Category Archives: Dermatology

Dermatology

Skin to Skin: Getting to know UMs new dermatology club – The Miami Hurricane

Despite the allure of year-long summers and poolside views, Canes often overlook the harmful effects of the damaging rays they soak up. Even more concerning, late-night junk food and unremoved makeup after a long night out contribute to the skin damage that comes with a typical college lifestyle.

Yet Skin to Skin, one of the newest clubs at the University of Miami, focuses on creating a space for students to gain a deeper understanding of their skins needs.

Through speaker events and workshops, the organization focuses on educating its members on the importance of daily rituals and updated skin care practices, as well as educating the future generation of dermatologists on how to develop a successful career path.

Julia Sarama, the president of Skin to Skin, started the club as early as January of this year as a result of her own skin concerns as a college student.

My journey with my skin has been one of the largest influences on the person Ive become, said Sarama. Growing up I was really insecure, and now its what has given me purpose to create Skin to Skin.

Sarama also emphasized the importance of bringing attention to skin care, especially living in Florida, where sun exposure is constant.

Experiencing a year-round summer at the University of Miami is easily one of the most loved aspects of being a student here, Sarama said. And while every person experiences UV rays regardless of the season or their location on the map, living in Florida does put you at an increased risk for developing skin cancer. Floridas low latitude contributes to us getting more UV radiation than the rest of the US, and therefore, without proper protection, it is easy to put yourself in harms way.

Many students are known for focusing on aesthetics and beauty standards, whether online or in their daily habits, and tanning is a particularly important part of this culture.

However, according to the City of Hope Cancer Center, about one in five Americans will develop skin cancer in their lifetime. The increased melanin produced by the skin when tanning is often the bodys protective response to UVA radiation, and too much exposure to these UV rays put many at a greater risk of the deadly disease.

From my understanding, there are two major reasons why skin cancer is an issue: lack of education and societal beauty standards, Sarama said. And some refuse to take it seriously because they feel more confident with a tan. I have felt the latter before and once I became more educated on the matter, I understood that serious health concerns outweighed any sort of aesthetic pressures I felt.

In order to bring awareness to topics such as skin cancer prevention and overall skin health, local dermatologists are often invited by the new student organization to speak on these issues.

For instance, during a club meeting on Nov. 6, board-certified dermatologist Dr. Barry Resnik spoke with Skin to Skin members and debunked common skin care myths, specifically in regards to sunscreen, skin cancer and aging. Having completed his residency at UM and serving as the medical director for the Resnik Skin Institute in Aventura, Resnik also gave some general advice to prospective dermatology students as to how to proceed in their career.

My dad was a dermatologist and I would go around and do his rounds with him. I learned how to take warts off of him in high school and I read lots of articles about dermatology. Dermatology is a wonderful profession, I get to deal with very sick people and I get to help people and make a difference. But, if youre gonna be a physician you are gonna have to work for a really long time and have to work even more to get into residency, the idea of work-life balance isnt realistic if you want to be a doctor, said Resnik.

Skin to Skin also hopes to get the UM community at large more involved in the practice of protecting their skin. According to Sarama, one of the ways the new club hopes to promote better skin care practices among students is with their latest fundraiser to implement sunscreen dispensers on campus.

On campus would be the place to start in order for more students to gain awareness of the daily exposure we face, said Sarama. It may not seem like you are affected now, but skin damage sneaks up on us and shows with time.

With successful fundraising, this new program will target a major point for most dermatologists: reapplying sunscreen. Not only would the implementation of these dispensers put skin care at the forefront of most students minds, according to Sarama, but it would also begin to help students start thinking about how to better take care of their skin in additional ways.

Skin to Skin is especially dedicated to disproving other common myths and harmful stereotypes that sometimes come with certain skin concerns and practices. For instance, according to a study published in the National Library of Medicine, the lack of skin cancer education has disproportionately impacted many people of color, with the estimated five-year melanoma survival rate being 70% for Black patients and 94% for white patients.

There is a misconception that exists that people of color are immune to skin cancer, said Sarama. Because of a lack of skin cancer education, more minorities die of skin cancer than white people as a result of the delays in detection. Stigma and lack of education kills people and its our responsibility to make sure people are aware of this.

As seen with Skin to Skins mission, students like Sarama hope to go far beyond the superficial allure of skincare trends and aesthetically-pleasing products. Its a dedicated pursuit of a greater causeone that confronts harmful stigmas, educates others on cancer-preventing practices and prioritizes holistic skin health for the student community.

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Skin to Skin: Getting to know UMs new dermatology club - The Miami Hurricane

Dermatology

Schweiger Dermatology Group Acquires New Jersey Practices of NavaDerm Partners in Millburn and Englewood Cliffs – PR Newswire

MILLBURN, N.J.and ENGLEWOOD CLIFFS, N.J., Dec. 18, 2023 /PRNewswire/ -- Schweiger Dermatology Group ("SDG") has announced it has acquired the two New Jersey practices previously owned by NavaDerm Partners: Scherl Dermatology in Englewood Cliffs, founded by Dr. Sharon Scherl, and Millburn Laser Center in Millburn, New Jersey, founded by Dr. Eric Siegel. Both Drs. Siegel and Scherl will continue seeing patients at their respective offices.

"We are excited about the opportunity to expand our New Jersey footprint with the addition of Drs. Siegel and Scherl and their teams. Both physicians have built outstanding practices, and we look forward to continuing their commitment to excellent patient care under Schweiger Dermatology Group," says Dr. Eric Schweiger, founder, and CEO of Schweiger Dermatology Group.

SDG welcomes the following providers: Allyson Brockman-Bitterman, MD, Jennifer Chwalek, MD, Amy Freeman, MD, Ezra Hazan, MD, Ana Cristina Laureano, MD, Gail Mautner, MD, Lisa Rothman, MD, Eric Siegel, MD, and Sharon Scherl, MD.

The new SDG offices are located at:

140 Sylvan Ave Suite 302 Englewood Cliffs, NJ (201) 568-8400

12 East Willow St. Millburn, NJ (973) 376-8500

About Schweiger Dermatology Group

Schweiger Dermatology Group is the largest group dermatology practice on the East Coast with over 100 offices and over 300 healthcare providers. Schweiger Dermatology Group provides medical, cosmetic and surgical dermatology services with over 1,500,000 patient visits annually. Schweiger Dermatology Group has been named to Crain's New York Fast 50, honoring the fastest growing companies in New York and the Inc. 5000 Fastest Growing Private Companies in America, each for five consecutive years. Schweiger Dermatology Group has also received Great Place to Work certification. To learn more, visit schweigerderm.com.

Media Contact:Melissa Schweiger Kleinman [emailprotected]

SOURCE Schweiger Dermatology Group

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Schweiger Dermatology Group Acquires New Jersey Practices of NavaDerm Partners in Millburn and Englewood Cliffs - PR Newswire

Dermatology

More Images of Patients With Psoriasis Are Needed in Published Studies – Dermatology Times

Well-demarcated plaques with silvery scale in chronic plaque psoriasis

Image courtesy of DermNet

Very few images of patients with psoriasis are depicted in published studies, according to one review. Including more images in scientific research would help to strengthen a patients perspective and understanding of what treatment effects can be expected.

This systemic review is published in the Journal of Dermatological Treatment.1 In this review, the researchers aimed to measure the proportion of shared clinical images in psoriasis trials.

"Patients often find it challenging to grasp the core messages of scientific manuscripts, said Sam Polesie, associate professor at Sahlgrenska Academy, the University of Gothenburg's faculty of medicine, and lead author of the study, in a statement.2 The clinical results are most often described in something called PASI [psoriasis area severity index] values, which is a composite score for redness, scaling, induration, and distribution on predefined body areas.

Psoriasis is defined as a chronic immune-mediated inflammatory systemic disease, characterized by red and scaly plaques on the skin. Furthermore, the severity of psoriasis can range from mild to severe, in which advanced systemic therapies and biologics may be warranted.

In this study, randomized controlled trials involving biological agents for the treatment of psoriasis were searched from inception to October 26, 2021, using Embase, MEDLINE, and Scopus databases.

The search yielded a total of 1918 studies of which 192 were reviewed in full text, with 67 studies excluded for reasons such as wrong outcome, wrong publication type, wrong study drug, etc. In total, 152 studies with 62,871 patients were included in the review. Of these studies, 77% did not include photos of any patients at all. Additionally, the scientific manuscripts and all supplementary material featured a total of only 203 images of 60 patients, yielding an overall share rate [IQR] of 0.1% [0.3- 4.4].

Most of these patients (n = 51,857) were randomized in trials in the primary outcome. Among these patients, only 23 individuals were depicted in images. Furthermore, 5 medical journals with the highest number of randomized patients (n = 50,809) accounted for 80.8% of all individuals included in the review. These journals included the British Journal of Dermatology, Journal of the American Academy of Dermatology, Journal of the European Academy of Dermatology and Venereology, and the New England Journal of Medicine.

However, the researchers acknowledged the study had some limitations, such as being restricted to studies involving biological agents for the treatment of psoriasis, only including apremilast, ciclosporin, deucravacitinib, dimethylfumarate, and methotrexate as comparative study drugs, and being restricted to studies in the English language.

Despite these limitations, the researchers believe the study supports greater use of patient images in clinical literature and manuscripts to boost patient understanding, compared with psoriasis area severity index and/or physical global assessment scores, which can be difficult to interpret.

The researchers also acknowledged that health care professionals are usually the target audience for these scientific publications. However, a patients rights to shared decision-making has become increasingly important and requires a paradigm shift to bridge the gap between clinical research and a patients understanding of their disease and treatment.

"We hope that this systematic review can serve as an invitation to the pharmaceutical industry and other sponsors, as well as journal editors and authors, to include more images in scientific publications, said Polesie in a following statement.2 Including more clinical images with our original manuscripts could better support patient involvement."

References

1. Polesie S, Alinaghi F, Egeberg A. A systematic review investigating at what proportion clinical images are shared in prospective randomized controlled trials involving patients with psoriasis and biological agents. Journal of Dermatological Treatment. 2023;34(1). doi:10.1080/09546634.2023.2281261

2. University of Gothenberg. Hardly any photos of patients with psoriasis in published studies. EurekAlert. November 20, 2023. Accessed December 18, 2023. https://www.eurekalert.org/news-releases/1008573.

[This article was originally published by our sister brand, the American Journal of Managed Care.]

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More Images of Patients With Psoriasis Are Needed in Published Studies - Dermatology Times

Dermatology

Case Based Roundtables Part 2: Valorizing Topical Treatment Options for Patients With Vitiligo – Dermatology Times

Read Part 1 here.

Leading experts in vitiligo recently hosted a series of Dermatology Times Case-Based Roundtables in cities around the country to discuss approaches to complex cases, understand challenges across different age groups and skin types, and explore the conditions impact on patient well-being.

Roundtable hosts included Benjamin Lockshin, MD, FAAD, in Washington, DC; Heather Woolery-Lloyd, MD, in Miami, Florida; Elizabeth Kiracofe, MD, FAAD, in Chicago, Illinois; James Song, MD, in Seattle, Washington; and Karan Lal, DO, FAAD, in Scottsdale, Arizona. Here are a few additional cases that the roundtable participants delved into.

A 35-year-old Whiteman with Fitzpatrick skin type II and vitiligo on multiple areas of his body, particularly the dorsal hands and forearms, was presented to Chicago roundtable participants. The focus was on unstable vitiligo, characterized by changing depigmented patches. The challenges that were discussed included managing the inflammation that causes vitiligo to worsen. The group reached a consensus on usingoral dexamethasone as the primary treatment for actively depigmenting or unstable vitiligo.

The patient, an outdoor enthusiast and guitarist, faced challenges with topical treatments due to lifestyle constraints. The discussion emphasized the significant benefits of light therapy for vitiligo, recommending sunlight exposure when possible or using specific narrowband wavelengths and UVB light boxes. The contradictory nature of advising careful sun protection while using ultraviolet radiation for treatment was highlighted.

The stability of vitiligo was discussed in terms of satellite lesions, sharp borders, and pigment network absence as markers of stability. The patient had previously used topical corticosteroids and calcineurin inhibitors but, due to his lifestyle, switched to topical ruxolitinib, which showed improvement in adherence and repigmentation.

The conversation touched on the challenges of obtaining insurance coverage for topical ruxolitinib despite its US Food and Drug Administration (FDA) approval. The group shared experiences from different regions.

I know just from a policy perspective [that] there [are] still some states that consider vitiligo a cosmetic condition. But we all experienced that patients really like the vehicle of topical ruxolitinib and are seeing results with it. The biggest hesitation with using it issimply theres no hesitation with using it. The biggest [universal] pause was [that]...unfortunately, sometimes it can be hard to get covered, Kiracofe said.

Despite coverage difficulties, the group expressed the positive response from patients to topical ruxolitinib, emphasizing its importance as a novel therapy.

Lal presented a case involving a 51-year-old African American man with persistent depigmented patches, impacting his self-esteem. Despite considering topical ruxolitinib as the ideal treatment, Medicaid limitations categorized vitiligo as a cosmetic disease, hindering insurance coverage. The patient initially underwent alternative therapies, including topical steroids and tacrolimus, with minimal improvement.

In our discussion, most patients [of colleagues] were using topical mometasone and topical hydrocortisone 2.5% both in ointment formulations as topical steroids of choice for starting their treatment regimen for vitiligo, and including topical tacrolimus as steroid sparing therapy, where people alternate topical tacrolimus along with topical steroids to reduce the side effects from topical steroids specifically clench acacias, skin thinning, atrophy and stretch marks, Lal explained.

Challenges in accessing phototherapy due to Medicaid restrictions were also discussed. After 3 months, the patient received topical ruxolitinib, resulting in focused improvements on cosmetically sensitive areas. The discussion emphasized the success of topical ruxolitinib, but acknowledged challenges in insurance approval for Medicaid recipients. Side effects, specifically folliculitis with topical ruxolitinib, were addressed, emphasizing management strategies without discontinuing therapy. The discussion concluded with insights into prior authorization processes and the use of specific pharmacies for medication access. Overall, the Scottsdale roundtable participants expressed success with combination therapies and emphasized the need for a holistic approach in vitiligo management.

A 23-year-old African American man with Fitzpatrick skin type VI presented with deep pigmented patches on visible areas such as thehands, arms, neck, and face. The contrast between normal skin and vitiligo patches were particularly noticeable due to his dark complexion, impacting his quality of life, especially as an active sports enthusiast. The continued discussion in Seattle focused on treating patients with different skin colors, considering that darker skin may make vitiligo more noticeable.

Initial treatment involved topical corticosteroids and calcineurin inhibitors, with the addition of phototherapy when the response was limited. However, the patient developed extensive vitiligo involvement, prompting a shift to alternative treatments. Stable vitiligo was defined as 1 to 2years without new areas of vitiligo.

The panel discussed oral steroids as an option for unstable vitiligo, with varying dosing regimens. The patient received 12 weeks of weekly dexamethasone dosing, followed by repigmentation efforts. Later, due to the patients preference and difficulty with topical treatments, they switched to topical ruxolitinib.

Concerns were raised about the box warning associated with topical ruxolitinib, and the discussion highlighted strategies to communicate the warning to patients without causing undue alarm. Absorption rates of the topical form compared with the oral version were discussed, indicating lower systemic exposure and reduced risk of cumulative effects.

Access to topical ruxolitinib was a significant point of discussion, with practitioners sharing their experiences. Its important to make sure we always prescribe a topical corticosteroid and a topical calcineurin inhibitor. Then we document that this is nonsegmental vitiligo in the note, rather than segmental vitiligo, which topical ruxolitinib is not approved for, Song said.We alsoneed to be very clear when we write topical ruxolitinib for vitiligo. It shouldnt be greater than 10% BSA [body surface area], which is different than what we see with atopic dermatitis, which is no greater than 20% BSA.Sometimes if you mix those 2up, that can lead to a drug denial. Lastly, there are some payers that consider vitiligo to still be cosmetic, so sometimes they will deny ruxolitinib.... We talked about resources we can use to get these medications approved. The patient can get a passive letter of medical necessity that we can print out, [going] over why vitiligo is not a cosmetic disease.

Case-Based Roundtable moderators across the country reflected on 3 main take-home points to remain cognizant of when meeting a patient with vitiligo.

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Case Based Roundtables Part 2: Valorizing Topical Treatment Options for Patients With Vitiligo - Dermatology Times

Dermatology

Practical Approaches to Atopic Dermatitis: Real-World Case Analyses – Dermatology Times

Panelist:

Shawn Kwatra, MD

Johns Hopkins University School of Medicine

Baltimore Maryland

Program Description:

An expert in dermatology provides insights from a case-based roundtable conversation, discussing the management of atopic dermatitis patients. They emphasize the complexities of the cases, the considerations regarding topical versus systemic treatments, and the administrative challenges associated with prior authorizations.

Segment Description:

Shawn Kwatra, MD, introduces a video program providing insights from a case-based roundtable conversation, discussing the management of atopic dermatitis across diverse age groups and skin types. The discussion centers on understanding the complexities of the presented cases, the considerations regarding topical versus systemic treatments, and the administrative challenges associated with prior authorizations.

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Practical Approaches to Atopic Dermatitis: Real-World Case Analyses - Dermatology Times

Dermatology

Schweiger Dermatology Group Expands into South Florida with Locations in West Palm Beach and Miami Beach – Tullahoma News and Guardian

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Schweiger Dermatology Group Expands into South Florida with Locations in West Palm Beach and Miami Beach - Tullahoma News and Guardian

Dermatology

Receding Hairline: Symptoms, Causes, Treatments – Men’s Health

NOTICING THAT YOUR HAIR is looking a little thin on top? Or that your hairline seems to be getting higher and higher? These are signs of a

And, its pretty common. By age 35, about two-thirds of men will experience some kind of hair loss, according to the American Hair Loss Association. By the time you reach 50, about 85 percent of men have thinner hair.

A receding hairline refers to hair loss or thinning at the top of the forehead and front of the scalp, explains Jeremy Brauer, M.D., a board-certified dermatologist and dermatologic surgeon at Spectrum Skin and Laser in New York.

He adds that receding hairlines can be caused by genetics, hormones, stress, overall health, and some lifestyle habits.

When your hair starts to recede, your self-esteem may take a hit. Fortunately, there are several treatments that can help minimize hair loss and even help with hair regrowth. Usually, you need to see a dermatologist to get the right treatment.

If you are experiencing hair thinning or hair loss, a dermatologist will conduct a thorough consultation, including a review of personal and family history, medical, surgical, social, medication, and allergy history, Dr. Brauer says.

The doctors visit will also include a scalp exam and lab work or other tests to determine the health of your hair and a possible cause for your receding hairline. That helps doctors recommend the best treatment.

Here, dermatologists discuss the common signs of a receding hairline, the most common causes, and possible treatments.

Thinning hair and hair loss are the most common ways hairlines recede, says John Kahen, M.D., chief surgeon, hair transplant specialist, and founder of Beverly Hills Hair Restoration. Receding hairlines may look different from person to person, and they can range from mild to severe, where you become bald.

Some symptoms include:

Receding hairlines often happen in stages, especially if you have male pattern hair baldness, which is common.

Many people first experience thinning hair at the front of their hairline, starting at the temple, before losing the hair completely, Dr. Kahen says. The hair may become patchy or thinner than it was originally.

According to the Cleveland Clinic, there are several stages of male pattern baldness:

Several factors can cause your hairline to recede, including:

Also referred to as male pattern baldness or androgenic alopecia, this is the most common cause of a receding hairline in people born male, according to the American Academy of Dermatology. It can be caused by age, genetics, and hormones.

High levels of the sex hormone dihydrotestosterone (DHT) in the hair follicles can contribute to thinning hair and eventual hair loss, says Amy Huang, M.D., a board-certified dermatologist with Medical Offices of Manhattan and contributor to LabFinder.

High DHT levels can also shorten your hair growth cycle, lead to hair shedding and brittle hair, and slow hair growth, Dr. Brauer says.

Smokers may be predisposed to a receding hairline because of the oxidative stress smoking has on your hair follicles, Dr. Kahen says. Research suggests that smoking can change the growth cycle of hair follicles, contributing to hair loss. When you quit smoking, you reverse the receding hairline.

Going overboard with hair care might contribute to a receding hairline, Dr. Brauer says. If youre harsh with your hair, the physical force may cause it to fall out.

Heat styling, using too many chemicals, coloring, or aggressive washing or styling may lead to hair loss.

Emotional stress or the stress related to an injury or surgery may impact your hair and cause hair loss, Dr. Brauer says.

Some health problems, including hypothyroidism, hormonal disorders, or malnutrition, might cause a receding hairline, Dr. Huang says. Infectious diseases or autoimmune disorders can also be contributors, Dr. Brauer adds.

Dr. Brauer says hair loss may result from a poor diet. Vitamin B12, riboflavin, biotin, and folate deficiencies have been linked with hair loss. Research in mice suggested that obesity may induce cellular stress that can trigger hair thinning.

Early treatment is crucial for a receding hairline. Dr. Brauer says long-term treatment is usually necessary to prevent additional hair loss. These are the most common treatments:

Many people start with the over-the-counter treatment Minoxidil to help with their hair loss, Dr. Huang says.

This topical treatment usually works best to treat early-stage hair loss, Dr. Kahen says. Its usually effective at preventing hair loss and increasing hair thickness.

Its believed that Minoxidil increases blood flow to hair follicles, increasing hair growth, he explains. But, the AAD says its unlikely to spur full hair regrowth.

Finasteride has been shown to slow hair loss, and some people see hair regrowth when they start taking it at the first signs of hair loss, according to the AAD.

The results arent always permanent, Dr. Kahen says. The medication is meant to be taken long-termif you stop taking it, your hair loss may recur.

Sometimes, finasteride is prescribed along with minoxidil,

Low-level light therapy and microneedling can stimulate hair growth in the areas where its thinning, Dr. Kahen says. Lasers can boost cell growth in hair follicles. Microneedling creates tiny injuries to the skin and heightens the skins natural healing response, which may help regrow hair.

This procedure involves drawing blood, placing it in a machine to separate the red blood cells from plasma, and then injecting it into your scalp, according to the AAD. This helps regulate hair growth and thicken hair. Its not a permanent solution, though.

Doctors might prescribe corticosteroids for hair loss caused by autoimmune conditions, says Dr. Brauer. These drugs may reduce inflammation, counteract the effects of the disease, and allow hair to grow.

A hair transplant is a permanent treatment for hair loss. Dr. Kahen says its the best option when youre genetically predisposed to hair loss. It can take several months to see results, however.

Vitamins and supplements that claim to help with hair loss could help with hair regrowth, but Dr. Brauer says most havent been studied. The effectiveness depends on whats causing the receding hairline, and they may work best when caused by a vitamin deficiency, Dr. Kahen says.

Still, many dermatologists recommend some over-the-counter hair supplements, including Nutrafol, Viviscal, and Isdin, Dr. Huang says.

The earlier, the better, Dr. Kahen says.

I recommend seeing a dermatologist or trichologist for a receding hairline as soon as you begin experiencing symptomsif it is something thats bothering youso, you can begin preventative measures as soon as possible, he adds.

Erica Sweeney is a writer who mostly covers health, wellness and careers. She has written for The New York Times, HuffPost, Teen Vogue, Parade, Money, Business Insider and many more.

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Receding Hairline: Symptoms, Causes, Treatments - Men's Health

Dermatology

Podcast CE: Ophytrium in Dermatology: When, where and whys of using Douxo S3 topical therapies – DVM 360

Program Description

During this podcast, we will discuss the innovative new science behind the DouxoS3 line by Ceva specifically focused the new to veterinary medicine active ingredient, Ophytrium.We will discuss the basics of cutaneous structure aka the epidermal barrier function as well as the cutaneous immune system and response and finally the cutaneous microbiome.These 3 different systems all play a role in many different dermatologic diseases which plague our veterinary patients.

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Podcast CE: Ophytrium in Dermatology: When, where and whys of using Douxo S3 topical therapies - DVM 360