Category Archives: Dermatology

POLL: Which Skin Cancer Drug Recently Received a Complete Response Letter From the FDA? – Dermatology Times

Which skin cancer drug recently received a Complete Response Letter from the FDA?

All 3 drugs listed in this poll have recently made appearances in the news for various reasons.

Moderna and Merck recently announced follow-up data from the phase 2b randomized KEYNOTE-942/mRNA-4157-P201 study, a clinical trial evaluating mRNA-4157 (V940), an investigational individualized neoantigen therapy, in combination with pembrolizumab (Keytruda), Merck's anti-PD-1 therapy, in patients with resected high-risk melanoma (stage III/IV) following complete resection.

V940 plus pembrolizumab also continued to demonstrate a meaningful improvement in distant metastasis-free survival, compared with pembrolizumab alone, reducing the risk of developing distant metastasis or death by 62%.

Read more from Dermatology Times here.

Additionally, AiViva Biopharma recently announced positive and promising data from its phase 1/2 clinical trial of AIV001 (Axitinib), a novel intradermal treatment, in patients with basal cell carcinoma.

It is exciting and important to have AiViva Biopharma develop a drug, with a new mechanism of action, that has the potential to treat BCC that avoids surgery, said Brian Berman, MD, PhD, in a press release. Berman is Professor Emeritus of DermatologyandDermatologicSurgery at The University of Miami Miller School of Medicine.

Read more from Dermatology Times here.

Checkpoint Therapeutics, Inc. faces a delay in the approval process for its cosibelimab biologic license application (BLA) following the issuance of a complete response letter (CRL) by the US Food and Drug Administration (FDA).

The CRL specifically points to issues uncovered during an FDA inspection of Checkpoint's third-party contract manufacturing organization.

Notably, no concerns were raised regarding clinical data, safety, or labeling.

James Oliviero, President and CEO of Checkpoint, remains optimistic, stating that the company aims to address the deficiencies in a resubmission, anticipating marketing approval for cosibelimab in 2024.

Reference

U.S. Food and Drug Administration Issues Complete Response Letter for COSIBELIMAB solely due to inspection findings at third-party manufacturer. Checkpoint Therapeutics, Inc. December 18, 2023. Accessed December 19, 2023. https://ir.checkpointtx.com/news-events/press-releases/detail/111/u-s-food-and-drug-administration-issues-complete-response

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POLL: Which Skin Cancer Drug Recently Received a Complete Response Letter From the FDA? - Dermatology Times

How to Treat Textured Skin, According to Dermatologists – Prevention Magazine

Searching for a smooth, bump-free complexion? Figuring how to get rid of textured skin is the best place to start. If your skin is full of highs and lows (literally), youve likely searched at-home solutions like acne treatments, anti-aging creams, the best face exfoliators, and beyondbut these can only do so much. Ahead, our experts share the best tips to help you get even, smoother skin.

Meet the experts: Marisa Garshick, M.D., F.A.A.D., a board-certified dermatologist in New York; and Lesley Clark-Loeser, M.D., F.A.A.D., a board-certified dermatologist and co-founder of Precision Skin Institute.

Textured skin can refer to a number of skin conditions, but in general it refers to skin that may feel raised, bumpy, or uneven, explains Marisa Garshick, M.D., F.A.A.D., a board-certified dermatologist in New York. This can be a result of breakouts, clogged pores, fine lines and wrinkles, acne scarring, rough, dry or irritated skin, as well as pores.

You can tell if you have uneven skin texture by the way your skin looks and feels. If you can see or feel any sort of bumpy or otherwise raised areas while applying your skincare products or makeup, this may be an indicator of textured skin.

Some are more prone to experience textured skin than others, and your skin type may determine what type of texture you have, Dr. Garshick explains. For example, those with oily skin may experience clogged pores and breakouts leading to more textural changes, while those with dry skin may experience rough, flaky patches that contribute to changes in texture. Additionally, those with mature skin tend to experience things like fine lines and wrinkles, which can contribute to the skins overall texture, Dr. Garshick explains.

While there are a slew of products and treatments that can make skin feel more even, there really is no specific secret weapon or a one-size-fits-all all solution for textured skin, as its causes can be quite varied, says Lesley Clark-Loeser, M.D., F.A.A.D., a board-certified dermatologist and co-founder of Precision Skin Institute. The key is knowing your skin or consulting with a dermatologist to help you understand your skin type and tailor a routine that is ideal for you. In addition to discovering the cause of your skin texture, consider the below options for a smoother complexion.

For many causes of textured skin, the skincare products you apply can mean the difference between a smooth and bumpy complexion. For example, those who struggle with dry skin or dry patches should focus on using hydrating, moisturizing ingredients while those with acne should focus on using proven acne-fighting ingredients like exfoliating acids, benzoyl peroxide, or retinoids/retinol, Dr. Garshick says. For those who experience texture due to sun damage, fine lines, or wrinkles, at-home use of exfoliating acids, and products that induce collagen production like retinoids and growth factors can help smooth the skin, explains Dr. Clark-Loeser.

If you arent satisfied with the results of at-home efforts to smooth skin, consider speaking to your dermatologist about professional skincare treatments, including:

Below, find some of the most common causes of textured skin to help you figure out how to best care for your complexion:

Rosacea, a skin condition, is a common reason for textured skin in adults and young adults, explains Dr. Clark-Loeser. In fact, the skin condition, characterized by flushed skin (usually on the cheeks) and bumps or pimples, affects more than 14 million Americans. Dr. Clark-Loeser suggests a less is more approach to treating rosacea via gentle products. Products containing niacinamide and sulfur soap can be particularly helpful.

Milia, which appear as small white or yellow papules are a type of cyst that appears on the skin due to trapped dead skin, Dr. Garshick explains. While certain people may be more susceptible than others, it can occur in all ages, genders, races and ethnicities. Exfoliating acids and retinol/retinoids may be effective at preventing milia, but seeing your dermatologist for manual extraction is often the best way to have milia removed.

Whether due to your skin type or from environmental factors, dry skin can contribute to less smooth and even possibly bumpy skin, Dr. Clark-Loeser explains. Extreme temperatures and humidity, like cold temperatures with low humidity or hot climates with either very low or high humidity can challenge the barrier function of the skin, resulting in inflammation and dryness. There are lots of dry skin treatments, like using mild cleansers, the best moisturizers for dry skin, and gentle facial exfoliants.

Blackheads and whiteheads are types of breakouts known as comedones and may occur when the pores become clogged, Dr. Garshick says. Blackheads, or open comedones, appear darker because the clogged pore is open to the air which causes oxidation. Whiteheads, or closed comedones, are not open to the air, appearing lighter in color. The best way to treat blackheads and whiteheads is with the use of retinoids, as well as exfoliating acids to help prevent the buildup of dead skin, Dr. Garshick says.

In addition to blackheads and whiteheads (which are non-inflammatory acne), inflammatory acne like papules and pustules, also contributes to textured skin. This type of acne results from a combination of oil, inflammation, bacteria, and buildup of dead skin cells. Garshick recommends using acne-fighting ingredients like benzoyl peroxide, salicylic acid, and retinoids.

A common result of mild to severe acne, acne scars also contribute to textural changes as scars may be raised or depressed, Dr. Garshick says. In some cases, the treatment may include lasers or microneedling to help boost collagen production or steroid injections to help flatten keloid or hypertrophic scars.

While fine lines and wrinkles are normal, they may become more pronounced with age and lead to textural changes in the skin, explains Dr. Garshick. Luckily, if these visible signs of aging bother you, there are a variety of treatments to help smooth the skin, like at-home use of retinoids, peptides, growth factors, and sun protections, as well as in-office procedures including neuromodulators (like Botox) and lasers, Dr. Garshick adds.

According to Dr. Clark-Loeser, Accumulated sun damage, with or without precancerous lesions, can also contribute to overall skin texture. In addition to causing fine lines, wrinkles, and sun spots, sun damage can cause other textural changes like rough patches and loose skin, per the American Academy of Dermatology Association. Treat sun damage with the same topicals you would use on fine lines and wrinkles (with an emphasis on SPF), says Dr. Clark-Loeser, and schedule a visit with your dermatologists to rule out skin cancer and find out your options for in-office skin smoothing procedures.

Sometimes it can be hard to avoid a bit of skin texture every once in a while, but following a skincare routine tailored to your skin type and concerns can go a long way toward mitigating the many causes of textured skin. Consider using topical exfoliating acids (like glycolic acid or salicylic acid) to buff away dryness and dead skin, and always be sure to use at least SPF 30 to prevent sun damage and skin cancer, Dr. Clark-Loeser and Dr. Garshick note.

The texture of your skin does tend to change with age. This occurs due to the loss of collagen which causes changes in skin texture leading to fine lines, wrinkles, as well as enlarged pores, Dr. Garshick explains.

Shannen Zitz is an Assistant Editor at Prevention, where she covers all things lifestyle, wellness, beauty, and relationships. Previously the Editorial Assistant at Prevention, she graduated from the State University of New York at Cortland with a bachelor's degree in English. If shes not reading or writing, you can probably find her frequenting the skincare and makeup forums on Reddit or hogging the squat rack at the gym.

Karan Lal, D.O., F.A.A.D., is a native New Yorker now living in Scottsdale, Arizona. He practices in both Scottsdale and New York. Dr. Lal is the only double fellowship trained pediatric and cosmetic dermatologist in the USA. He is a key opinion leader and international speaker with interests including social media medicine, LGBTQ health, eczema, psoriasis, vitiligo, laser surgery, melasma, and soft tissue augmentation. He is the chair of the social media committee for the Society of Pediatric dermatology and is on the ASDS DEI committee. Dr. Lal is often seen either on the news, at F45, or playing with his parrot Maui.

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How to Treat Textured Skin, According to Dermatologists - Prevention Magazine

Dermatology decoded with Dr. Davin Lim – manilastandard.net

With the number of popular ingredients and buzzwords these days, it can be overwhelming to do research and digest skincare information. Its a good thing Dr. Davin Lim, a board-certified dermatologist based in Brisbane, Australia, provides bite-sized content on social media and the video streaming platform YouTube for a better understanding of dermatology.

Dr. Lim veers away from the often jargon-heavy side of the field, making it easier for regular individuals to grasp essential information about skincare. He stands out not only for his medical expertise but also for his ability to demystify dermatology for non-medical audiences. He turns it from an intimidating subject into one that everyone can comprehend and navigate, very much like a friend casually discussing things with you.

With a mission to cut out the hype and mystery of the skin care industry, Dr. Lim has become a trusted voice in the field, providing valuable skincare insights. From dissecting the intricacies of various skincare products to sharing do-it-yourself (DIY) techniques and delving into the world of advanced skin procedures like lasers, peels, injectables, and surgery, Dr. Lim covers it all with the mission to share useful information.

In a one-on-one interview during his visit to the country earlier this month, Dr. Lim helped me understand the new technology of a power duo Potenza RF microneedling and the AnteAGE MDX Exosome Solution. He described the new treatment as a step up from microneedling.

Were using needles, very fine microneedles. Were adding something called radio frequency and it generates heat. Heat, itself, does wonderful things for the skin. It can remodel scarring, tighten up the skin, reduce wrinkles, and treat large pores as well.

In the Philippines, the services are offered at the Facial Care Centre at GT Tower in Makati.

Dr. Lim explained that Potenza Radio Frequency (RF) microneedling seamlessly combines two established methods for rejuvenating the skin: microneedling for mechanical stimulation, initiating skin renewal, and monopolar radio frequency energy for thermal stimulation, enhancing neocollagenesis or the process of creating new collagen. Essentially, it integrates controlled heat energy into the microneedles, providing a dual impact of youth-enhancing benefits to the skin.

The ideal combination to the Potenza procedure is the AnteAGE MDX Exosome Solution, ensuring optimal outcomes by guiding your cells to naturally promote skin regeneration, alleviate inflammation, and stimulate healthy collagen growth, effectively reversing the aging process of the skin.

What are exosomes?

Exosomes, lipid nanoparticles released by cells, serve as messengers to communicate with other cells, playing a vital role in overseeing biological processes within the body. In the context of the skin, this implies that exosomes play a key role in signaling the skin to engage in beneficial actions such as increasing the production of healthy collagen, reducing inflammation, and promoting skin renewal.

AnteAGE MDX Exosome Solution is a unique treatment that combines exosomes from human bone marrow and umbilical cord stem cells, known for their anti-inflammatory and healing properties. This high-quality and pure formula stands out as a potent exosome treatment unlike any other.

If theres one thing Dr. Lim said that stuck with me, it would be the major skincare rule he swears by Be intentional. Everything that you put on [your skin] should be thoughtful. If you want to change, pick an ingredient for your concerns, Dr. Lim shared. The biggest mistake I see is people just using too much stuff. If youre focused on using one or two things according to your concern and be very precise with your skincare, youll get your skincare goals a lot better than trying everything.

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Dermatology decoded with Dr. Davin Lim - manilastandard.net

Moderna and Merck’s V940 Plus Pembrolizumab Demonstrates Improvement in RFS and DMFS in Stage III/IV … – Dermatology Times

Superficial spreading melanoma

Image courtesy of DermNet

Moderna and Merck recently announced follow-up data from the phase 2b randomized KEYNOTE-942/mRNA-4157-P201 study, a clinical trial evaluating mRNA-4157 (V940), an investigational individualized neoantigen therapy (INT), in combination with pembrolizumab (Keytruda), Merck's anti-PD-1 therapy, in patients with resected high-risk melanoma (stage III/IV) following complete resection. After a follow-up of 3 years, adjuvant treatment with V940 plus pembrolizumab continued to demonstrate a clinically meaningful improvement in recurrence-free survival (RFS), reducing the risk of recurrence or death by 49% (HR=0.510 [95% CI, 0.288-0.906]; one-sided nominal p=0.0095) compared with pembrolizumab alone. V940 plus pembrolizumab also continued to demonstrate a meaningful improvement in distant metastasis-free survival (DMFS), compared with pembrolizumab alone, reducing the risk of developing distant metastasis or death by 62% (HR=0.384 [95% CI, 0.172-0.858]; one-sided nominal p= 0.0077).

Based on data from the phase 2b KEYNOTE-942/mRNA-4157-P201 study, the FDA and European Medicines Agency granted Breakthrough Therapy Designation and the Priority Medicines (PRIME) scheme, respectively, for V940 plus pembrolizumab for the adjuvant treatment of patients with high-risk melanoma.

"As we continue to follow participants in the KEYNOTE-942/mRNA-4157-P201 study, we are excited to see such a robust clinical benefit with mRNA-4157 (V940) as adjuvant treatment in combination with KEYTRUDA in people with resected high-risk melanoma," said Kyle Holen, MD, the senior vice president and head of development of therapeutics and oncology at Moderna, in the news release. "These data add another positive analysis to the multiple endpoints and subgroups previously assessed in this study. Importantly for this technology, the KEYNOTE-942/mRNA-4157-P201 study was the first demonstration of efficacy for an investigational mRNA cancer treatment in a randomized clinical trial and the first combination therapy to show a significant benefit over KEYTRUDA alone in adjuvant melanoma. We look forward to sharing these data with people impacted by this disease and the broader scientific community."

Adverse events observed with V940 in KEYNOTE-942 are similar to those previously reported. At a median planned follow-up of approximately 3 years, the number of patients reporting treatment-related grade 3 adverse events was similar between the arms (25% for V940 plus pembrolizumab vs 20% for pembrolizumab alone). The most common adverse events associated with V940 were fatigue (60.6%), injection site pain (56.7%), and chills (49%).

In July 2023, Moderna and Merck announced the initiation of a pivotal phase 3 randomized INTerpath-001 (NCT05933577) clinical trial evaluating V940 plus pembrolizumab, as an adjuvant treatment in patients with resected high-risk (Stage IIB-IV) melanoma. Global recruitment in INTerpath-001 has started.

"We are committed to driving research forward for innovative modalities in earlier stages of cancer, where we can make the most meaningful impact for patients, by combining Merck's expertise in immuno-oncology with Moderna's innovative mRNA technology," said Marjorie Green, MD, the senior vice president and head of late-stage oncology and global clinical development at Merck Research Laboratories, in the news release. "We are pleased to see the results from this planned analyses on recurrence-free survival for V940 (mRNA-4157), and look forward to working with Moderna in expanding our clinical development program for the individualized neoantigen therapy."

Reference

Moderna and Merck announce mRNA-4157 (v940) in combination with Keytruda(r) (pembrolizumab) demonstrated continued improvement in recurrence-free survival and distant metastasis-free survival in patients with high-risk stage iii/iv melanoma following complete resection versus Keytruda at three years. News release. Moderna. December 14, 2023. Accessed December 18, 2023. https://investors.modernatx.com/news/news-details/2023/Moderna-And-Merck-Announce-mRNA-4157-V940-In-Combination-with-KeytrudaR-Pembrolizumab-Demonstrated-Continued-Improvement-in-Recurrence-Free-Survival-and-Distant-Metastasis-Free-Survival-in-Patients-with-High-Risk-Stage-IIIIV-Melanoma-Following-Comple/default.aspx

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Moderna and Merck's V940 Plus Pembrolizumab Demonstrates Improvement in RFS and DMFS in Stage III/IV ... - Dermatology Times

Aptar Digital Health and Legit.Health Partner to Improve Patient Experience in Immuno-Dermatology – Healthcare Packaging

This content was written and submitted by the supplier. It has only been modified to comply with this publications space and style.

Aptar Digital Health, a developer of Software as a Medical Device (SaMD), digital Patient Support Programs (PSPs), and disease management solutions, has announced a new partnership with Legit.Health, an artificial intelligence-based, medical device software company that focuses on the early detection, evaluation, and monitoring of skin diseases.

Legit.Healths technology, which supports the diagnosis of approximately 300 conditions including atopic dermatitis, psoriasis, and skin cancer, will be integrated into Aptar's Digital Health proprietary platform. Focused on enhancing patient care and increasing patient autonomy, this advanced digital solution will support healthcare professionals (HCPs) to diagnose skin conditions earlier and will enable patients to start treatment plans sooner to improve their overall quality of life. The solution also may be used to facilitate patient enrollment in clinical trials.

Legit.Health's use of AI for monitoring disease progression through automated, clinically validated scoring systems, such as the Psoriasis Area Severity Index (PASI) and SCORing Atopic Dermatitis (SCORAD), will be leveraged within this partnership. This will help to ensure patients receive the most accurate and timely information to manage and treat their skin condition more effectively. The AI-powered technology also extends to the quantification of the intensity, count, and extent of the visible clinical signs of skin conditions, offering HCPs a more precise measure of disease severity, an indicator considered critical in determining the most appropriate treatment.

This strategic partnership is set to drive digital transformation in the healthcare sector. Aptar Digital Health andLegit.Healthtogether will pave the way towards harnessing the power of AI to improve patient experiences and outcomes in immuno-dermatology.

Sai Shankar, President, Aptar Digital Health, stated, Since 2021, Aptar Digital Health has been growing our portfolio of technology partners to provide improved solutions for patients in multiple therapeutic areas such as cardiology, neurology and visual acuity. With this new partnership, Aptar Digital Health is acquiring the ability to leverage AI technology to accelerate the diagnosis and monitoring of skin conditions.

Andy Aguilar, CEO and Co-Founder ofLegit.Health, commented, One of our main aims within the medical assistance process in the field of dermatology is to be able to offer patients the opportunity of having the earliest and most accurate diagnosis, with the appropriate referral and treatment to reduce uncertainty and waiting times. She added, Legit.Health's technology helps the medical practitioner to provide this kind of care to their patients and today, thanks to our partnership with Aptar Digital Health, we will be able to reach even more people who will benefit from our service

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Aptar Digital Health and Legit.Health Partner to Improve Patient Experience in Immuno-Dermatology - Healthcare Packaging

Navigating Location Specific Treatment Selection and Topical Therapy Limitations – Dermatology Times

This is a video synopsis/summary of a panel discussion involving Lisa Swanson, MD, FAAD, and Robert J. Casquejo, PA-C.

The conversation begins with an exploration of the distinctive features of plaque psoriasis that differentiate it from other dermatologic conditions. The difficulty of diagnosing psoriasis is discussed, with attention to variables like location, skin color, and ethnic variability. The challenges become apparent when distinguishing between psoriasis and conditions such as eczema.

The speakers note that psoriasis diagnosis can be straightforward in some cases but challenging in others, particularly when there is an overlap with conditions like eczema. An expert shares experiences from his pediatric specialty, highlighting instances where psoriasis is misdiagnosed as other dermatologic conditions.

The conversation shifts to the significance of the location of psoriasis involvement in guiding treatment decisions. Scalp psoriasis is emphasized as a challenging area for topical management, prompting considerations of both physical and psychosocial impact. An expert discusses his approach, focusing on the severity of physical symptoms and the psychosocial impact when deciding on treatment options.

The speakers delve into the challenges of managing scalp psoriasis with topical medications, noting issues like greasiness and patient dissatisfaction. An expert suggests that systemic treatment options may be more practical for areas like the scalp due to ease of use and patient preferences.

The speakers agree on the complexity of treating psoriasis in problematic areas like the scalp, acknowledging the limitations of topical medications and the need for more aggressive approaches. The conversation concludes with an acknowledgment that certain areas, including the scalp, pose challenges that may require systemic treatments beyond topical applications.

Video synopsis is AI-generated and reviewed by DermatologyTimes editorial staff.

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Navigating Location Specific Treatment Selection and Topical Therapy Limitations - Dermatology Times

POLL: What Percent of the Global Population is Estimated to Have … – Dermatology Times

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

In fact, they note that the amount of people living with chronic, excessive sweating is even higher than the amount of people living with other dermatologic conditions like psoriasis.

Just how common is hyperhidrosis in real-world comparisons?

The prevalence of hyperhidrosis is much higher in younger populations than in the general population, with 8.8% of individuals between the ages of 18 to 39 years old living with the condition.

When comparing these statistics to everyday, common occurrences like hair color, the number of people with hyperhidrosis is greater than the 1% of individuals with natural red hair and 2% of individuals with natural blond hair.

Despite how common hyperhidrosis is, it is estimated that 27% of those with the condition never receive a diagnosis.

This Hyperhidrosis Awareness Month, Dermatology Times wants to hear from you. What percentage of the global population is estimated to have hyperhidrosis?

Vote below or email us at DTEditor@mmhgroup.com to share your hyperhidrosis insights or research.

What percent of the global population is estimated to have hyperhidrosis?

Reference

Albert. Fact check: Hyperhidrosis - International Hyperhidrosis Society: Official site. Home - International Hyperhidrosis Society. October 24, 1970. Accessed November 16, 2023. https://www.sweathelp.org/home/news-blog/542-fact-check-hyperhidrosis.html

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POLL: What Percent of the Global Population is Estimated to Have ... - Dermatology Times

Purple Heart Project Seeks to Provide Veterans With Access to … – Dermatology Times

Jorge Garcia-Zuazaga, MD, MBA, FAAD, FACMS, is a Mohs surgeon and the founder of Apex Dermatology and Skin Surgery Center in Northeast Ohio.

Garcia-Zuazaga is also a former flight surgeon for a Marine squadron, leading him to combine his passions for military service and skin health via the creation of the Purple Heart Project, an initiative aimed at supporting skin health in veterans with severe wounds.

Garcia-Zuazaga recently spoke with Dermatology Times to discuss the Purple Heart Project and its efforts in providing this patient population with access to dermatologic care.

"Usually on Veterans Day, around the Marine Corps birthday, it's a big time where we go out there and remind people that we're here for that," he said. "But it really is a whole year type of thing. We don't just do it on only one day."

Transcript

Jorge Garcia-Zuazaga, MD, MBA, FAAD, FACMS: My name is Jorge Garcia-Zuazaga. I am a Mohs surgeon, and I'm the founder of Apex Dermatology and Skin Surgery Center here in the Northeast Ohio area.

Dermatology Times: What is the Purple Heart Project, and what are its main goals?

Garcia-Zuazaga: This started way back probably 10 years ago, when I founded Apex. I was looking for a community project to do that kind of blended my interest in dermatology and skin cancer but at the same time, my military service. Before I did dermatology, I was a flight surgeon for a Marine F-18 squadron. I did that for about 4 years, and so we bonded, and I had a lot of great experiences. I owe a lot of what I am today to the military service that I've done.

I was thinking about something that could resonate with me and the community. Then years later, the Boston Marathon bombing, there was some type of group [a plastic surgery group or medical group] that, assisted in some of those burn-wounded folks. And then I was like, "Maybe they can do something with scars." And then I started thinking more deep about it, and I thought, in dermatology, we're blessed that we connect with our patients, and the patient opens up to us, and scars tell their story. A lot of the folks in the military, the veterans, those scars go a lot deeper than the skin. Some some of them have PTSD and deal with other mental health issues. I was thinking, "Well, maybe I can do something that can help them feel better about themselves. Maybe I can get their mind clearer, or maybe get them back into the game, get them back into their community." That's kind of how it started, and it's really kind of started as just me, just grassroots, just me talking to my patients. I do a lot of VA care, and I connect with a lot of my patients. And basically, that's how we started now.

Over the years, it's developed into what it is now, which is a little bit more organized. We decided to kind of put it together more like a formal program, where the veterans can log into our website at ApexSkin.com/PurpleHeartProject and basically find the information there. Really, this is not a program for somebody that has a little mini scar on the hand. This is really for somebody that has a traumatic scar or wounded from battle. We assess them; we have a panel of our providers that are going to look at them, and they have to submit information. I talk to the veterans, and I do a lot of it on my own free time.

And then we evaluate scars, because sometimes in dermatology, we can treat scars. Some scars, you can use with lasers, sometimes we can do other things, sometimes you can't help. It's more of an education thing that we do, and then we make the treatment plan, what's needed. So it's all complimentary to the vet, and it's our way really to give back to the community and also honor the vets that sacrificed a lot for our country. So that's kind of how we started, and now it's a cooler program, because more people kind of know about it. In fact, hopefully, this interview will maybe raise some awareness or somebody that's out there, and they want to do something similar. I'm happy to help with that.

Dermatology Times: How have your personal experiences shaped your commitment to the Purple Heart project?

Garcia-Zuazaga: For me, it was always all about having a purpose. At Apex, we're a big fan of having a mission or a purpose. That way, we are part of a bigger group. You want to be part of a winning team, usually. And if you're just doing dermatology to do dermatology, punch in and punch out, you can get burnt out very quickly. For us in our group, it's more about trying to rally behind a mission. Our mission an Apex Dermatology is transforming lives through healthy skin, and I really feel that the Purple Heart Project really goes right into that purpose, right on target. It's part of our DNA. We want to transform lives, and what better way of transforming lives than helping somebody who's wounded, and maybe is depressed or maybe has PTSD, and maybe feeling a little bit better about themselves, and maybe understand, "Hey. You know what? I need to seek some help. I'm not alone here. We're going to continue with our life."

For us, that's really the whole point of the project, and sometimes we can't help them. Sometimes we say, "Hey, listen, I can't help you here. You need a plastic surgeon. You need large reconstructions." But sometimes we can, and sometimes we make a little bit of an impact. And if we can do one person, then I feel great. We continue to do that.

In our community, we still are pretty much grassroots. We're not really putting a big banner here: "Hey, this is what we're doing. We're so great." People know how to find us. I have my patients and they say, "Hey, I'm going to have my cousin [come to you]. He was in Iraq. He had a wound." So that's kind of how I find our patients. We do a lot of community service here. Usually on Veterans Day, around the Marine Corps birthday, it's a big time where we go out there and remind people that we're here for that. But it really is a whole year type of thing. It's a whole year thing. We don't just do it only one day.

I don't really have a sense of how much of an impact this has had in our community, but I can tell you that is really touching when I have a patient that we connect, and they say, "Listen, thanks Doc. You really helped me do this," or I see them send me a postcard or a Christmas card and say, "Hey, I'm working here now." It's one of those things that we continue our communication and touch base. That's why I went into medicine. I went into medicine to help people and to make an impact, and that's my way of doing it.

Dermatology Times: How do you hope the Purple Heart Project will expand or evolve over time?

Garcia-Zuazaga: In terms of expanding this project, we've had a couple of people from other states call me up and say, "Hey, listen, how do you do that? I'm interested in helping in something like that." And I'm an open book; I give them my information, I give them how I started it. We've had people from other states sending, "Hey, do you accept donations for that project?" We're not set up for that, at least not yet. I'm always happy to show people how we do it here, so that they can replicate it over there. But really, what it takes is somebody that really has a passion for helping people. You put in your time.

In terms of how dermatologists can impact the veteran community, I would say that most of us are public servants. We do skin cancer screenings already. They do that, or they volunteer their time, or they give a lecture. So I think raising awareness of not just skin cancer, but anything else that can happen for veterans is important. Sometimes, you may be the first line for them [veterans] to see you because they had a skin cancer, and maybe you need to say, "Hey, listen, are you up to date with your age appropriate cancer screenings? Do you need a colonoscopy?" That's what we do. Just because we're dermatologists, it doesn't mean that I'm only going to see that mole you have your back. You have to treat the patient.

I think in this day and age, a lot of dermatologists are very busy. It can be very easy to just stay on your lane and spend 5 minutes with the patient and move on. But I think what makes our specialty a great one is that we recognize internal disease in the outside. Just by us spending the extra 5 minutes to say, "Oh, yeah, that could be lupus," or "We'll send you to rheumatology to see if you have something." So I think just raising awareness of that, because a lot of the vets, you know, they're in areas where there are some environmental factors that sometimes you're exposed to, a lot of our vets talk about Agent Orange back when in the Vietnam War era. Candidly, I had a buddy of mine from my squadron, he was 50 years old, and he just passed from colon cancer. There's a lot of awareness now in people in the aviation community to get earlier colon cancer screening, because you are getting exposed to radiation in that jet.

Again, just paying attention and understanding that the vets are a special group of people that one time in their lifetime they volunteered to give their life for this country, and I think that has a lot of weight, especially in this day and age when the world is how it is. It's a cool thing that we do, and I encourage anybody that's doing derm to do that, too.

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Purple Heart Project Seeks to Provide Veterans With Access to ... - Dermatology Times