists prescribed off-label medications nearly twice as frequently.
The study authors found that their data highlight the need for the continued development of FDA-approved treatments for skin diseases as well as the importance of patient access to off-label prescribing for the treatment of skin disease.
Related content:
- When insurance doesn’t cover standard of care treatments, what can be done? – Dermatology World (September 2019)
- Promoting off-label uses of drugs or devices: Free speech rules – Dermatology World (January 2017)
- AADA prior authorization letter generator: Create appeal letters to help overturn denials
- AAD product: Dialogues in Dermatology podcast subscription
DW Insights and Inquiries: Shingles and the battle of the bulge
I thought I knew herpes zoster (HZ, shingles) inside and out — from patients’ experiences and my late mother’s herpes zoster ophthalmicus (I could not believe how devastatingly awful she appeared arriving back from Europe!), to my recent vaccination with Shingrix. I just became cognizant of a “new” complication of HZ (new to me, at least) — the post-herpetic abdominal pseudohernia (PHAP).
Following primary varicella infection, the varicella-zoster virus persists in spinal and cranial nerve ganglia. After reactivation and replication, the virus traverses through sensory nerve fibers associated with the involved ganglion resulting in its classical dermatomal vesicular eruption. Keep reading!
Feedback requested: AAD/NPF draft guidelines for the management of psoriasis with non-biologics
The American Academy of Dermatology is requesting feedback from members about its draft Guidelines of Care for the Management of Psoriasis with Systemic Non-biological Therapies. AAD members are encouraged to provide comments on the draft guidelines before the comment period closes Sept. 12.
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.
View the Academy’s current and upcoming clinical guidelines in the AADA Practice Management Center.
Related content:
- Collaboration and diverse expertise strengthen clinical practice guidelines – Dermatology World (February 2019)
- New urticaria guidelines update antihistamine recommendations – Dermatology World (June 2018)
- Setting the standards – Dermatology World (July 2016)
Deadline approaching to submit a 2018 MIPS targeted review request
MIPS-eligible clinicians or groups may request that CMS review their performance feedback and final score calculation through a process called targeted review. The deadline to submit your request is Sept. 30, 2019, at 8 p.m. EDT.
Here’s how to access your 2018 MIPS final score and performance feedback and request a targeted review:
- Go to the Quality Payment Program website.
- Login using your HCQIS Access Roles and Profile System (HARP) credentials; these are the same credentials that allowed you to submit your MIPS data. Please refer to the QPP Access User Guide for additional details, including if you do not have a HARP account or role.
Related content:
- Get ready for MIPS in 2019 – Dermatology World (February 2019)
- Earning a high-performance bonus for MIPS: Using DataDerm to report – Dermatology World (November 2018)
- AAD product: 2019 MIPS Reporting Module
- AADA MACRA Resource Center
- AAD resources: DataDerm
FDA expands approval of two topical psoriasis therapies to pediatric patients
The U.S. Food and Drug Administration (FDA) has expanded the approval for two plaque psoriasis therapies to include pediatric patients. Calcipotriene and betamethasone dipropionate (Enstilar Foam) is now indicated for the treatment of plaque psoriasis in patients 12 years and older. Previously, the treatment had been approved for patients 18 years and older.
Additionally, Taclonex Topical Suspension, which contains the same active ingredients as the foam, has been approved for the treatment of plaque psoriasis of the scalp and body in patients 12 years and older. Previously, it had only been indicated for plaque psoriasis of the body in patients 18 years and older. Read more about advances in psoriasis treatments in Dermatology World.
Related content:
- The new frontier for biologics and psoriasis may be adherence – DW Insights and Inquiries (June 2019)
- Prolactin and its role in stress-induced psoriasis – DW Insights and Inquiries (January 2018)
- What advice should dermatologists give psoriasis patients about CV risk? – Dermatology World (March 2017)
- AAD product: Psoriasis and Psoriatic Arthritis patient pamphlet
- For your patients: Psoriasis Resource Center
Grants available for technology-based teaching applications
The AAD’s Sulzberger Institute for Dermatologic Education Committee is seeking grant proposals for technology-based teaching applications that further education in dermatology and dermatologic surgery. There is a two-stage application process. In the first stage, applicants will submit an online Letter of Intent (LOI). If the LOI is selected by the committee, the applicant will be invited to move forward to the second stage and submit a full proposal. The deadline to submit the LOI is Sept. 20, 2019.
Applicants will be notified in late fall 2019 if their LOI was accepted and if a full proposal will be requested by the committee.
The American Academy of Dermatology is a non-profit professional organization and does not endorse companies or products. Advertising helps support our mission.
Opportunities
Find a Dermatologist
Member directory
AAD Learning Center
2026 AAD Annual Meeting
Need coding help?
Reduce burdens
Clinical guidelines
Why use AAD measures?
New insights
Physician wellness
Joining or selling a practice?
Promote the specialty
Advocacy priorities
