Expert dermatologists provide an overview of vitiligo while reviewing presentation, diagnosis, and the goals of therapy related to current and future therapies.

DermView: Innovations in the Treatment of Vitiligo

and joined the MJH Life Sciences team in April 2021. She graduated from Kent State University in 2018 with a bachelor's degree in journalism and a minor in sociology. Linda used to work as a creative writer for 

 and was a technical writer/regulatory specialist/purchasing agent at GM Industrial before coming on to the team. She enjoys reading, traveling, and learning new perspectives. You can reach her at 

Abrocitinib (Cibunqo; Pfizer), a once-daily, Janus kinase 1 (JAK1) inhibitor, has been approved by the FDA for the treatment of adults living with refractory, moderate-to-severe atopic dermatitis (AD) whose disease is not adequately controlled with other systemic drug products, including biologics, or when use of those therapies is inadvisable.

The approved recommended doses are 100 mg and 200 mg, with the 200 mg dose recommended for patients who are not responding to the 100 mg dose. Also, a 50 mg dose was approved to treat moderate-to-severe AD in patients with moderate renal impairment (kidney failure), certain patients receiving treatment with inhibitors of cytochrome P450 (CYP) 2C19, or patients who are known or suspected to be poor metabolizers of CYP2C19, 

. For patients with moderate renal impairment who are not responding to 50 mg once daily, 100 mg once daily may also be prescribed.

“The reality for patients living with chronic inflammatory skin disease such as moderate-to-severe atopic dermatitis is that many experience debilitating symptoms that are not managed by current treatment options,” said Jonathan Silverberg, MD, PhD, MPH, Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington DC.“Today’s approval of CIBINQO will provide an important new oral option that could help those who have yet to find relief. In multiple large-scale clinical trials, CIBINQO demonstrated strong efficacy at clearing skin, improving itch, and managing the extent and severity of eczema, offering a benefit-risk profile that supports the use of this treatment in the FDA-approved patient population.”

The approval was based on the results of 5 clinical trials from a large-scale clinical trial program of more than 1,600 patients which assessed the safety and efficacy of the treatment in phase 3 trials. Across the trials, abrocitinib demonstrated a consistent safety profile and improvements in skin clearance, extent of disease, and severity, as well as rapid improvement in itch after 2 weeks, for some people living with AD vs placebo. Also, another 2 monotherapy trials found that a higher proportion of subjects treated with abrocitinib achieved improvement in itching at week 12 compared to placebo.

The most common adverse events (AEs), which were reported in more than 5% of patients treated with abrocitinib are nasopharyngitis (12.4% at the 100 mg dose, 8.7% at the 200 mg dose, and 7.9%, with placebo), nausea (6%, 14.5%, and 2.1%, respectively), and headache (6%, 7.8%, and 3.5%, respectively).

“The FDA’s approval offers hope to the millions of patients across the U.S. who are suffering daily with an immuno-inflammatory condition that can cause intense and persistent itching, pain, discomfort, and distress if left uncontrolled,” said Mike Gladstone, global president of Pfizer inflammation & immunology, New York, New York. “CIBINQO, an efficacious once-daily pill, is a medical breakthrough made possible by Pfizer researchers and the people living with moderate-to-severe atopic dermatitis who participated in our clinical trials.”

“Atopic dermatitis is so much more than just a rash, and it goes beyond the surface of the skin. It’s a chronic condition that can both significantly disrupt patients’ daily lives and negatively impact their emotional well-being,” said Julie Block, president and CEO, National Eczema Association, San Francisco, California. “We appreciate Pfizer’s commitment to this resilient patient community and eagerly await the positive impact CIBINQO could have on the treatment landscape for moderate-to-severe atopic dermatitis.”

1. Breaking news: FDA approves Cibinqo (Abrocitinib). National Eczema Association. Published January 14, 2022. Accessed January 17, 2022. 

https://nationaleczema.org/cibinqo-approval/

Articles

The FDA has approved abrocitinib for adult patients with moderate to severe AD.  

Abrocitinib FDA Approved for AD

Patients are looking for a holistic approach to their skin care and taking the time to review with your patients what they are using on their skin, as well as counseling about their lifestyle relating to diet, exercise, sleep, and stress can go a long way to helping them address their skin concerns, according to a speaker at Winter Clinical Dermatology Conference, held this week in Kauai, Hawaii.

“I sit down with my patients and try to make it easy,” Diane S. Berson, MD, of Weill Cornell Medical College, told the audience. “I have found that if I keep it basic and explain to them what the ingredients are doing, and write out their regimen, they will comply and see the benefits.”

Berson said the most common issues cited by her patients include concerns over redness, discoloration, aging, acne, and hair growth issues. For patients with any of these concerns, she stresses the importance of protection during the day, with items like antioxidants and sun protection, and at night, repairing the skin with retinols.

For “day” care, Berson discussed the importance of encouraging moisturizer use, including for patients who are using retinoids for things like acne. She cited previously published data that showed patients who used a hydrating moisturizer first under their retinoid did not get irritated with the retinoid use and were more compliant with the regimen. There are a range of moisturizer options including emollients that contain ceramides and humectants that contain glycerin.

Discussing sun protection, Berson noted, “This is important for all your patients, particularly for those with acne and rosacea.” She said that it is important to stress the importance of sunscreen use, but if the patient expresses concerns about certain chemicals in sunscreens, that the dermatologist can encourage mineral-based products.

She also tailors her advice to particular groups, noting that she’s seen an uptick in millennials coming to her seeking advice about skin care.

“They are being targeted to buy certain skin care products, and they are buying them, so I will look at the products with them, and if the active ingredients are ones I approve of, I recommend them if they like them,” she said. She said younger patients often ask her about using a moisturizer, sunscreen, and makeup if they have acne or rosacea, and she takes that question as an opportunity to discuss a good skin care regimen, combined with mineral makeup that deflects light.

Along those same lines, Berson said it’s common for younger patients to question their dermatology about “clean” skin care options.

“A lot of our patients are looking for natural, cleaner alternatives… they don’t want parabens, formaldehyde, sulfates in their products,” she said. As such, there is an explosion of products now on the market that are “plant based,” including topical cannabinoid-based products. But, she said, it’s important to advise patients that certain plants can put them at risk of contact dermatitis, so remaining aware of what they are putting on their skin is their best defense against dermatitis flare-ups.

Berson also counsels her patients about the importance of diet in terms of reducing skin problems, and she stresses the benefits of the Mediterranean diet, as a western diet is typically more proinflammatory, affecting the gastrointenstinal flora and increasing inflammation.

Berson DS. Cosmeceuticals: Answers to your patients’ questions. Presented at: 2022 Winter Clinical Dermatology Conference; January 14 to 19, 2022; Kauai, Hawaii.

Targeting skin care regimens to the individual patient is most likely to yield compliance to a recommended routine.

Answers to Your Patients' Questions on Skin Care

Resident billing was examined at the 19th Winter Clinical Dermatology Conference, held January 14 to 19, in Kauai, Hawaii, by comparing effectiveness of the new coding and modified note template on resident billing accuracy from before and after implementation.

The researchers recorded all Current Procedural Terminology (CPT) codes and modifiers for 256 patient encounters before and after intervention. The intervention was 4 monthly billing lectures with 2 quizzes as well as a note template designed by Michael Tassavor, MD. The note template automatically lists the correct procedural codes according to the numbers and types of procedures chosen from a dropdown list, according to the poster. After, the billing accuracy is checked by 2 attending dermatologists through chart review and is then compared between 2 time periods.

Overall, 513 patient visits were included in the billing data, 257 from before the intervention and 256 from after, which were all checked for accuracy. The Evaluation & Management Services (E/M) level of service were comparable post-intervention (44.4% vs 44.8%, respectively). The same was found of the undercoding and overcoding, with 35.4% undercoded and 8.1% overcoded pre-intervention and 35.8% and 8.9% post-intervention, respectively.

There were improvements in the rate of errors with both procedural codes and modifiers, the researchers noted, with 22% of procedural codes incorrectly billed pre-intervention and 3.7% incorrect post-intervention. Likewise, 55.2% of modifiers were incorrectly billed pre-intervention and 27.3% were incorrect post-intervention.

Overall, the accuracy of billing by dermatology residents were improved after the lectures and it was found most often residents were consistently undercoding E/M rather than overcoding. The researchers suggested this could be due to the perception that there is no meaningful benefit to maximizing their billing.

1. Tassavor M, MD, Owji S, BS, Han J, BS, et al. Improving dermatology resident billing. Icahn School of Medicine at Mount Sinai. Poster. Presented at: Winter Clinical Dermatology Conference, January 14-19, Kauai, HI.

Resident billing can have huge financial implications on academic institutions. A poster from the Icahn School of Medicine at Mount Sinai aimed to assess new medical coding lectures and a modified note template at Winter Clinical Dermatology Conference.

Poster Aims to Show Improvement in Resident Billing

: You might ask the question: If we potentially have oral JAK [Janus kinase] inhibitors that we get by mouth for atopic dermatitis, are you worried about systemic levels? I mean, does that worry you if it’s a transient increase?

: It’s a hard question. For the immunosuppression, I’m really not. It’s hard for me to believe that the amount that’s getting into the blood with topical ruxolitinib [Jakafi] is enough that it really is immune-suppressive. Clotting risk for blood clots are such a black and white phenomenon: you had one and then you didn’t. Maybe this increases your risk of a blood clot by 1%, but right now, if your risk at baseline is 1 in 1000 per year, and that increases it by 1% so it’s 1 in 999 people versus 1 in 1000, that’s not a very meaningful effect. But it might be 0, or it might be a tiny increase. I could imagine it. But it’s a really interesting question. The way that I phrase it for patients is that “I don’t think this has any effect on how your blood would clot, but I can’t tell you 100% that it has 0 risk. It may have a very small effect. We just don’t really know.”

: We did that maximum use study, but we also did some pharmacokinetic analyses from the phase 3 clinical trials where, again, they use it between 3% to 20%. Matt, as you mentioned earlier, we saw much lower systemic levels that were way lower than what we would expect to see orally. So I think from this basically what you’ve said, and what the data shows us, is that if you stay within the packaged label, the 3% to 20%, you can be fairly confident that the amount of systemic exposure that your patient would experience will be quite low and well below the oral levels. However, if you push it, and instead of doing 20%, you do 60%, you could potentially get a level that would be similar to what you would experience taking the struggle early. This drug is approved orally for other indications outside of dermatology. It’s not something that can’t be used by mouth because we certainly have it available by mouth.

: I always think about what the instances are where insurance and package size are actually protecting us. So it comes in a 60-gram tube, you know what? At most, you’re never going to get insurance to pay for more than 1 tube a month. So at 30 days in a month the most you’re going to get daily is 2 grams, and we know that 2 grams can treat probably 5% to 10% body surface area. So by the size of the package it would be almost impossible to treat more than 10% body surface area with this drug.

: Right. That’s definitely a good thing. You mentioned that we saw some rare systemic side effects with topical rux [ruxolitinib], but there were a few cases of thromboembolic events. On the label, they talk about serious infections. This really mirrors what we see with the oral JAK inhibitors, but they mentioned you want to watch for a serious infection. If that should occur, you want to stop taking it. They talk about TB [tuberculosis], however no cases of TB were reported in the clinical trials with topical. They talk about viral reactivation, and there were a few cases of varicella- zoster virus that did occur in the clinical trials. We saw it, so what do we make from it? It’s really kind of hard to know. And then they go into the other things like lymphoma and other malignancies. This is more appropriate to talk about with the orals, but the label includes the massive events, again more appropriate to talk about with the orals, but it’s on the label. I’m kind of going down what we’ll see in that box warning, and we did see, rarely, some cases of thromboembolic events with ruxolitinib. They didn’t find any clear relationship of the thromboembolic events and the platelet count, so we’re not really sure. For laboratory abnormalities, we very rarely saw some thrombocytopenia, some anemia, and some neutropenia ,but it’s not on the label that it is mandatory to be checking any types of blood counts, so it’s left up to the individual physician to do what you think is appropriate. That kind of goes over what we see on the label, and where that comes about. It’s not unusual that we have things on a label that are associated with the oral route, but not with the topical. We’ve seen, for instance, with minocycline, if you look at the topical minocycline foam, we know that there’s almost no systemic levels of minocycline when it’s applied topically. Yet, when we look at the package insert, they have exactly the same label as oral minocycline, even though it states on the label that none of these particular side effects have been seen with topical minocycline, yet it’s still in the label. So, this is something, and I think Matt, you would agree, that we’re used to seeing. We’re used to seeing labels that are very conservative and cause us to kind of stop and think for a minute.

Videos

Clinicians provide insight into the risk of high systemic absorption levels with JAK inhibitor treatments.

Risk of Systemic Absorption with JAK Inhibitors

 and joined the MJH Life Sciences team in September 2019. She graduated from Cleveland State University in 2018 with a bachelor's degree in journalism and promotional communications. She enjoys yoga, hand embroidery, and trying new restaurants. You can reach her at 

AbbVie, a biopharmaceutical company, recently announced the FDA approval of upadacitinib (Rinvoq; AbbVie) for the treatment of moderate to severe atopic dermatitis (AD) in patients 12 years of age and older whose disease did not respond to previous treatments, is not well controlled using other pills and injections or pills and injectables are not recommended–including biologics.

For those aged 12 years and older weighing at least 40 kg (88 lbs), upadacitinib 15 mg can be initiated. Additionally, for adults less than 65 years old who do not achieve adequate response, the dose may be increased to 30 mg once daily, according to the press release announcing the approval.

"Early in my career as an allergist, I saw how relentless the itch and rash could be for my patients with moderate to severe [AD] yet had limited options to offer those whose disease could not be adequately controlled with systemic therapy," said Thomas Hudson, MD, senior vice president, research and development, chief scientific officer, AbbVie, in the press release. "This additional approval for RINVOQ provides a once-daily oral option that can significantly improve the debilitating itch and skin symptoms of [AD]. It's also a proud moment for AbbVie as we continue our efforts to improve care in this disease state and other chronic, immune-mediated conditions."

The FDA approval comes after safety and efficacy data from 3 studies (Measure Up 1, NCT03569293; Measure Up 2, NCT03607422; and AD Up, NCT03568318), which included more than 2,500 patients. The studies reported that approximately 52% of these patients had prior exposure to systemic AD treatment. Measure Up 1 and 2 evaluated the efficacy and safety of upadacitinib monotherapy, while AD Up evaluated combination therapy with topical corticosteroids.

Study treatment using upadacitinib 15 mg and 30 mg with or without topical corticosteroids met all primary and secondary end points at week 16, with some patients achieving higher levels of skin clearance, [Eczema Area and Severity Index (EASI 90) and 100].

For itch, all 3 studies showed improvement as early as week 1, compared to placebo (worst pruritus NRS greater than or equal to 4).

"Despite available therapies, many people with moderate to severe [AD] are caught in an endless cycle of itching and scratching," said Emma Guttman-Yassky, MD, PhD, Waldman professor and system chair of dermatology at the Icahn School of Medicine at Mount Sinai in New York, New York, in the release. "In clinical trials, upadacitinib showed a robust response across skin and itch symptoms that may help evolve treatment goals for those who have not achieved adequate control of their disease. And as an oral pill with 2 dose strengths, upadacitinib is a welcome addition to the toolbox of clinicians who are striving to make a significant difference for their patients with moderate to severe [AD]."

1. U.S. FDA approves Rinvoq (upadacitinib) to treat adults and children 12 years and older with refractory, moderate to severe atopic dermatitis. AbbVie. Press Release. Published January 14, 2022. Accessed January 17, 2022. 

https://news.abbvie.com/news/press-releases/us-fda-approves-rinvoq-upadacitinib-to-treat-adults-and-children-12-years-and-older-with-refractory-moderate-to-severe-atopic-dermatitis.htm?view_id=6943

AbbVie announces the approval after 3 studies show the efficacy and safety of upadacitinib using mono- and combination therapy. 

FDA Approves Upadacitinib for Moderate to Severe AD

Ruxolitinib cream 1.5% (Opzelura; Incyte) is a first-in-class topical JAK inhibitor for short term and noncontinuous chronic treatment of mild to moderate atopic dermatitis (AD), which targets the key cytokines believed to contribute to itch and inflammation and offers a newer option for patients whose AD is uncontrolled.

In a non-continuing medical education presentation that was sponsored by Incyte and presented at the Winter Clinical Dermatology Conference this week in Kauai, Hawaii, Alexandra K. Golant, MD, who is medical director of the Dermatology Faculty Practice at the Icahn School of Medicine at Mount Sinai, explained ruxolitinib cream’s role in treating AD. This was a particularly timely talk since the FDA recently approved this product for AD.

She presented findings from Incyte’s TRuE-AD clinical trial program, which evaluated the topical in over 1,200 patients, ages 12 years and older, who had been diagnosed with AD for at least 2 years and were also candidates for topical therapy. The NDA filing also included safety and efficacy data from a supplemental 44-week, open-label, long-term extension study of both TRuE-AD1 (

, results of TRuE-AD1 showed 50% of the ruxolitinib cream 0.75% group and 53.8% of the ruxolitinib cream 1.5% group achieved the primary end point compared to 15.1% vehicle. Moreover, 56% of the ruxolitinib cream 0.75% group and 62.1% of the ruxolitinib cream 1.5% group achieved the secondary end point of 75% improvement or more in Eczema Area and Severity Index (EASI) score compared to baseline vs 24.6% vehicle.

In TRuE-AD2, 39% of patients treated with ruxolitinib cream 0.75% and 51.3% treated with 1.5% met the primary end point compared to 7.6% of the vehicle group. Also, more than 51% of patients in the 0.75% group and 61.8% of patients in the 1.5% group achieved 75% improvement or more in the EASI score from baseline, vs 14.4% vehicle, according to a press release announcing the study’s results.

Once the approval was announced, in the release, officials with Incyte advised physicians to 

educate themselves about important safety information regarding ruxolitinib

, including a recently issued boxed warning from the FDA for serious infections, mortality, malignancy, major adverse cardiovascular events, and thrombosis, seen with JAK inhibitors for inflammatory conditions.

Fielding a question from an audience member about discussing these warnings with patients, Golant advised the dermatologists in attendance to “be upfront about it,” and advise the patients: “you are going to see a boxed warning when you get this from the pharmacy, and this largely comes from not an AD population,” she said. “I do try to talk to them about the indication I’m prescribing it for, on a limited body surface area in a little period of time.” She said she also discusses the risks of their use as topicals rather than systemic.

Golant AK. Atopic dermatitis: the burden of disease and a novel topical pathway. Presented at: 2022 Winter Clinical Dermatology Conference; January 14 to 19, 2022; Kauai, Hawaii.

Incyte announces acceptance and priority review of nda for ruxolitinib cream for atopic dermatitis. Incyte. Press release. Published February 19, 2021. Accessed March 12, 2021. 

https://investor.incyte.com/press-releases/press-releases/2021/Incyte-Announces-Acceptance-and-Priority-Review-of-NDA-for-Ruxolitinib-Cream-for-Atopic-Dermatitis/default.aspx

The FDA approved the topical JAK1/JAK2 inhibitor ruxolitinib for the treatment of mild to moderate atopic dermatitis in September 2021. 

FDA Approval Gives Dermatologists New Option for Uncontrolled AD

Remembering that it is “safe to laze,” and “the redder the better,” can make treating rosacea “as easy as pie,” according to a speaker at the 19th Winter Clinical Dermatology Conference, being held January 14 to 19, in Kauai, Hawaii.

Emmy Graber, MD, board-certified dermatologist and founder of the Dermatology Institute of Boston, and affiliate clinical instructor, Northeastern University, shared these 3 pearls with the dermatologists in attendance, encouraging them that it is, in fact, acceptable to begin pulse dye lasers combined with or immediately after low-dose isotretinoin, a practice once thought incorrect.

She cited 2 different studies by Spring and Ibrahim et al, that showed this practice is safe. One of the papers was a review of 32 publications reporting 1485 procedures, that concluded: “there was insufficient evidence to support delaying manual dermabrasion, superficial chemical peels, cutaneous surgery, laser hair removal, and fractional ablative and nonablative laser procedures for patients currently receiving or having recently completed isotretinoin therapy.”

The second paper, which looked at patients with 46 patients with acne who were divided into 2 groups, 1 of which was treated with just oral isotretinoin (0.5 mg/kg/day), and compared them with a second group treated with oral isotretinoin and 5 sessions of pulse dye laser. In that study, the combined groups showed a statistically significant greater improvement regarding all parameters.

The second pearl Graber shared from her own practice, which is the “redder the better.” She said often patients will tell the physician when their rosacea flares, and a lot of times, it’s after high heat situations, like getting out of the shower or working out. She said she recreates this type of situation by keeping a hairdryer in her office and recreating the flared red appearance, to provide a clearer target for the laser.

Finally, Graber reminded her audience about the “easy as pie” rule, which means treating the post-inflammatory erythema with 3 monthly PDL treatments.

In a separate session at the meeting, Graber told the audience that “several studies have shown that basic skin care alone can improve rosacea symptoms,” and she advised the audience to share some cleansing pearls with patients with rosacea, including moisturizing and washing the face with mild products. She also advises her patients to use sunscreens and avoid alcohol-based products.

“I tell my patients to check all their products for anything on them that says alpha-hydroxy acids,” she said. “These are the things we want our patients to avoid because it exacerbates their rosacea.”

Del Rosso JQ, Bhatia ND, Graber EM, Harper JC. Clinical and therapeutic pearls in acne and rosacea. Presented at: 2022 Winter Clinical Dermatology Conference; January 14 to 19, 2022; Kauai, Hawaii.

Spring LK, Krakowski AC, Alam M, et al. Isotretinoin and timing of procedural interventions: A systematic review with consensus recommendations. 

Ibrahim SM, Farag A, Hegazy R, et al. Combined low-dose isotretinoin and pulsed dye laser versus standard-dose isotretinoin in the treatment of inflammatory acne. 

Graber EM. What’s new and hot in rosacea. Presented at: 2022 Winter Clinical Dermatology Conference; January 14 to 19, 2022; Kauai, Hawaii.

Treating these patients can be a challenge, but it can also be ‘as easy as pie’ if you follow these tips. 

Expert Pearls for Treating Rosacea Patients

Recognizing knowledge gaps can help address disproportionate treatment that affects patients with skin of color (SOC), according to a speaker at the Winter Clinical Dermatology Conference, held this week in Kauai, Hawaii.

Susan Taylor, MD, of the University of Pennsylvania’s Perelman School of Medicine, said it is important for dermatologists to understand the different presentations of conditions like atopic dermatitis (AD) and psoriasis in patients with SOC, because correct diagnosis is directly correlated with adequately treating these patients.

“Black children are nearly twice as likely to develop AD compared with White children after controlling for socioeconomic factors, and Asian and Pacific Islanders are 7 times more likely than White [patients] to be diagnosed with AD,” which makes accurate diagnosis all the more important, Taylor said.

She noted 1 of the key differences between diagnosing AD in patients with SOC is erythema.

“We think of inflammation as being red, but not so much in our patients with [SOC],” Taylor said. “That can be a problem because erythema is a significant portion of the EASI and other scoring systems for AD and as such they often underestimate AD prevalence in [SOC].”

Patients with SOC may get hypo-or hyperpigmentation, she said, and follicular morphology is more commonly seen in Black patients compared with White patients. This is key, she said, because follicular prominence in AD may be the only sign in this population.

One pearl she offered for diagnosing this condition in patients with SOC was to: “close your eyes and palpate the skin, using your fingertips may be helpful in identifying a flare.” She also said patients have variability in color in their flares, as the flares could be more brown or grey in appearance, with some scaling.

Keloidal prurigo is sometimes present in Black patients with AD, and Taylor said, Black and Asian patients may present more with lichenification when compared to White patients.

Describing other AD in SOC characteristics, Taylor noted Dennie-Morgan lines, periorbital hyperpigmentation, and palmar hyperlinerarity.

Taylor noted that several studies have also shown that SOC patients are less likely to be correctly diagnosed than white patients with skin diseases. Additionally, some studies have indicated these patients may be less likely to be prescribed proper treatment.

One study by Bell et al, demonstrated that Black patients were less likely to receive topical corticosteroids, topical immunomodulators, crisaborole, or dupilumab despite other data showing good efficacy of these medications in these population for treatment of atopic dermatitis.

Taylor S. Managing challenges in skin of color. Presented at: 2022 Winter Clinical Dermatology Conference; January 14 to 19, 2022; Kauai, Hawaii.

Bell MA, Whang KA, Thomas J, Aguh C, Kwatra SG. Racial and ethnic disparities in access to emerging and frontline therapies in common dermatological conditions: A cross-sectional study. 

One of the key differences between diagnosing AD in patients with skin of color compared to White skin is erythema.

Diagnosing Skin Issues Pose Challenges in SOC

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POLL: Are Your Patients Turning to CBD Products to Treat Skin Conditions?

Dermatologists must continue lending their voice to access issues surrounding the iPLEDGE Risk Evaluation and Mitigation Strategy (REMS) update that happened on December 13, 2021, because some patients are now going “weeks” without isotrenoin, according to a speaker at the 19th Winter Clinical Dermatology Conference, being held January 14 to 19, in Kauai, Hawaii.

Neal Bhatia, MD, FAAD, vice president of the American Academy of Dermatology (AAD),discussed the iPLEDGE situation during his presentation, echoed a recently issued letter from the academy that suggested some solutions, 

He also discussed the Academy’s top priorities of the year, which include:

Increasing access to prescription medications;

Improving access to specialty care and private and public payers;

Preserving the private practice model, even in the time of consolidation, and; 

Encouraging members to be “their best advocates.”

“Our biggest [priority] is scope of practice … emphasizing how much training it takes to get to this point and making sure we’re not getting blindsided by people who don’t have our training,” Bhatia said. “We tell people, be your own advocate, use FAAD whenever and wherever possible.”

To advocate for the good work individuals are doing, Bhatia pointed to the Academy’s website and their “Skin Serious” section, which highlights patient and physician stories, specifically, “how board-certified dermatologists assist patients with serious skin diseases to enhance care.”

“We encourage you to share your stories of treating patients during the COIVD-19 pandemic to demonstrate the dedication of dermatologists who are treating serious conditions,” Bhatia said. “Also, participate in our #chooseadermatologist campaign.”

COVID-19 was a pivotal issue for the Academy in the past 2 years, he said, as the Academy rolled our “practical and actionable information to members since the start of the pandemic,” he said, including, but not limited to, “regulatory guidance, practice guidance, and scientific developments.” He explained the Academy continues to share updates with members so that they can keep their patients informed of the latest protocols and keep up to date on teledermatology options.

In addition to continuing to roll out COVID-19 information, Bhatia also said the Academy is focusing in the year ahead, on reestablishing their in-person continuing medical education in the year ahead, with two meetings planned, including the 2022 AAD Annual Meeting, in Boston, Massachusetts from March 25-29, and 2022’s AAD Innovation Academy, planned for July 21-24 in Vancouver, Canada.

1. Bhatia N. American Academy of Dermatology update. Presented at: 2022 Winter Clinical Dermatology Conference; January 14 to 19, 2022; Kauai, Hawaii.

AAD vice president challenges dermatologists to advocate for their patients and themselves.  

FDA Approval Gives Dermatologists New Option for Uncontrolled AD

Expert Pearls for Treating Rosacea Patients

Diagnosing Skin Issues Pose Challenges in SOC

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Top Priorities for the AAD: 2022

DermView: Innovations in the Treatment of Vitiligo