Category Archives: Dermatology

Dermatology

The Weekly Roundup: November 12-17 – Dermatology Times

Abby L. Allen, RN, NP: Update on Biologics for Atopic Dermatitis

What are some of the challenges and triumphs in using biologics for atopic dermatitis? Abby L. Allen, RN, NP, shares insights at the American College of Allergy, Asthma and Immunology 2023 Annual Scientific Meeting.

A poster presented at the American College of Allergy, Asthma and Immunology (ACAAI) 2023 Annual Scientific Meeting found once daily roflumilast cream 0.15% safely and significantly improved atopic dermatitis.

Late-breaking data adds important safety and efficacy data for leukotriene receptor antagonists augmentation in chronic urticaria treatment.

Kamran H. Imam, MD, hopes to unlock insights into the atopic disease burden among Native American populations.

Marcella R. Aquino details issues in differential diagnosis for rashes that mimic allergic skin conditions at the ACAAI Annual Meeting.

Session at the American College of Allergy, Asthma and Immunology (ACAAI) 2023 Annual Scientific Meeting explored issues in understanding and testing for physical urticaria.

Keep up with the latest headlines in dermatology from the past week, including the rise of teledermatology platforms leading patients to opt out of in-person consultations, WHO and ILO estimates of non-melanoma skin cancer deaths attributable to outdoor work in the sun, and more.

In this weeks Pointers With Portela, the 208SkinDoc reviews medical health insurance on his podcast.

2023 has been complete with numerous innovations in the dermatology space, including in atopic dermatitis, psoriasis, alopecia areata, and more.

Dermatology encompasses cosmetics, unregulated products, OTC drugs, OTC devices, prescription devices, and prescription drugs, whether oral, injectable, or topical.

In addition to improvements in work productivity, tildrakizumab also demonstrated significant efficacy and safety.

Bimekizumab is the first dual IL-17 A/F inhibitor to treat moderate-to-severe plaque psoriasis. It launches with a list price of $7,200 per syringe.

In honor of National Healthy Skin Month, it is the perfect time to encourage patients to integrate gentle laser treatments into their yearly routine to maintain healthy, radiant skin.

Experts discuss insights and hot topics stemming from this year's Science of Skincare Summit, including upcoming innovations and considerations in dermatology.

Label warnings may affect the initiation of new treatment and real-world switching patterns for psoriasis patients starting treatment with risankizumab.

Dermatology Times, the SDPA, and more are celebrating the invaluable contributions of nurse practitioners in dermatology this NP Week (November 12-18).

This weeks collection of the latest dermatologic studies covers atypical molluscum contagiosum lesions with a CD30-positive T-cell lymphoid infiltrate, comorbidities in pediatric psoriasis, tralokinumab for adolescents with severe AD, and intralesional bleomycin combined with lidocaine for recalcitrant keloid scars.

Almirall, Absci Partner to Develop AI-Designed Therapies for Dermatologic Conditions

Experts Heather Woolery-Lloyd, MD; Chesahna Kindred, MD, MBA, FAAD; Gary M. Owens, MD; and Renata Block, MMS, PA-C, discuss the evolving landscape of vitiligo, particularly from an economic lens.

There are currently no FDA-approved therapies for the rare, genetic disease.

Experts discuss enhancing patient outcomes, the "mounting mutiny" against topicals, and more.

Baricitinib is more commonly prescribed by dermatologists for patients with alopecia in the US and is projected to maintain a substantial market lead over ritlecitinib.

Findings from a phase 2 trial showed improvements in relapse-free survival with an mRNA vaccine plus Keytruda compared with Keytruda alone in patients with high-risk resected melanoma.

November is Native American Heritage Month. Access to dermatological health care has been a persistent challenge for individuals in the AIAN community.

Hyperhidrosis is not rare. According to the International Hyperhidrosis Society, approximately 385 million people worldwide live with hyperhidrosis.

Germany will be the first country where lebrikizumab will be available for prescription, with a subsequent rollout across European countries throughout 2024.

Jorge Garcia-Zuazaga, MD, MBA, FAAD, FACMS, discusses Apex Dermatology's Purple Heart Project.

Kwatra presented on the unmet need for itch improvement in patients with skin of color.

To stay up-to-date with the latest dermatology news, sign up to receive oureNewsletters.

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The Weekly Roundup: November 12-17 - Dermatology Times

Dermatology

Almirall, Absci Partner to Develop AI-Designed Therapies for … – Dermatology Times

Absci Corporation, a leader in generative artificial intelligence (AI) drug creation, and Almirall, a global biopharmaceutical company specializing in medical dermatology, have announced1 a strategic partnership aimed at revolutionizing the landscape of dermatological therapeutics. The collaboration seeks to incorporate the power of AI in developing and commercializing treatments for chronic and debilitating skin diseases.

The partnership will combine Abscis Integrated Drug Creation platform with Almiralls expertise in dermatology. The collaboration represents Almiralls inaugural de novo AI drug initiative, marking a shift toward embracing AI-driven innovation in drug development and is aimed at driving innovation in dermatologic drug development.

Read more from Dermatology Times about the use of AI in dermatology here.

Absci's "zero-shot" generative AI, which allows the design and validation of de novo therapeutic antibodies, will be leveraged in the partnership to create therapeutic candidates for 2 specific dermatologic targets.

Earlier this year, Absci announced2 that zero-shot was breakthrough in generative AI drug creation capable of "binding to specific targets without using any training data of antibodies known to bind to those specific targets."

When validated against more than 100,000 antibodies, Absci found that the zero-shot generative AI's hit rate was estimated to be 5 to 30 times greater than the examined biological baselines.

"Almirall chose Absci because their de novo platform brings truly novel innovation in solving the industrys most challenging targets facing high unmet medical need," said Karl Ziegelbauer, PhD, in a press release. Ziegelbauer is Amirall's Executive VP of Research and Development.

"Our partnership underlines Almiralls commitment to target innovative approaches to help patients suffering from severe skin diseases to achieve their dream of leading a healthy life," Ziegelbauer said.

Absci's Founder and CEO, Sean McClain, echoed the sentiment, saying, Our partnership with Almirall marks an important leap forward for dermatologic drug development and is poised to transform the lives of millions managing skin conditions.

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Dermatology

The Skin of Color Society Kicks Off a Season of Giving with its My … – PR Newswire

The first of its kind campaign is built around public education, volunteerism and giving in support of much-needed mentorship and research in skin of color dermatology

CHICAGO, Nov. 14, 2023 /PRNewswire/ -- TheSkin of Color Society (SOCS), the world's leading professional skin of color dermatology organization, has established a national health awareness day known asMy Best Winter Skin Day,kicking off an annual seasonal campaign built around public education, volunteerism and giving. While raising awareness about a common skin condition that affects people of all ages, skin types and tones in the colder months of the year, funds raised through this public educational campaign will go to the SOCS Foundation to help support innovative research and mentorship in skin of color dermatology.

My Best Winter Skin Day launched nationally on October 24, featuring two successful community outreach events in Chicago and Washington, D.C., involving teams of SOCS members, medical students and dermatology residents from Northwestern University and Howard University respectively. As part of their public outreach activities, participating SOCS volunteers shared educational tips for managing winter skin that were developed by the SOCS Patient Education Committee, and distributed free moisturizers generously donated by campaign sponsors, La Roche-Posay and CeraVe. Campaign support was also provided by Restore Hair.

Building on the tremendous momentum of these two MBWS launch events, SOCS members in 18 states in the USA have committed to conduct outreach events in their communities and on college campuses in the coming winter months. In a variety of settings, SOCS volunteers will distribute MBWS educational material and donated moisturizers in SOCS-branded travel bags to raise awareness about optimal winter skin care and generate donations to the SOCS Foundation.

Winter skin is a seasonal condition that can be bothersome, uncomfortable or even unsightly for many people. The cold, dry air draws moisture from the skin, leading to dryness, cracking, itching, and even bleeding. SOCS' dermatologic experts recommend the following steps to keep skin healthy during harsh, winter weather:

To learn more about how to engage with SOCS and support mentorship and research, as well as the My Best Winter Skin Campaign, visit here.

About the Skin of Color SocietyThe Skin of Color Society (SOCS) is a globally recognized leader in advancing skin of color dermatology, with dermatologist members from 30 countries around the world. Founded in 2004 by Dr. Susan C. Taylor, the SOCS mission is to achieve health equity and excellence in patient care through research, education, mentorship, and advocacy. Since inception, SOCS has worked tirelessly to strengthen the pipeline of dermatology students, and residents as well as comprehensively train dermatology fellows in delivering culturally competent care to diverse populations. SOCS membership includes highly skilled mentors across dermatology subspecialties (medical, cosmetic and surgical), and practice settings (private practice, public service and academia). SOCS has successfully mentored hundreds of medical students, dermatology residents and fellows and has awarded various research, fellowship, observership, career development and innovation grants to early and mid-career dermatologists. http://www.skinofcolorsociety.org

SOURCE Skin of Color Society

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Dermatology

Clascoterone Cream in Patients With Acne: New Long-Term Data – Medpage Today

Clascoterone (Winlevi) cream was safe and effective for up to 12 months in patients with acne ages 12 and older, and may in fact become more efficacious over time.

That's according to results of an extension study that appears in the Journal of Drugs in Dermatology.

Enrolled patients applied clascoterone cream 1% twice daily to the entire face and, if desired by the patient and/or investigator, truncal acne, for up to 9 months.

Patients achieving Investigator's Global Assessment score of 0 or 1 (IGA 0/1) could stop and resume treatment if needed. Of 600 patients ages 12 and older (original randomization: 311 clascoterone, 289 vehicle) included in the original study, 343 completed the extension study (177 clascoterone, 166 vehicle).

Participants reported 187 adverse events in 108/598 clascoterone-treated patients (18.1%); these affected 56/311 (18.0%) and 52/287 (18.1%) patients originally randomized to clascoterone and control groups, respectively. The percentage of patients with facial and truncal IGA 0/1 increased to 48.9% (156/319) and to 52.4% (65/124), respectively, among those who completed the study per protocol.

The study was conducted by a team of U.S.-based researchers, including first author Lawrence Eichenfield, MD, chief of pediatric and adolescent dermatology at Rady Children's Hospital-San Diego and professor of dermatology and pediatrics and vice-chair of the department of dermatology at University of California San Diego School of Medicine. The following study excerpts have been lightly edited for length and clarity.

What was the key objective of this trial?

Clascoterone cream 1%, a novel topical androgen receptor inhibitor, was approved in the U.S. in 2020 for the treatment of acne vulgaris in males and females ages 12 years and older.

The cream's efficacy and safety were assessed in two identical Phase 3 clinical trials and in a long-term extension study in patients ages 9 and older with moderate-to-severe acne vulgaris. In the Phase 3 pivotal studies, treatment with clascoterone cream 1% resulted in significant clinical improvement compared with vehicle cream after 12 weeks of twice-daily application, with a favorable safety profile.

Clascoterone safety was well maintained for up to an additional 9 months of treatment in patients ages 9 and older with moderate-to-severe acne vulgaris. Here, the study team presented long-term safety and efficacy data in the subgroup of clinical trial patients ages 12 and older who entered the long-term extension study.

What were the key findings?

This 9-month extension study confirmed the favorable safety profile of clascoterone cream 1% in the long-term treatment of patients ages 12 and older with moderate-to-severe facial and/or truncal acne vulgaris. The frequencies of treatment-emergent adverse events (TEAE) and local skin reactions were low throughout the study. Most of the TEAEs were mild, and no accumulation of adverse events was observed over time.

The proportions of patients with facial and truncal IGA 0/1 increased over time and were highest at the end of the study, indicating that clascoterone efficacy continued to increase with long-term treatment. These results suggest that clascoterone may be a suitable option for long-term topical treatment of both facial and truncal acne vulgaris in patients in this age group.

What was the safety profile after the extension period?

Overall, 108/598 (18.1%) patients in the safety population experienced a total of 187 TEAEs; frequency was similar between patients previously treated with clascoterone (56/311 [18.0%]) versus vehicle (52/287 [18.1%]). Most TEAEs were mild or moderate and not considered related to clascoterone treatment.

A total of 6/598 (1.0%) patients reported serious adverse events, none of which were considered related to clascoterone treatment; 9/598 (1.5%) patients had TEAEs leading to study discontinuation. The most frequent TEAEs by percentage of patients affected included nasopharyngitis (17 [2.8%]), upper respiratory tract infection (11 [1.8%]), sinusitis (5 [0.8%]), viral respiratory tract infection (5 [0.8%]), and application site acne (4 [0.7%]) among all patients.

What are the key takeaways for dermatologists?

This and previous studies support clascoterone as an option for long-term treatment of acne vulgaris.

The proportion of patients whose skin was clear or almost clear increased at each visit and was highest at the end of the study, indicating that clascoterone efficacy improved over time for up to 12 months in patients with moderate-to-severe acne vulgaris.

Eichenfield is an employee of the University of California San Diego, which received compensation from Cassiopea S.p.A., for study participation; he also reports relationships with Almirall, Dermata, Galderma Laboratories, and Ortho Dermatologics.

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Dermatology

Discovery of hemoglobin in the epidermis sheds new light on our … – EurekAlert

image:

Hemoglobin (magenta) in mouse hair follicles during the growth phase of hair cycles.

Credit: Umi Tahara, Takeshi Matsui, Keitaro Fukuda, and Masayuki Amagai

Philadelphia, November 17, 2023 Researchers have shown for the first time that hemoglobin, a protein found in red blood cells where it binds oxygen, is also present in the epidermis, our skin's outermost body tissue. The study, which appears in the Journal of Investigative Dermatology, published by Elsevier, provides important insights into the properties of our skin's protective external layer.

This research was driven by a curiosity about how the epidermis protects our delicate body from the environment and what unexpected molecules are expressed in the epidermis. Researchers discovered the hemoglobin protein in keratinocytes of the epidermis and in hair follicles. This unexpected evidence adds a new facet to the understanding of the workings of our skin's defense mechanisms.

Lead investigator of the study Masayuki Amagai, MD, PhD, Department of Dermatology, Keio University School of Medicine, Tokyo, and Laboratory for Skin Homeostasis, RIKEN Center for Integrative Medical Sciences, Yokohama, explains: "The epidermis consists of keratinized stratified squamous epithelium, which is primarily composed of keratinocytes. Previous studies have identified the expression of various genes with protective functions in keratinocytes during their differentiation and formation of the outer skin barrier. However, other barrier-related genes escaped prior detection because of difficulties obtaining adequate amounts of isolated terminally differentiated keratinocytes for transcriptome analysis."

Hemoglobin binds gases such as oxygen, carbon dioxide, and nitric oxide, and it is an iron carrier via the heme complex. These properties make epidermal hemoglobin a prime candidate for antioxidant activity and potentially other roles in barrier function.

Professor Amagai continues: "We conducted a comparative transcriptome analysis of the whole and upper epidermis, both of which were enzymatically separated as cell sheets from human and mouse skin. We discovered that the genes responsible for producing hemoglobin were highly active in the upper part of the epidermis. To confirm our findings, we used immunostaining to visualize the presence of hemoglobin protein in keratinocytes of the upper epidermis."

Professor Amagai concludes: "Our study showed that epidermal hemoglobin was upregulated by oxidative stress and inhibited the production of reactive oxygen species in human keratinocyte cell cultures. Our findings suggest that hemoglobin protects keratinocytes from oxidative stress derived from external or internal sources such as UV irradiation and impaired mitochondrial function, respectively. Therefore, the expression of hemoglobin by keratinocytes represents an endogenous defense mechanism against skin aging and skin cancer."

Journal of Investigative Dermatology

Experimental study

Cells

Keratinocytes of the Upper Epidermis and Isthmus of Hair Follicles Express Hemoglobin mRNA and Protein

17-Nov-2023

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

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Dermatology

Effective Therapies for Atopic Dermatitis: Expert Recommendations … – HealthDay

THURSDAY, Nov. 16, 2023 (HealthDay News) -- In updated guidelines issued by the American Academy of Dermatology and published online Nov. 7 in the Journal of the American Academy of Dermatology, recommendations are presented for use of phototherapy and systemic therapies for atopic dermatitis (AD) and include strong endorsements of monoclonal antibodies and Janus kinase inhibitors.

Dawn M. R. Davis, M.D., from the Mayo Clinic in Rochester, Minnesota, and colleagues conducted a systematic review and applied the Grading of Recommendations, Assessment, Development, and Evaluation approach for assessing the certainty of evidence and formulating and grading recommendations to provide evidence-based recommendations for use of phototherapy and systemic therapies for adults with AD.

The workgroup developed 11 recommendations on management of AD in adults. These include strong recommendations for dupilumab, tralokinumab, upadacitinib, abrocitinib, and baricitinib for adults with moderate-to-severe AD. Phototherapy is conditionally recommended for adults with AD. Methotrexate is also conditionally recommended, with proper monitoring, as is mycophenolate mofetil, azathioprine, and limited-term use of cyclosporine, all with proper monitoring. There is a conditional recommendation against use of systemic corticosteroids.

"When AD is more severe or refractory to topical treatment, advanced treatment with phototherapy or systemic medications can be considered," the authors write. "In this clinical practice guideline, we make strong recommendations for the use of dupilumab, tralokinumab, abrocitinib, baricitinib, and upadacitinib."

Several authors disclosed ties to the pharmaceutical industry.

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Dermatology

Nonablative Lasers Offer a Gentle Approach to Healthy Skin – Dermatology Times

In honor of National Healthy Skin Month, it is the perfect time to encourage patients to integrate gentle laser treatments into their yearly routine to maintain healthy, radiant skin.

In recent years, laser technology has undergone significant advancements, expanding the range of available lasers for various applications. Lasers are specifically designed to target different tissue typeswith water, hemoglobin, and pigment being the most common chromophores.1

Lasers come in2 categories: ablative and nonablative. Ablative lasers vaporize tissue at the level of the epidermis in a fractionated or fully ablative manner, which is a very effective technique for skin rejuvenation; however, increased downtime, infection risk, and persistent erythema are all potential adverse effects.

Nonablative lasers deliver less thermal injury and promote dermal wound healing while protecting the stratum corneum through precise penetrating waves and cooling mechanisms.2This process, known as photothermolysis, generates heat at the dermal level, stimulating collagen and elastin production and, in some cases, scar remodeling.1,3Nonablative fractional lasers (NAFLs) achieve this by using thousands of tiny, deep columns to deliver preciseheat levels.4

Nonablative lasers can also have specific targets, such as hemoglobin and pigment. Many of these devices are used to treat redness, photoaging, and unwanted tattoos with minimal downtime due to preservation of the skin barrier.2,5See theTable1,2for a comparison of both typesof lasers.

Skin cancer is the most prevalent cancer in the United States and that more than3 million Americans are diagnosed with nonmelanoma skin cancers each year.6Repeated exposure increases the risk of developing nonmelanoma skin cancers, such as basal cell carcinoma and squamous cell carcinoma. These2 types of cancer are collectively known as keratinocytecarcinoma (KC).

In individuals with a history of prior KC, the risk of developing subsequent KC remains a significant concern. This risk is particularly pronounced in the5 years following the initial diagnosis. For instance, within3 years post diagnosis, there is a 35% probability of developing another KC, and this risk escalates to as much as 50% within a 5-year period. Factors that contribute to an increased risk of KC include being male, being older than 60 years, having a history of multiple previous skin cancers, and having substantial actinic skin damage or skin that is prone to sunburn.7

According to the American Society for Dermatologic Surgery, even precancerous skin lesions such as actinic keratosis and actinic cheilitis have the ability to transform into squamous cell carcinoma.8There is, however, good news for those who already have sun-damaged skin and are looking to improve the overall health of their skin. A recent retrospective study conducted at the Massachusetts General Hospital Dermatology Laser and Cosmetic Center in Boston found that in patients treated with NAFLs for facial KCs, only 20.9% subsequently developed a KC, whereas the control group had a 40.4% rate of subsequent KC development. After accounting for age, gender, and skin type, individuals in the control group had a higher likelihood of developing new facial KC compared with patients who underwent laser treatment.9

In 2014, a study in theJournal of Cosmetic and Laser Therapyexamined a group of 10 female participants. These individuals, ranging in age from 35 to 53 years and with skin types I to IV, exhibited mild to moderate facial photodamage. This photodamage was characterized by various features, including hyperpigmentation, telangiectasia, skin laxity, skin roughness, and actinic keratosis. These individuals underwent a series of treatments using a nonablative fractional Q-switched 1064-nm Nd:YAG laser. The therapeutic regimen included4 sessions spaced at 2- to 4-week intervals, with follow-up assessments at1 and3 months after the final treatment session.

Baseline assessments using the Glogau scale revealed that6 participants were classified as type II (indicating wrinkles in motion), and4 participants were designated as type III (indicating wrinkles at rest). Impressively, at the 3-month follow-up after the final session, 60% of participants exhibited a notable 1-point or greater enhancement in their overall Glogau scale score. Moreover, it was observed during the study that the laser treatments resulted in substantial improvements in various skin irregularities: Hyperpigmentation decreased by 70%, telangiectasias by 80%, laxity by 80%, tactile roughness by 60%, and actinic keratoses by 60%. The investigators concluded that the nonablative fractional Q-switched 1064-nm Nd:YAG laser demonstrated both safety and efficacy in ameliorating mild to moderate photodamage with minimal downtime and discomfort and without any discernibleadverse effects.10

In a 2021 study published in the same journal, researchers investigated the safety and effectiveness of a 1565-nm NAFL for addressing facial photoaging. Patients underwent3 NAFL treatment sessions (1 month apart) on1 side of their face, and then the treated side was compared with the untreated side between sessions. The results showed significant improvements in facial skin laxity, wrinkles, and pores as well as reduced sagging of the nasolabial groove on the NAFL-treated side compared with the untreated side (baseline). Additionally, the study compared NAFL with microneedle fractional radiofrequency (MFR) and found similar outcomes for MFR-treated skin but that NAFL offered a more convenient treatment option due to itsshorter downtime.11

Nonablative lasers have emerged as a gentle yet highly effective approach to achieving healthier skin. They utilize precise photothermolysis to stimulate collagen and elastin production and promote dermal wound healing with minimal downtime. These lasers can reduce the development of KC and improve the overall health of sun-damaged skin. NAFLs have also demonstrated remarkable success in ameliorating photodamage and improving hyperpigmentation, telangiectasias, skin laxity, and tactile roughness.

In conclusion, nonablative lasers represent a promising solution for individuals seeking healthier and more youthful-looking skin with fewer associated risksand downtime.

Nina Venturaisa doctor of osteopathic medicine candidate and a master of health services administration candidate at Lake Erie College of Osteopathic Medicine in Elmira, New York.

Mara C. WeinsteinVelez, MD, FAAD, is a board-certified dermatologist and the director of cosmetic and laser dermatology at University of Rochester Medical School in New York.

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Dermatology

Aging, Acne, and the Armamentarium: Hot Topics From the Science … – Dermatology Times

Im not a cosmetic dermatologist, but patients ask me all the time what they should be using. They come in with little pieces of paper, things that theyve ripped out of magazines. Is this good? Is that good? and I dont always know what to say. This conference allows me to learn more about these individual active ingredients, said Hilary E. Baldwin, MD, about the Science of Skincare Summit 2023 held in Austin, Texas. The scientific rigor of the meeting in discussing over the counter treatment options was especially helpful, noted Baldwin, who added, I think its very important for us all to be on the same page and be making soundscientific recommendations.

In addition to Baldwins insights,Dermatology TimesExpert Perspectivescustom video seriesalso features insights from Cheri N. Frey, MD; Adelaide A. Hebert, MD, FAAD; Kavita Mariwalla, MD, FAAD; Darrell S. Rigel, MD, MS; and Saranya P. Wyles,MD, PhD.

I think the future of skin care and care in general for our acne patients is very bright, Baldwin said. On the pharmaceutical side, we have new combination therapies. We have our first new triple combination therapy. We have even better formulations coming down the pipe, where we recognize that many of our acne medications can be quite irritating and that irritating medications dont get used.

Baldwin is optimistic about the future of acne care: probiotics, prebiotics, and postbiotics and their potential to manage acne using more natural means. Some companies, she said, are attempting to manufacture a subtype ofCutibacteriumacnes(formerly known asPropionibacterium acnes).

It would be a very natural approach, which would not be using antibiotics, Baldwin said. We wouldnt have to worry about antibiotic resistance, and I think its a possibility that we might be going there or in the future, or even [using] bacteriophages to kill theC acnes,as opposed to using an antibiotic todo that.

Hebert echoed interest in recent acne research and innovations.

We know in our skin of color patients, they tend to have postinflammatory hyperpigmentation as their acne lesions resolve, and weve learned that they have more inflammation within their acne lesions, and that results in the increased pigmentation, which persists considerably longer than their acne lesions, Hebert said.

Herbert also commented onC acnes. She is excited to learn more about its role in the driving inflammatory componentsof acne.

Acne appears to be developing in patients at a younger age, added Hebert, who is also a pediatric dermatologist. This may be due to estrogens in the food chain, among other causations, she said.

Fortunately, some of the new medications have been studied down to age 9, Hebert said. We are having an expanded understanding of acne in the younger age group, but were also developing therapies in that part of the age spectrum that can be beneficial to our patients.

Wyles was intrigued to see new hallmarks of aging emerge. DNA damage, oxidative stress, reactive oxygen species, and mitochondrial dysfunction contribute to skin aging.

If we look at an active retinaldehyde, they can affect that skin turnover and break apart those factors that are contributing to senescence and modify those, Wyles said. Were still early in trying to understand how those are affecting it, but its a new way of looking at skin care from anovel mechanism.

Both Wyles and Frey mentioned retinoids as cornerstones of the antiaging therapeutic armamentarium.

Weve been looking at new molecules, Frey said. How do we deliver efficacy in the way that retinoic acid or tretinoin can?... I think the science behind the new molecules that are coming out is really,really impressive.

Frey thinks everyone could benefit from retinoids, especially folks who live in sunny climates or have a history of skin cancers. We do have some evidence that retinoids help to prevent skin cancers and specifically those cellular changes that lead to pre-cancers and skin cancers, Frey said. It is probably a crime if a dermatologist doesnt recommend a retinoid for those patients because the benefits go beyond just anti-aging. They go beyond the surface. Were really talking about making an impact and preventing skin cancer in those patients.

Mariwalla described pre-aging as a new hot topic in dermatology. You cant prevent [aging] from occurring, but what you can do is modulate it, Mariwalla said. You can modulate your experience of it. You can modulate how your skin responds to it, and what were learning now is that aging isnt just somethingthats chronologic.

Rigel discussed the direct relationship between ultraviolet exposure and aging, noting that a lack of sun protection contributes significantly to the risk of skin cancer and accelerates the skin aging process. Fortunately, he noted that advances have been made in the field, especially for skin of color.

Previously patients complained about the sheen and how sun protection, Rigel said. The good news is that there are new products out there that really get rid of that problem... you can use it in a way to really make your skin protected and still look great, he explained. Thats basically what I say to them , and the fact is that they do adopt them. Most of my darker skinned patients really enjoyed having the tinted sunscreens to have the protection and stilllook great.

All6 experts were excited by the science and the advancement in the field, and appreciated the opportunity to come together to share and discuss research and practical implications. As Mariwalla said, One of the things thats great about the Science of Skin Care Summit is that you get to see whats on thehorizon.

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Aging, Acne, and the Armamentarium: Hot Topics From the Science ... - Dermatology Times

Dermatology

Prior Treatment Options and Outcomes for SD – MD Magazine

Transcript

Linda Stein Gold, MD: Now, Neal, Im going to come back to you for a minute because this is something that we havent talked about that much. When we look at our treatment armamentarium, where have we been?

Neal Bhatia, MD: Well, you mentioned how we all do trials. We all have to bring something to the market for some indication. Psoriasis and atopic dermatitis have been the popular flavors over the years, but to bring something truly to the market for seborrheic dermatitis has not been a goal not only of any project or product, but even [by] a lack of interest by the dermatology world. That being said, we can apply the mechanisms of action of the therapies we know work for those anti-inflammatory approaches and apply them to seborrheic dermatitis in a very similar way. But the more we have good trial data, the more we have good before and after pictures, the more patient-related outcomes, like weve seen with a couple of the trials that were going to talk about, the more we can impact that. Yes, weve been using ketoconazole shampoo, antifungals over the counter, hydrocortisone lotion, but again, its like throwing things at the mirror to see if they stick. But at the same time, we havent had really some dedicated treatments until a few years ago. We had a 510(k) device that had a really interesting approach. It had shea butter,vitis vinifera, gluconic acid, and lanolin; all of that, which was in a nice green base that really did work well. But unfortunately, that product isnt as commonly found as it was. The other part of it, again, and you touched on this, Linda, is about the patient perception. If they feel like theyre looking in the mirror and seeing dryness, they think theyre dirty, or someone looks at them as not really taking care of their hygiene, which is not fair. So we have to really get back to good counseling on fundamentals of cleansing and moisturizing, maybe going back to sulfacetamide cleansers like we used to, thinking about how long do we leave cleanser on, and how long do we leave shampoo on? These are things that patients really need some handholding to say, "Look, you need to let these shampoos sit for 5 minutes and then rinse." Youre not just treating your hair, but youre treating your whole head. Same with cleansing. They have to think about what they are using in the shower versus what are they using in the evening. So, all these little nuances, aside from the prescription products we use, the fundamentals of skin care have to be just as important.

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Prior Treatment Options and Outcomes for SD - MD Magazine