J Drugs Dermatol
. 2020 Jun 1;19(6):592-600.
Consensus on Neonatal Through Preadolescent Acne
No authors listed
PMID: 32574026
Abstract
Background: Acne vulgaris is the most common dermatological disorder. Pediatric acne may be a manifestation of the underlying pathology and can occur in the first weeks, months, or years of life. Acne in childhood can be categorized by age and pubertal status.

Objective: An expert panel of pediatric dermatologists and dermatologists developed a consensus paper on neonatal through preadolescent acne, providing information on differential diagnosis, prevention, treatment, and maintenance of the condition.

Methods: A systematic literature review explored present clinical guidelines, treatment options, and therapeutic approaches addressing neonatal through preadolescent acne. The information from the literature searches was used together with the panel’s expert opinion and experience to adopt consensus statements following established standards.

Results: The panel members reached unanimous consensus on seven statements addressing the various age categories of pediatric acne: neonatal acne: birth to ≤ 8 weeks; infantile acne: 8 weeks to ≤1 year; mid-childhood acne: 1 year to <7 years; preadolescent acne: ≥7 to 12 years; adolescent acne: ≥12 to 19 years or after menarche for girls. Health care providers treating children need to pay more attention to pediatric acne and should monitor the risk of endocrine-associated abnormalities, especially in mild-childhood acne. When prescribing acne treatment, newer medications approved for use in children older than nine years of age may offer a suitable option.

Conclusion: The differential diagnosis of pediatric acne, as well as its treatment and maintenance, requires much more attention and consideration from health care providers treating children. J Drugs Dermatol. 2020;19(6):592-600. doi:10.36849/JDD.2020.5065.

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J Drugs Dermatol
. 2020 Mar 1;19(3):306-313.
Efficacy and Safety of Systemic Treatments for Skin and Joint Manifestations in Patients With Psoriasis
William Abramovits, Joel Schlessinger
PMID: 32550687
Abstract
Psoriasis is a chronic, systemic disease with features suggestive of autoimmune dysregulation. Patients with psoriasis vulgaris frequently experience systemic comorbidities, including cardiovascular and metabolic diseases, and approximately 30% develop psoriatic arthritis (PsA), which requires treatment. It is important that physicians and patients are aware of the breadth of treatment options available to treat the complete spectrum of psoriasis manifestations. This narrative review summarizes clinical information from approved systemic psoriasis therapies relevant to the treatment of PsA and related systemic pathologies. We include pivotal clinical trials of biologic therapies that are approved by the US Food and Drug Administration for psoriasis and PsA and additional studies identified from PubMed and congress abstract searches through August 21, 2019. We comment on the real-world effectiveness of traditional nonbiologic treatment options, including methotrexate, cyclosporine, acitretin, systemic corticosteroids, and nonsteroidal anti-inflammatory drugs and consider targeted synthetic and biologic disease-modifying antirheumatic drugs and their efficacy and safety in treating skin and joint manifestations. Finally, we discuss key considerations when managing patients with PsA as a comorbidity of psoriasis. The individual treatment needs of patients should be met while psoriasis and its systemic complications are managed. When addressing these needs, it is important to consider modern biologics and other systemic therapies. J Drugs Dermatol. 2020;19(3): doi:10.36849/JDD.2020.4690THIS ARTICLE HAD BEEN MADE AVAILABLE FREE OF CHARGE. PLEASE SCROLL DOWN TO ACCESS THE FULL TEXT OF THIS ARTICLE WITHOUT LOGGING IN. NO PURCHASE NECESSARY. PLEASE CONTACT THE PUBLISHER WITH ANY QUESTIONS.

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J Drugs Dermatol
. 2020 Jun 1;19(6):639-645.
United States Stock Market Response to FDA Approval of New Dermatologic Drugs
Rishabh S Mazmudar, Raghav Tripathi Tripathi, Harib H Ezaldein, Jeffrey F Scott
PMID: 32574024
Abstract
Background: The Food and Drug Administration (FDA) has approved several new dermatologic drugs in the last decade. The public response to their approval has not yet been evaluated.

Objective: To analyze the United States stock market response surrounding FDA approval of new dermatologic drugs between 2008 and 2018.

Methods: A list of 34 FDA approved dermatologic drugs for publicly traded companies was compiled from the CenterWatch New Dermatology Drugs List and the FDA Annual Reports on New Drugs. Company and stock market data was acquired from the Center for Research in Security Prices (CRSP) United States Stock database. Cumulative abnormal returns (CAR) were calculated as the difference between raw returns and expected value-weighted returns. Data analyses were performed using SAS 9.4 (Cary, NC).

Results: The average CAR for the 21-day window period surrounding FDA approval of new dermatologic drugs was +1.71%. Drugs approved for the treatment of hyperhidrosis (+17.7%), bacterial skin infections (+7.18%), and rosacea (+6.83%) added the most market value.

Limitations: The market value added to private or internationally traded companies could not be assessed.

Conclusion: FDA approval of dermatologic drugs generally has a positive market response. Information on market reaction may provide important insights for investors, pharmaceutical companies, and researchers. J Drugs Dermatol. 2020;19(6): doi:10.36849/JDD.2020.5033.

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J Drugs Dermatol
. 2020 Jun 1;19(6):658-660. doi: 10.36849/JDD.2020.10.36849/JDD.2020.5121.
Non-Steroidal Topical Therapy for Facial Seborrheic Dermatitis
Jaime Piquero-Casals, Edgar La Rotta-Higuera, Juan Francisco Mir-Bonafé, Eduardo Rozas-Muñoz, Corinne Granger
PMID: 32574015 DOI: 10.36849/JDD.2020.10.36849/JDD.2020.5121
Abstract
Seborrheic dermatitis (SD) is a chronic, recurrent, inflammatory skin disorder occurring in areas rich in sebaceous glands. It manifests clinically as erythematous macules or plaques with varying levels of scaling and associated pruritus. Although the pathogenesis of SD has yet to be fully understood, Malassezia yeasts, hormones, sebum levels, and immune response are known to play important roles. Additional factors including drugs, winter temperatures, and stress may exacerbate SD. Current available treatments include antifungal agents, topical low-potency steroids, and calcineurin inhibitors. We aimed to evaluate the effectiveness of a topical non-steroidal cream in treating facial seborrheic dermatitis (FSD). We performed a case series of 11 patients with mild or moderate FSD and a history of several previous treatments without improvement. The patients were treated for 8 weeks with a topical non-steroidal facial cream (NSFC) containing zinc PCA, piroctone olamine, hydroxyphenyl propamidobenzoic acid, biosaccharide gum-2, and stearyl glycyrrhetinate. Signs and symptoms and tolerance were assessed before, during, and at the end of treatment. All of the patients had improved symptoms of FSD (desquamation, pruritus, erythema, and stinging sensation); 81.8% showed an excellent response and 18.1% showed a good response. None of the patients had adverse effects. J Drugs Dermatol. 2020;19(6): doi:10.36849/JDD.2020.5121.

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J Drugs Dermatol
. 2020 Jun 1;19(6):611-615. doi: 10.36849/JDD.2020.10.36849/JDD.2020.4772.
Improving the Appearance of Surgical Facial Scars With IncobotulinumtoxinA and Microneedling
Gabriela R Casabona, Thais Bello Giacomo
PMID: 32574010 DOI: 10.36849/JDD.2020.10.36849/JDD.2020.4772
Abstract
The appearance of post-surgical scars on the face is a major concern for surgeons and a source of anxiety for patients after Mohs surgery due to nonmelanoma skin cancer (NMSC). The objective of this retrospective study was to assess the effectiveness of combining incobotulinumtoxinA and microneedling to improve the appearance of post-operative facial scars. Enrolled subjects underwent surgical removal of facial NMSCs followed by flap reconstruction by the same surgeon during 2014 (n=35) and 2015 (n=35). Sutures were removed 7 days after the procedure. Subjects treated during 2014 received no additional treatment and served as a control group. Subjects treated during 2015 also received micro-doses of incobotulinumtoxinA along the scar border and microneedling of the surgical area. Microneedling was repeated after 15 days. Scar severity was determined by the surgeon and an independent dermatologist using the modified Vancouver Scar Scale (VSS) scores on day 7 and day 30 following suture removal. Patient Satisfaction Scale scores were also determined using a 5-point scale on day 30. Mean (SD) VSS scores were 10.4 (1.14) on day 7 among treated subjects vs. 9.5 (1.88) among control subjects (P<0.05). On day 30, mean VSS scores had decreased to 1.1 (0.89) for treated subjects vs. 7.6 (1.72) for control subjects (P<0.05). Patient Satisfaction Scores were significantly higher among treated patients vs control subjects (4.45 vs 3.14; P<0.001). The use of incobotulinumtoxinA is a promising therapeutic option for improving scar appearance. Combined with microneedling, it significantly reduced VSS scores and improved overall satisfaction of treated subjects following surgery for NMSCs. J Drugs Dermatol. 2020;19(6): doi:10.36849/JDD.2020.4772.

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J Drugs Dermatol
. 2020 Mar 1;19(3):230-234.
Nail Surgery Myths and Truths
Jose W Ricardo, Shari R Lipner
PMID: 32550691
Abstract
Introduction: There is a paucity of randomized trials on nail surgery. Since there are no established guidelines, dermatologists may have false beliefs about best practices in performing nail surgery and post-procedural care.

Methods: We identified five common myths concerning nail surgery. A PubMed search was performed to refute or support these beliefs.

Results: We found compelling evidence that refutes these nail surgery myths. We found that epinephrine can be safely used for nail surgery, hydrogen peroxide and tap water is recommended for wound cleansing, prophylactic topical antibiotics should be avoided, calcium alginate, or amniotic membrane dressings are valuable dressing alternatives, and digital dressings have a low risk profile with precise technique.

Discussion: Randomized controlled trials for nail surgery are lacking. Data from similar fields may guide dermatologists in performing nail surgery. J Drugs Dermatol. 2020;19(3): 230-234 doi:10.36849/JDD.2020.4861.

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J Drugs Dermatol
. 2020 Mar 1;19(3):333-334.
Basal Cell Carcinoma in the Nasal Vestibule
Amir A Bajoghli, Kyra Gassmann
PMID: 32550683
Abstract
Basal Cell Carcinoma (BCC) is one of the most common human malignant neoplasms and is the most prevalent skin cancer in the United States with over four million new cases reported annually.1,2 Most BCCs arise in the skin from exposure to the sun’s ultraviolet radiation. However, it is possible for BCCs to present in sun-protected areas due to factors other than sun exposure. We present a case of a basal cell carcinoma located in the nasal vestibule. In presenting this case, we would like to emphasize the importance of attentive full skin examinations, both by physicians and patients, that include observation of sun-protected areas, as skin cancers such as basal cell carcinomas may occur in these unusual areas. In addition, BCCs have been reported in the literature to have occurred in the interdigital area of the foot, the female and male nipples, the axillae, and the genital and perianal areas.3,4,5,6,7,8 J Drugs Dermatol. 2020;19(3):333-334 doi:10.36849/JDD.2020.4517.

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J Drugs Dermatol
. 2020 Jun 1;19(6):632-636. doi: 10.36849/JDD.2020.10.36849/JDD.2020.5139.
Development of a Photonumeric Lip Health Scale
Zoe Diana Draelos, Darrell Rigel, Adam Friedman
PMID: 32574022 DOI: 10.36849/JDD.2020.10.36849/JDD.2020.5139
Abstract
Background: The lips are important facial anatomic features with particular vulnerability to environmental damage, yet they have received little attention in the dermatologic literature. A photonumeric rating scale for clinically assessing lip heath is needed to advance lip research.

Objective: To develop a photonumeric lip health assessment scale for clinical use that can evaluate the efficacy of products for improving lip health.

Methods: The VISIA®-CR 4.3 system was used to photograph the frontal face of 103 subjects with Fitzpatrick skin types I–III exhibiting a range of lip health status based on the key characteristics of lip shine, texture, and vermilion border. An expert panel comprising 3 dermatologists independently rated the images based on the proposed rating scale. Images with ≥75% rater agreement were redistributed to the panel for selecting the final images and verification of the final scale.

Results: The panel selected 15 images for the final scale: 5 for each of the key characteristics (lip shine, texture, and vermilion border) and 1 for each ordinal rating of 0–5 within a characteristic (eg, 0=very shiny, 5=very dull). All of these images achieved 100% agreement among the raters.

Conclusion: This scale provides healthcare professionals and researchers a way to evaluate current lip health, track improvement, and evaluate the efficacy of treatments. It can be used to communicate with patients during discussions about lip conditions, recommending treatments, and setting goals. The scale also provides a research tool to evaluate different formulations for developing lip care products. J Drugs Dermatol. 2020;19(6):   doi:10.36849/JDD.2020.5139.

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J Drugs Dermatol
. 2020 Jun 1;19(6):646-651. doi: 10.36849/JDD.2020.M5108.
Treatment of Moderate to Severe Acne and Scars With a 650-Microsecond 1064-nm Laser and Isotretinoin
Michael H Gold, Natalia E Manturova, Larisa S Kruglova, Evgeniya V Ikonnikova
PMID: 32574021 DOI: 10.36849/JDD.2020.M5108
Abstract
Background: Laser procedures for acne and acne scars have traditionally been postponed for at least 6 to 8 months after the end of systemic isotretinoin therapy. Lower dosages with more modern laser devices having unique energy parameters of high power in microsecond pulse durations have made it possible to administer laser therapy during or shortly after completion of isotretinoin therapy, thus reducing the risk of side effects of isotretinoin.

Methods: Patients with moderate to severe facial acne (n=46) and atrophic scars enrolled in a 6-month study. Genetic analysis of patients revealed the presence of polymorphisms of genes Col1A2, MMP3, ESR1, MMP1, and MMP7, which can lead to scar formation. Patients underwent low-dosage isotretinoin therapy (0.2-0.3 mg/kg/day) in combination with facial laser treatment using a 650-microsecond, 1064-nm Nd: YAG laser. Acne severity was graded using the Investigators Global Assessment (IGA) scale and quality of life was evaluated by the Dermatology Life Quality Index (DLQI).

Results: IGA parameters decreased from 1.8 ± 0.2 (mean ± SD) initially to 0.5 ± 0.4 at the end of the study, a 72.3% reduction which was significant (P<0.01). The DLQI index decreased from 10.1 ± 1.3 initially to 2.8 ± 1.2, a 72.3%, a significant reduction (P<0.01). Inflammatory elements resolved without scarring. Laser treatment was well tolerated and improvement in pre-existing scars was noticeable.

Conclusions: The 650-microsecond, 1064-nm laser in combination with low-dose isotretinoin is safe and effective in patients with acne complicated by atrophic scars and genetically prone to post-acne scarring. J Drugs Dermatol. 2020;19(6):   doi:10.36849/JDD.2020.5108.

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10
J Drugs Dermatol
. 2020 Mar 1;19(3):30-35.
Androgens, Androgen Receptors, and the Skin: From the Laboratory to the Clinic With Emphasis on Clinical and Therapeutic Implications
James Q Del Rosso, Leon H Kircik, Linda Stein Gold, Diane Thiboutot
PMID: 32550699
Abstract
The effects of androgens on human skin include growth and differentiation of sebaceous glands, terminal hair growth, epidermal barrier function, wound healing, and modification of the cutaneous microbiome. Androgens exert their activities via ligand formation with intracytoplasmic androgen receptors which can then translocate to the nucleus and interact with genetic androgen response elements to influence signaling cascades. Differences in tissue distribution and activities of enzymes that modify androgen synthesis and catabolism, variations related to gender and ethnicity/race, and genetic polymorphisms that affect androgen receptor functionality directly impact androgen physiology and the pathophysiology associated with a variety of disease states. This manuscript reviews the fundamentals of androgen physiology, androgen synthesis and catabolism in local skin tissue, androgen receptor activity, as well as the impact of genetic polymorphisms and gender. Emphasis is placed on the roles of androgenic activity in sebaceous gland development, sebum production, and the pathophysiology of acne vulgaris. J Drugs Dermatol. 2020;19(3 Suppl 1):s30-35.

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11
J Drugs Dermatol
. 2020 Jun 1;19(6):625-631. doi: 10.36849/JDD.2020.10.36849/JDD.2020.5085.
A Double-Blind, Comparative Clinical Study of Newly Formulated Retinol Serums vs Tretinoin Cream in Escalating Doses: A Method for Rapid Retinization With Minimized Irritation
Zoe Diana Draelos, R Scott Peterson
PMID: 32574009 DOI: 10.36849/JDD.2020.10.36849/JDD.2020.5085
Abstract
Objective: The goal of this 12 week, double-blinded, controlled, clinical study was to compare the efficacy, tolerability, and consumer acceptance of three novel retinol serums to tretinoin.

Method: Forty-five photoaged females ages 35-65, Fitzpatrick skin types I-IV, with moderate wrinkling were enrolled in the 12-week study. A step-up protocol for increasing the dose of retinol serum (0.25%, 0.5%, 1.0%) or tretinoin cream (0.025%, 0.05%, and 0.1%) in combination with a test moisturizer or currently marketed dermatologist-recommended moisturizing cream was used. Overall severity of investigator graded photodamage, subject assessed photodamage, and tolerability criteria were evaluated using a 5-point ordinal scale at weeks 4, 8, and 12. Facial photography occurred at each visit and TEWL was measured at baseline and week 12. Histologic evaluation of punch biopsies was completed on baseline and week 12 samples.

Results: After 12 weeks of use, both retinol serum and tretinoin demonstrated parity across investigator and subject assessment measurements as well as diagnostic measures including TEWL. Retinol serum subjects showed significant week 4 improvement in visual skin smoothness compared to tretinoin subjects (P=0.031). There was highly significant improvement in skin dryness with the retinol serum (P<0.001) not seen in the tretinoin group. Histologic analysis of baseline and 12-week punch biopsies demonstrated newly formed collagen and greater epidermal thickening in retinol serum subjects compared to tretinoin treated subjects.

Conclusion: Retinol serum (0.25%, 0.5%, 1.0%) was safe and effective with equivalent/or better performance and tolerability than tretinoin creams. J Drugs Dermatol. 2020;19(6): doi:10.36849/JDD.2020.5085.

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12
J Drugs Dermatol
. 2020 Jun 1;19(6):637-638. doi: 10.36849/JDD.2020.10.36849/JDD.2020.4938.
The Effect of Isotretinoin on Vitiligo and Autoimmune Comorbidity
Megan O'Connor, Jonathan I Silverberg, Nanette B Silverberg
PMID: 32574013 DOI: 10.36849/JDD.2020.10.36849/JDD.2020.4938
Abstract
Several case reports have noted development of vitiligo as a potential side-effect of isotretinoin. In an IRB approved on-line survey of vitiligo patients we queried 1,301 vitiligo patients, 1115 with generalized vitiligo responding as to whether they had taken isotretinoin to address whether this issue was a common phenomenon amongst vitiligo patients. 3.6% of respondents had taken isotretinoin, 1.4% (n=16) before onset of vitiligo, and 2.2% (n=24) after onset of vitiligo. When compared with age-matched vitiligo peers who had not taken isotretinoin before onset of vitiligo (n=64) , isotretinoin use prior to onset of vitiligo was associated with: decreased disease body surface area (conditional logistic regression: OR of BSA≥50% (95% CI)=0.12 (0.03–0.57), P=0.007); decreased odds of body and face involvement when compared with either body or face alone (OR (95% CI)=0.20 (0.06–0.73), P=0.02); and decreased co-morbid autoimmunity (OR (95% CI)=0.17 (0.04–0.58), P=0.01). The volume of isotretinoin usage in vitiligo patients is additionally suggestive of a link between cystic acne and vitiligo. J Drugs Dermatol. 2020;19(6): doi:10.36849/JDD.2020.4938.

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13
J Drugs Dermatol
. 2020 Mar 1;19(3):281-290.
Treatment of Impetigo in the Pediatric Population: Consensus and Future Directions
Lawrence A Schachner, Antonio Torrelo, Ayman Grada, Giuseppe Micali, Pearl C Kwong, Gwenolyn B Scott, Latanya Benjamin, Mercedes E Gonzalez, Anneke Andriessen, Thomas Eberlein, Lawrence F Eichenfield
PMID: 32550690
Abstract
Background: Impetigo is a common contagious superficial bacterial skin infection. Treatment of localized lesions can be achieved through topical antibiotics. Oral antibiotics are reserved for extensive disease. Increasing antimicrobial resistance to existing therapies have raised concerns. Antimicrobial stewardship, achieved through the responsible use of antibiotics, is an important measure to re-duce bacterial resistance. This review highlights treatment options for impetigo and shares consensus statements to help guide the management of impetigo in the pediatric population.

Objective: An expert panel of dermatologists and pediatricians convened in February 2019 to establish evidence-based consensus on the management of impetigo in the pediatric patient population.

Methods: The consensus was created in accordance with the Appraisal of Guidelines, Research and Evaluation (AGREE) II instrument. Prior to the consensus meeting, a systematic literature review was conducted, with the selected literature deemed clinically relevant to the consensus statements. Statements were further refined and assessed systematically following established standards. The consensus process consisted of a modified Delphi approach. The consensus was established through a minimal 75% “agree” rate.

Results: Thirteen consensus statements were developed addressing clinical challenges, existing treatment options and their limita-tions, and new therapeutic alternatives.

Conclusion: Bacterial resistance to antimicrobials commonly used in treating impetigo has been reported. Antimicrobial stewardship is critical to optimize patient outcomes and to prevent the development of resistance. Healthcare providers should be aware of local resistance patterns in impetigo to help guide therapy. The use of newer safe and effective topical antibiotic alternatives as a first-line treatment should be an important step in antimicrobial stewardship.J Drugs Dermatol. 2020;19(3): doi:10.36849/JDD.2020.4679.

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14
J Drugs Dermatol
. 2020 Mar 1;19(3):295-304.
Rosacea Treatment Satisfaction: Matching Adjusted Indirect Treatment Comparison Analysis of Metronidazole Gel or Cream vs Azelaic Acid Foam
Todd Williamson, Anneliese LaRose, Jennifer Cameron, Jason Lott, Michael Eaddy, Sari Hopson, Huai-Che Shih, Linnea Tennan Tennant
PMID: 32550696
Abstract
Objective: To assess differences in patient-reported treatment side effects and concerns associated with azelaic acid 15% foam (AAF) vs metronidazole cream (MC) and metronidazole gel (MG).

Methods: This study used matching-adjusted indirect comparison (MAIC) to compare patient-reported outcomes from survey data evaluating rosacea treatments. Outcomes of interest included percentages of patients reporting concerns and side effects and measures of importance of the concerns and tolerability of the side effects. Patients in each analysis (MG vs AAF and MC vs AAF) were matched using stabilized inverse propensity scores.

Results: When compared to AAF, MG-treated patients more frequently reported concerns with treatment efficacy (54% vs 4%), application (7% vs 3%), and treatment side effects. MC-treated patients more frequently reported concerns with treatment efficacy (61% vs 5%) and dryness (8% vs 5%). AAF-treated patients more frequently reported concerns with cost of treatment compared with MG (7% vs 1%) and MC (9% vs 4%). Among patients reporting concerns, level of importance associated with these concerns was similar for AAF-treated patients compared with MG- and MC-treated patients. When compared to AAF-treated patients, MG-treated patients more frequently reported side effects of dryness (26% vs 15%) and uneven skin tone (3% vs 0%), and MC-treated patients more frequently reported side effects of burning (7% vs 3%), itching (7% vs 5%), and redness (7% vs 5%). MG- and MC-treated patients indicated greater intolerance for reported side effects than AAF-treated patients.

Conclusions: MG- and MC-treated patients more frequently reported treatment concerns and side effects than AAF-treated patients, and tolerability of those side effects was higher for patients treated with AAF. While treatment cost is a more frequent concern in patients treated with AAF, these patients less frequently reported concerns with treatment efficacy and reported similar or greater tolerance to side effects than patients treated with either MC or MG. J Drugs Dermatol. 2020;19(3): doi:10.36849/JDD.2020.3679.

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15
J Drugs Dermatol
. 2020 Mar 1;19(3):244-248.
Atopic Dermatitis: A Review of Current Diagnostic Criteria and a Proposed Update to Management
Matthew Reynolds, Joe Gorelick, Matthew Bruno
PMID: 32550689
Abstract
The diagnosis of atopic dermatitis (AD) remains primarily a clinical diagnosis, in which several clinical signs and symptoms including pruritus, the presence and location of skin lesions, and a personal or family history of atopic conditions are used to facilitate a diagnosis. In recent decades, several well-established sets of criteria have been developed to aid diagnosis. With increased awareness of AD and the recent development of systemic immunomodulators to treat the condition, there exists a need to further define and consolidate the current diagnostic criteria while refining our current understanding of the clinical features of AD. We propose a novel, simplified set of criteria that comprises the clinical features generally considered to be essential for a confirmed diagnosis of AD, together with features previously regarded as having less clinical significance. It is essential, however, that any refinements to the diagnostic criteria for AD are made alongside regular updates of treatment guidelines so that these also reflect current developments. In this regard, the current guidelines in the United States are lacking and should be updated. J Drugs Dermatol. 2020;19(3): doi:10.36849/JDD.2020.4737 THIS ARTICLE HAD BEEN MADE AVAILABLE FREE OF CHARGE. PLEASE SCROLL DOWN TO ACCESS THE FULL TEXT OF THIS ARTICLE WITHOUT LOGGING IN. NO PURCHASE NECESSARY. PLEASE CONTACT THE PUBLISHER WITH ANY QUESTIONS.

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16
J Drugs Dermatol
. 2020 Mar 1;19(3):335-336.
Field Therapy in Solid Organ Transplant Recipients: Are We Initiating Early Enough?
Christina Topham, Dylan Haynes, R Samuel Hopkins, Justin Leitenberger
PMID: 32550695
Abstract
Organ transplant recipients (OTRs) are at increased risk for more aggressive non-melanoma skin cancer (NMSC). Recent emphasis on field therapy has complimented the canonical surgical treatment paradigm. This retrospective analysis of survey responses by patients seen at Oregon Health and Science University from 2013-2018 offers insights into patient trends and practice gaps in caring for OTRs. All patients completed a 57-point questionnaire at their first clinic visit, which included questions regarding demographics, transplant history, dermatologic history, and use of field therapy. Of the 295 patients (mean age, 56 years; M/F: 193/102) who completed the questionnaire, field therapy was reported by 31 (11%) patients. Field therapy patients noted an overall higher AK and SCC burden, with a greater proportion of patients reporting >20 AKs and >10 SCCs. Field therapy use was sparse in the low AK/low SCC group (n=25) when compared to those reporting high AK/high SCC (n=11) burden (n=4 (16%) vs n=8 (73%), P<0.01). This data suggests that OTRs with several clinically evident AKs and/or a low number of SCCs are less likely to have been treated with field therapy modalities compared to OTRs who have developed >10 AKs or ≥6 SCCs. A delay in initiation of preventative measures or field therapy in this population, however, may be a missed opportunity for intervention. Early intervention with field therapy in particularly high-risk OTRs with a low skin cancer burden may mitigate future skin cancer development.J Drugs Dermatol. 2020;19(3): doi:10.36849/JDD.2020.4759.

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17
J Drugs Dermatol
. 2020 Jun 1;19(6):602-610. doi: 10.36849/JDD.2020.10.36849/JDD.2020.4959.
New Polymeric Once-Daily Tazarotene 0.045% Lotion Formulation for Moderate-to-Severe Acne: Pooled Phase 3 Pediatric Analysis
Lawrence F Eichenfield, Emil A Tanghetti, Eric Guenin, Gina Martin, Radhakrishnan Pillai
PMID: 32574011 DOI: 10.36849/JDD.2020.10.36849/JDD.2020.4959
Abstract
Background: Acne vulgaris affects approximately 85% of adolescents. Topical tazarotene is efficacious and safe for acne treatment but irritation limits its use. The objective was to evaluate efficacy, safety, and tolerability of a new tazarotene 0.045% lotion formulation in patients aged 10-13 and 14-17 years with moderate-to-severe acne.

Methods: In two phase 3, double-blind, vehicle-controlled 12-week studies, patients with moderate-to-severe acne (N=1,614) were randomized (1:1) to receive tazarotene 0.045% lotion or vehicle once-daily. Efficacy assessments included changes from baseline in inflammatory/noninflammatory lesions and treatment success (≥2-grade reduction in Evaluator's Global Severity Score [EGSS] and a clear/almost clear score). Quality of life (QoL) and adverse events (AEs) were also assessed.

Results: Patients aged 10-13 years (n=136) and 14-17 years (n=548) were pooled. At week 12, mean percent reductions in inflammatory and noninflammatory lesion counts were significantly greater with tazarotene versus vehicle in both age groups (least-squares mean inflammatory 10-13 years: -55.6 vs -37.0%; 14-17 years: -53.3 vs -41.2%; noninflammatory 10-13 years: -47.7 vs -28.2%; 14-17 years: -52.7 vs -32.9%; P<0.01 all). More patients achieved treatment success with tazarotene versus vehicle in both age groups (P<0.05, both). There were no significant differences between tazarotene-treated age groups in lesion counts or treatment success. Acne-QoL scores at week 12 in both age groups were numerically improved in most domains with tazarotene 0.045% lotion versus vehicle. Most treatment-emergent AEs with tazarotene or vehicle were of mild or moderate severity in both age groups.

Conclusions: Tazarotene 0.045% lotion was efficacious and well tolerated in pediatric patients with moderate-to-severe acne. J Drugs Dermatol. 2020;19(6): doi:10.36849/JDD.2020.4959.

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18
J Drugs Dermatol
. 2020 Mar 1;19(3):320-322.
Lichen Myxedematosus: Case Report and Review of Literature
No authors listed
PMID: 32550685
Abstract
Lichen myxedematosus (LM) is an idiopathic cutaneous mucinosis, commonly described as localized scleromyxedema. In contrast to scleromyxedema, there is typically no systemic involvement. Treatment options are limited and spontaneous resolution has been reported. We present the case of a 66-year-old Hispanic male referred by his primary care physician for evaluation of asymptomatic dark spots on his trunk and extremities present for about one-year. Physical exam revealed smooth, brown hyperpigmented papules coalescing into plaques on the trunk. Multiple well-demarcated oval dark brown plaques measuring 3 cm in size were located on the upper back, peri-umbilical area, bilateral lower extremities, and buttocks. A diagnosis of lichen myxedematosus was made based on histologic features observed in the dermis. There are 5 subtypes of LM: a discrete papular form, acral persistent papular mucinosis, self-healing papular mucinosis, papular mucinosis of infancy, and a pure nodular form. Occasional patients with LM have atypical features or features intermediate between scleromyxedema and localized LM. We present a case of atypical LM with mixed features of the different subtypes. Herein we will review the varied clinical presentations of LM and highlight the distinguishing features of scleromyxedema. J Drugs Dermatol. 2020;19(3): 320-322 doi:10.36849/JDD.2020.4864.

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19
J Drugs Dermatol
. 2020 Mar 1;19(3):264-270.
The Effects of Primary Defect Characteristics on Reconstruction Type and Adjunctive Intervention in Mohs Micrographic Surgery: A Retrospective Review
Oscar Trujillo, Adetokunbo Obayemi, Gulce Askin, Kristina Navrazhina, Brienne D Cressey, Rohan Joshi, Kira Minkis, Anthony Sclafani
PMID: 32550697
Abstract
Background: Cosmetic concerns following Mohs Micrographic surgery (MMS) are significant and may require adjunctive treatments for unsatisfactory appearance.

Objective: To determine factors associated with adjunctive cosmetic intervention for facial defects following MMS.

Methods and materials: A retrospective review of 699 patients undergoing repair of facial defects after MMS from 2008-2018 was performed. Tumor types, defect sizes, patient demographics, repair methods, complications, and post-operative cosmetic interventions were examined.

Results: 666 Mohs cases and resultant defects were analyzed. The most common method of repair following MMS was primary closure (52.3%), and the most common post-operative intervention was steroid injection (18.3%). The lip subunit was more than twice as likely as other locations to be treated with steroid injections (P<.001). The lip subunit also had the highest frequency of scar revision (13%; P<0.001). Patients who had primary closure were less likely to require scar revision (P=0.003) or dermabrasion (P=0.042), and there was no significant association between skin graft repair and cosmetic intervention.

Conclusions: Both defect subunit and closure type were independently associated with adjunctive cosmetic intervention following MMS. Defect size was not significantly associated with an adjunctive intervention in our study. Understanding the factors affecting the need for adjunctive cosmetic interventions may improve patient counseling prior to Mohs repair. J Drugs Dermatol. 2020;19(3): doi:10.36849/JDD.2020.4701.

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20
J Drugs Dermatol
. 2020 Jun 1;19(6):652-656. doi: 10.36849/JDD.2020.10.36849/JDD.2020.4975.
The New Psoriasis Paradigm: Striving for Complete Clearance
Leon H Kircik
PMID: 32574025 DOI: 10.36849/JDD.2020.10.36849/JDD.2020.4975
Abstract
Newer biologics have introduced the possibility of higher and more complete clearance rates than previously possible. For many patients, PASI 90 and PASI 100 responses are realistic. Furthermore, higher levels of clearance, particularly total clearance, is associated with marked improvements in quality of life. Little data is available on the clinical benefits of higher clearance levels and how this might relate to improvements in other comorbidities. Is it time for dermatologists to strive for total clearance for our patients? We will examine the evidence that is available around this important topic. J Drugs Dermatol. 2020;19(6): doi:10.36849/JDD.2020.4975.

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21
J Drugs Dermatol
. 2020 Jun 1;19(6):619-624.
Demographics and Baseline Disease Characteristics of Early Responders to Crisaborole for Atopic Dermatitis
Linda F Stein Gold, Liza Takiya, Chuanbo Zang, Paul Sanders, Steven R Feldman
PMID: 32574023
Abstract
Introduction: Crisaborole ointment, 2%, is a nonsteroidal phosphodiesterase 4 inhibitor for the treatment of mild-to-moderate atopic dermatitis (AD). This post hoc, pooled analysis identified demographic characteristics associated with early response to crisaborole.

Methods: Early response was defined as day 8 Investigator’s Static Global Assessment (ISGA) success (clear [0] or almost clear [1] with ≥2-grade improvement), ISGA clear/almost clear, or Severity of Pruritus Scale (SPS) response (≥1-point improvement). Correlations between early response and day-29 response were calculated.

Results: Patients were more likely to be early ISGA success responders if they were aged <12 years (P=0.0023), were white (P=0.0316), had moderate baseline disease by ISGA (P=0.0003), had not received prior AD treatment (P=0.0213), had disease duration shorter than or equal to the median (≤6.45 years; P=0.0349), or did not concurrently use antihistamines (P=0.0148). Similar early response results were observed for patients achieving ISGA clear or almost clear; however, they were more likely to have mild baseline disease by ISGA (P<0.0001) or mild percentage of treatable body surface area involvement (5 to <16; P<0.0001). Patients aged <12 years (P=0.0001) or with moderate baseline disease (P=0.0475) were more likely to be early responders based on SPS criteria. By all 3 definitions, patients who achieved early response at day 8 were more likely to be responders at day 29 (P<0.0001).

Conclusion: Based on this analysis, patients aged <12 years were more likely to be early responders to crisaborole per all 3 definitions. Early response to crisaborole was a predictor of response at day 29.

Clinical trial registration: ClinicalTrials.gov, NCT02118766 and NCT02118792 J Drugs Dermatol. 2020;19(6): doi:10.36849/JDD.2020.5095THIS ARTICLE HAD BEEN MADE AVAILABLE FREE OF CHARGE. PLEASE SCROLL DOWN TO ACCESS THE FULL TEXT OF THIS ARTICLE WITHOUT LOGGING IN. NO PURCHASE NECESSARY. PLEASE CONTACT THE PUBLISHER WITH ANY QUESTIONS.

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22
J Drugs Dermatol
. 2020 Jun 1;19(6):571-572.
Safety Surveillance for Ustekinumab and Other Psoriasis Treatments From the Psoriasis Longitudinal Assessment and Registry (PSOLAR) Errata
Kim A Papp, Wayne Langholff
PMID: 32574028
Abstract
Erratum for article "Safety surveillance for ustekinumab and other psoriasis treatments from the Psoriasis Longitudinal Assessment and Registry (PSOLAR)." Retrieved from https://jddonline.com/articles/dermatology/S1545961615P0706XJ Drugs Dermatol 2015;14(7):706-714  J Drugs Dermatol 2020;19:e32-e34.

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23
J Drugs Dermatol
. 2020 Mar 1;19(3):250-253.
A Supersaturated Oxygen Emulsion for Wound Care and Skin Rejuvenation
Michael H Gold, Mark S Nestor
PMID: 32550688
Abstract
Although oxygen is essential for proper wound healing, wounds are often hypoxic with diminished oxygen delivery to the healing tissue. Since oxygenation of the outer layers of skin is almost exclusively provided by the atmosphere, increasing the presence of external oxygen enhances the healing process. Hyperbaric oxygen therapy is beneficial for treating nonhealing wounds, such as diabetic ulcers, and has been used to speed post-treatment recovery following aesthetic procedures; however, it is not suitable for home use. Recently, perfluorocarbon emulsions have been developed that can absorb large amount of oxygen. Preparations containing 2% of these compounds can absorb up to seven-times more oxygen than water at 37°C. A topical perfluorocarbon emulsion consisting of perfluorodecalin, water, plant derived emulsifiers, and a preservative, has been developed for use in dermatology (Cutagenix™ & Cutavive™ Professional Skin Care Emulsion; Cutagenesis, Niwot, CO). Designed to be applied 2 to 4 times daily following skin rejuvenation procedures, this topical oxygen emulsion reduces the incidence of post-procedure complications. The application of a topical emulsion is well-suited for patient application to enhance recovery following energy-based aesthetic procedures. J Drugs Dermatol. 2020;19(3): doi:10.36849/JDD.2020.4728.

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24
J Drugs Dermatol
. 2020 Jun 1;19(6):585-591. doi: 10.36849/JDD.2020.10.36849/JDD.2020.5187.
Treating Inflammation in Rosacea: Current Options and Unmet Needs
Jerry Tan, J Mark Jackson
PMID: 32574018 DOI: 10.36849/JDD.2020.10.36849/JDD.2020.5187
Abstract
Rosacea is a disease resulting from dysregulation of innate, adaptive, and neurovascular immune systems. Inflammatory pathways activated in rosacea can explain many of its signs and symptoms. Current treatments address some of these inflammatory processes, alleviating erythema and decreasing papules and pustules. However, for the majority of patients, complete clearance of these features is not currently achievable even with combination therapy. There is a need to address the spectrum of inflammatory processes involved in rosacea and for more efficacious agents with the goal of providing complete clearance for patients. J Drugs Dermatol. 2020;19(6): doi:10.36849/JDD.2020.5187.

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25
J Drugs Dermatol
. 2020 Jun 1;19(6):566-570.
Evaluation of Risk of Major Adverse Cardiovascular Events With Biologic Therapy in Patients With Psoriasis (Errata)
Robert Bissonnette, Wayne Langholff
PMID: 32574027
Abstract
Erratum for "Evaluation of Risk of Major Adverse Cardiovascular Events with Biologic Therapy in Patients with Psoriasis." Retrieved from http://jddonline.com/articles/dermatology/S1545961617P1002X/J Drugs Dermatol 2017;16(10):1002-1013. J Drugs Dermatol 2020;19:e28-e32.

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26
J Drugs Dermatol
. 2020 Mar 1;19(3):328-331.
Tumor Necrosis Factor Inhibitor-Induced Psoriasis in a Pediatric Crohn's Disease Patient Successfully Treated With Ustekinumab
Lauren Bonomo, Ellen H de Moll, Linden Li, Lauren Geller, Michael I Gordon, David Dunkin
PMID: 32550694
Abstract
Background: Tumor necrosis factor (TNF) inhibitors are widely used in pediatric patients with inflammatory bowel disease, as well as psoriasis. However, there is growing evidence that these medications can also paradoxically induce a psoriasiform skin reaction in a subset of patients.

Goals: We seek to share our experience in treating severe TNF inhibitor-induced psoriasis in a pediatric patient with Crohn’s disease.

Study: We report a case of a 10-year-old female with Crohn’s disease, who developed psoriasis after twelve months of infliximab therapy. Her skin disease was recalcitrant to topical therapies, methotrexate, and phototherapy.

Results: The patient was transitioned to ustekinumab with significant improvement in her symptoms and maintenance of remission of her bowel disease.

Conclusion: This is the first reported case of a school-age pediatric patient with TNF inhibitor-induced psoriasis treated with ustekinumab. Controlled trials are warranted to fully assess the safety and efficacy of ustekinumab for treating TNF inhibitor-induced psoriasis in the pediatric population.J Drugs Dermatol. 2020;19(3): doi:10.36849/JDD.2020.2106.

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27
J Drugs Dermatol
. 2020 Mar 1;19(3):28.
Game Changer in Acne Treatment
Leon H Kircik
PMID: 32550698
Abstract
Of the four primary pathogenic factors that drive acne vulgaris—androgen excess, increased sebum production, faulty keratinization, and overgrowth of C. acnes—androgen excess has been the most elusive therapeutic target. Oral contraceptive pills (OCPs) have direct effect on circulating hormones, but their potential use is limited to a subset of women. As such, a sizable portion of the population affected by acne vulgaris cannot even consider treatment with OCPs. While these systemic agents are generally associated with a low risk profile and have a history of safe and effective use, they are not entirely risk-free. Indirect androgen modulation through the use of spironolactone has become increasingly popular.

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28
J Drugs Dermatol
. 2020 Jun 1;19(6):573-574.
Safety Observations in 12095 Patients With Psoriasis Enrolled in an International Registry (PSOLAR): Experience With Infliximab and Other Systemic and Biologic Therapies Errata
Alice B Gottlieb, Wayne Langholff
PMID: 32574029
Abstract
Erratum for article "Safety observations in 12095 patients with psoriasis enrolled in an international registry (PSOLAR): Experience with infliximab and other systemic and biologic therapies." Retrieved from https://jddonline.com/articles/dermatology/S1545961614P1441XJ Drugs Dermatol 2020;19:e35-e36.

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29
J Drugs Dermatol
. 2020 Mar 1;19(3):236-242.
Long-Term Benefits of Daily Photo-Protection With a Broad-Spectrum Sunscreen in United States Hispanic Female Population
Pearl Grimes, Rebat Halder, Michele Verschoore, Janet Wangari-Talbot, Kumar Pillai, Peter Foltis, Charbel Bouez, Angelike Galdi, Deena Abdelhalim, I-Chien Liao, Qian Zheng
PMID: 32550692
Abstract
aThe Vitiligo and Pigmentation Institute of Southern California, Los Angeles, CA bDepartment of Dermatology, Howard University, Washington, DC cL’Oreal Research and Innovation, Paris, France dL’Oreal Research and Innovation, Clark, NJ.

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30
J Drugs Dermatol
. 2020 Mar 1;19(3):257-262.
Real-World Utility of a Non-Invasive Gene Expression Test to Rule Out Primary Cutaneous Melanoma: A Large US Registry Study
Brook Brouha, Laura K Ferris, Maral K Skelsey, Gary Peck, Ronald Moy, Zuxu Yao, Burkhard Jansen
PMID: 32550693
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31
J Drugs Dermatol
. 2020 Mar 1;19(3):316-318.
Real World SB4 (Etanercept Biosimilar) Use in Patients With Psoriasis: Data From the British Association of Dermatologists Biologic Interventions Register (BADBIR)
Alexander Egeberg, Giampiero Girolomoni, Steven R Feldman, Marc-Alexander Radtke, José Manuel Carrascosa, Jeehoon Ghil, Jung Won Keum, Jieun Lee, Hyoryeong Seo
PMID: 32550686
Abstract
Psoriasis is a chronic, systemic, inflammatory skin disease with a risk of comorbidities and a potential high impact on patients’ quality of life.

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32
J Drugs Dermatol
. 2020 Mar 1;19(3):324-325.
Pityriasis Lichenoides Chronica in a Patient With Ankylosing Spondylitis Treated With Etanercept
Mohamad Goldust, Jeffrey M Weinberg, Leon H Kircik, Sidharth Sonthalia, Vito Di Lernia, Dipali Rathod
PMID: 32550684
Abstract
Pityriasis lichenoides is a scarce cutaneous disorder with unknown etiology. It contains a range of clinical manifestations including acute papular lesions that quickly grow into pseudo vesicles and central necrosis to small, scaling, benign-appearing papules.1,2.

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33
J Drugs Dermatol
. 2020 Jun 1;19(6):673-675.
Biologics and Small Molecules in the Treatment of COVID-19
Dedee F Murrell, Lidia Rudnicka, Swathi Shivakumar, Martin Kassir, Mohammad Jafferany, Hassan Galadari, Torello Lotti, Roxanna Sadoughifar, Zuzanna Sitkowska, Mohamad Goldust
PMID: 32574020
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34
J Drugs Dermatol
. 2020 Jun 1;19(6):683.
Outpatient Teledermatology Implementation During the COVID-19 Pandemic: Challenges and Lessons Learned
Mehdi Farshchian, Geoffrey Potts, Arash Kimyai-Asadi, Darius Mehregan, Steven Daveluy
PMID: 32574014
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35
J Drugs Dermatol
. 2020 Jun 1;19(6):666-667.
COVID-19 Supply Chain Considerations for Prescription Drugs in Dermatology
Andjela Egger, Michael Abrouk, Merrick Brodsky, Robert S Kirsner
PMID: 32574019
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36
J Drugs Dermatol
. 2020 Jun 1;19(6):582.
Virtual Exams No Substitute for In-Person Care of Acne and Rosacea
No authors listed
PMID: 32574012
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37
J Drugs Dermatol
. 2020 Jun 1;19(6):679-680.
Considerations of Managing Lichen Planopilaris With Hydroxychloroquine During the COVID-19 Pandemic
Sahar Dadkhahfar, Farnaz Araghi, Mohammadreza Tabary, Hamideh Moravvej
PMID: 32574007
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38
J Drugs Dermatol
. 2020 Jun 1;19(6):677.
Teaching Lessons From the Coronavirus Disease 2019 (COVID-19) Pandemic in Telemedicine
Payal Shah, Daniel Gutierrez, John G Zampella
PMID: 32574008
Abstract
The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY.

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39
J Drugs Dermatol
. 2020 Jun 1;19(6):661-665.
Evaluating Population Interest in Vitiligo Through an Analysis of Google Trends and Social Media
Simone Nicole Boeckmann Montgomery, Nada Elbuluk
PMID: 32574016
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40
J Drugs Dermatol
. 2020 Jun 1;19(6):669-671.
Assessing a Paradigm Shift: Perceptions of the USMLE Step 1 Scoring Change to Pass/Fail
Chapman Wei, Misty G Eleryan, Alex Gu, Adam J Friedman
PMID: 32574017
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