February 15 2017 Issue

The AARS online Hot Topics Newsletter is an exclusive AARS member benefit!

This is a semi-monthly compilation of peer-review literature and online updates in acne and rosacea covering industry press, new medical research and what patients and your peers are talking about in patient counseling tips.

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Industry News

  • Understanding the effects of age, gender and ethnicity when treating a patient for acne can inform the best approach to treatment, according to a speaker at South Beach Symposium 2017.
  • Valeant Dermatology announced its annual Aspire Higher Scholarship Program will award up to $10,000 to students who have previously been diagnosed with a dermatologic condition and will be attending undergraduate or graduate education programs during the 2017 to 2018 school year, according to a press release.

New Medical Research

  • For the first time, the possible relationships of Coproporphyrin III (CpIII) and Protoporphyrin IX (PpIX) fluorescence as well as acne lesion-specific inflammation measurements with clinical signs of acne are investigated in a new exploratory study.
  • An open-label, randomized, multicenter study conducted to evaluate the safety and efficacy of long-term use of 2.5% and 5% benzoyl peroxide (BPO) gels administrated once daily for 52 weeks to Japanese patients with acne vulgaris found that both 2.5% and 5% BPO gels are effective and safe for long-term treatment of patients with acne vulgaris.
  • A case of moderate facial erythema that responded well to combination treatment with brimonidine 3 mg/g gel and a treatment course of potassium-titanyl phosphate (KTP) laser therapy is presented in a recent article, showing a reduction from baseline, maintained after final laser session, by applying brimonidine 3 mg/g gel daily.
  • A study of fifteen patients with atrophic facial scars of varied aetiology found dermal grafting can be used in the management of any round to oval facial scar which is soft, prominent and at least 4-5 mm across; linear scars at least 2-3 mm across and 3-4 cm in length. However, scars with prominent surface irregularities need further resurfacing techniques along with dermal grafting.

Clinical Reviews

  • A review of the literature identified a number of studies that tested an intervention to improve adherence in dermatology, including the following: electronic messages and/or reminders; more frequent or 'extra' clinic visits; audio-visual and internet-based interventions; and patient support programmes and/or self-management, educational training programmes.
  • The use of photographs and other therapeutic devices for the evaluation of erythema in skin conditions such as acne and rosacea is discussed in a new article.
  • Rosacea patients complaining of gastrointestinal symptoms warrant clinical suspicion of disease because, while the pathogenic link between gastrointestinal disorders and rosacea remains a mystery, an association between the two is clear, according to a new study. This and other studies exploring the link between rosacea and gastrointestinal disorders are reviewed in a recent article.
  • The link between rosacea and other comorbidities such as Parkinson's disease and type 1 diabetes is explored in a recent article.
  • Two cases of solid facial edema in young men with initially papulopustular acne resistant to topical retinoids are reviewed and showed both cases responded to oral isotretinoin, in one case combined with oral steroids.
  • Increased prescribing rates for systemic tetracyclines and isotretinoin were observed in the period 2005-15, while a decreased prescribing rate for hormonal therapy was observed from 2007, according to findings in a recent review.
  • A hybrid systematic review of the evidence for benefits and potential harms of oral spironolactone in the management of acne in adult females identified evidence of limited quality to underpin the expert endorsement of spironolactone at the doses typically used (≤100 mg/day) in everyday clinical practice.
  • Both acne and rosacea have a multifactorial pathology that is incompletely understood. A new article provides an overview of current perspectives on the pathogenesis and treatment of acne and rosacea, including a summary of findings from recent landmark pathophysiology studies considered to have important implications for future clinical practice.
  • A nationwide cohort study of the Danish population using individual-level linkage of administrative registers looking at the cancer incidence in patients previously diagnosed with rosacea found an increased risk of non-melanoma skin cancer (NMSC), breast cancer, and hepatic cancer, and a reduced risk of lung cancer, among patients with rosacea.
  • A nationwide cohort study in Taiwain with a total of 89,356 patients with rosacea and 178,712 matched patients without rosacea between 1997 and 2013 showed patients with rosacea may have an increased risk of inflammatory bowel disease (IBD).
  • A study to evaluate the clinical characteristics and epidermal barrier function of papulopustular rosacea by comparing with acne vulgaris found Erythema, burning, dryness and itching are the characteristics of papulopustular rosacea, which makes it different from acne vulgaris. The epidermal barrier function was damaged in papulopustular rosacea patients while not impaired in that of acne vulgaris patients.
  • A case of a young male who presented with complaints of diplopia after using isotretinoin for a prolonged period of time is explored in a recent article.
  • A prospective study identified 18 patients with papular acne scars of the nose and chin, leading investigators to propose that this new category be added to acne scarring classification schemes.
  • A panel working to obtain international consensus to establish a phenotype-led rosacea diagnosis and classification scheme with global representation recommended an approach for diagnosis and classification of rosacea based on disease phenotype.

Patient Counseling / Communication

  • Dermatologists need to become more confident in prescribing isotretinon (Accutane, Roche) to their acne patients. "After 35 years on the market, Accutane has been found to be safer and safer, not more and more dangerous," says Guy Webster, M.D., Ph.D., clinical professor of dermatology at the Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia.
  • An evaluation of the perceptions and beliefs of Saudi youth on acne found that that misconceptions of acne are widespread among Saudi youth. A health education program is needed to improve the understanding of the condition.
  • A new article discusses how to talk with patients about their expectations regarding treatment and whether relief of symptoms is a necessary component to living a better life.