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 and joined the MJH Life Sciences team in June 2022. She attended Otterbein University in Westerville, Ohio, and earned a Bachelor of Arts degree in literary studies with minors in creative writing and film studies. Prior to health care news, Kaitlyn worked in industrial marketing. She enjoys cooking, reading, and tending to her house plants. 

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In case you missed it, this week we had news about the FDA approval of deuruxolitinib for severe alopecia in adults, new nonmelanoma guidelines from the Dermatology Association of Radiation Therapy, Arcutis' submitted sNDA for roflumilast foam for scalp and body psoriasis, and more.

The Weekly Roundup: July 22-26

Investigators looked into pollutant-induced disruption of the skin barrier, increased transepidermal water loss, and heightened inflammatory responses.

Complex Relationship Between Air Pollutants and Secondary Sensitive Skin in Patients With Acne 

Iltefat Hamzavi, MD, discusses the REGINA 007 phase 2 trial evaluating MK-6194 for the treatment of non-segmental vitiligo.  

Emerging Therapeutic for Non-Segmental Vitiligo: Merck’s MK-6194

Maddi Hebebrand is an associate editor of 

and joined the MJH Life Sciences team in May 2024. She attended Baldwin Wallace University, studying Media Production and Film, and is now finishing her Masters in Digital Media through Ohio University. When she's not writing, Maddi loves to read, attend concerts and spend time with her family.

A recent study found psoriasis content deemed “unreliable” still obtained 850,000 likes.

Social Media and Psoriasis: Addressing Misinformation on TikTok

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An expert in dermatology shares his insights into the management considerations with traditionally utilized treatments for generalized pustular psoriasis and discusses the impact of a recent approval in this space.

Discussion of Traditional and Novel GPP Treatment Modalities

Dr Michael Payette discusses the patient QoL impacts and burden of generalized pustular psoriasis.

Burden and QoL Impacts on GPP

Michael Payette, MD, MBA, FAAD provides an overview of generalized pustular psoriasis, highlighting the challenges in the diagnosis of patients with this condition.

Overview of Generalized Pustular Psoriasis and Diagnosis Considerations

Hyperhidrosis is not rare. According to the 

, 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.

 wants to hear from you. What percentage of the global population is estimated to have hyperhidrosis?

 to share your hyperhidrosis insights or research.

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

Click here to answer this week's poll for Hyperhidrosis Awareness Month.

News 

Polls 

POLL: What Percent of the Global Population is Estimated to Have Hyperhidrosis?

Next weekend, more than 325 attendees from 26 states, including attendees from Canada, will convene in Orlando, Florida, from May 30 to June 2 for the 

Florida Society of Dermatology Physician Assistants

In 2023, there were an estimated 3,709 dermatology physician assistants (PAs) in the US, equating to a density of 1.11 DPAs per 100,000 people.

The conference is primed to have its largest year yet, with more sponsors and attendees than ever before and broadened aesthetic educational opportunities and lectures.

With a blend of physician, PA, and nurse practitioner speakers, the volunteer-run conference will also feature renowned individuals in the dermatology and aesthetics spaces, including Erika Bunny (

); Suneel Chilukuri, MD, FAAD, FACMS; Hayley Wood, NP; Hadar Lev-Tov, MD; and Mark Kaufmann, MD, FAAD, past president of the American Academy of Dermatology.

At this time, registration for the conference is nearly full. Interested attendees are invited to visit the 

General Education and Personalizable Tracks

Tiffani Botts Massey, PA-C, is the president elect of the FSDPA and works alongside Scott Freeman, PA-C, to select all of the conference's lecture topics and speakers. Speakers are chosen by hand and individually invited to participate via Botts Massey and Freeman's personal emails, adding a personalized, hands-on touch to outreach.

Freeman is spearheading the conference's general sessions, while Botts Massey looks forward to the conference's use of tracks this year.

"I think I'm most excited about that," she said. "It's going to make it so we can do some really deep dives into some amazing medical dermatology topics in the general sessions. We have created a beginner track, which is geared for PAs with either no derm experience, or PAs and nurse practitioners, about how to deal with these advanced medications we write, feeling comfortable with Accutane...stuff that we all would have loved to have when we were beginning."

Botts Massey is most proud of the conference's aesthetic track, which includes lectures from top aesthetic providers in the country, with the opportunity for attendees to partake in hands-on, intimate workshops and watch injection and laser demonstrations up close.

"I think one of the things that the FSDPA has always been known for is bringing really high value education that's not going to cost an arm or a leg. Especially in aesthetics, just a ticket in the door is almost $1,000 for an aesthetic conference," she said. "That's without any workshops or anything. We are just lucky that this is our 16th year; we've been doing this long enough that we can bring in some of the big guns."

Heather Gates, PA-C, is the current president of the FSDPA and the organization's current conference director. Gates serves as a primary liaison for the conference's accommodations, staffing, vendors, and industry partners. She echoed Botts Massey's excitement about the conference's tracks.

"I think that this is going to be really great," she said. "People can really dive in according to where they are in the dermatology space, whether they just do general dermatology, whether they just do aesthetics, or if they do a little bit of both, they can kind of tailor that to their own practice. You need to cater to everyone. You need to have those high-level talks for the experienced derm provider, but you also need to teach people who are new grads or have only been practicing for a few years. I think it's going to be a really great opportunity for whoever comes to have education tailored to their specific needs."

"This is our passion project," Gates said. "We work really, really hard to not only make the education great, but the experience great, as well."

Both Botts Massey and Gates hope attendees will take away practical pearls with the ultimate goal of advancing patient care.

"This is my conference I go to when I want a lot of pearls. I don't need like the basics; I want to know things that are going to help me in practice, whether that's surgical techniques, or billing and coding," Botts Massey said. "I usually come home my notebook full of all my notes, and I just hope that it's going to be like that for everybody. I hope that they walk away with some really helpful knowledge that they're going to be able to immediately utilize in their everyday practice."

Gates hopes attendees can also walk away from the conference feeling a sense of community.

"While we may look like a small, little regional society, it's really become a national conference. I'm hoping that people can improve patient outcomes from this across the US," she said. "Additionally, just develop a support network across Florida and the US too, because you meet so many different people who are nurse practitioners, PAs, doctors, from all over. It can create this nice dermatology community that becomes a support network for each other, and you can reach out to somebody if you have questions or need help, too. Here in Florida, it's truly a derm community, and we're trying to create that everywhere."

For more information on the conference and how to register, visit 

 or connect with the FSDPA team by emailing 

FSDPA. 2024 New Wave Dermatology Conference. Accessed May 22, 2024. 

https://fsdpa.org/events/2024-new-wave-dermatology-conference/

Burshtein J, Zakria D, Shah M, Miller Lauren, Rigel D. Trends in US dermatology physician assistant density 2016-2023: a cross-sectional analysis. 

Tiffani Botts Massey, PA-C, Florida Society of Dermatology PAs President Elect, and Heather Gates, PA-C, the organization's current president, preview the upcoming conference.

clinical

Previewing the 2024 New Wave Dermatology Conference

The 2024 Diversity in Dermatology conference held March 21 to 24 in San Antonio, Texas, provided attendees with a targeted educational opportunity that focused on various aspects of diversity within dermatology.

The 4-day CME conference covered specialized topics such as caring for patients with skin of color, cultural competency, women empowerment, dermatologic care for members of the LGBTQIA+ community, and more. While the conference only lasted 4 short days, the information presented remains crucial in ensuring equitable dermatologic care for all patients.

 spoke with conference faculty and presenters to discuss pearls and lessons learned from the meeting, including caring for patients with sexually transmitted diseases (STDs), using dermatopathology in skin of color, managing inflammatory skin conditions in women, and ensuring patients are able to access the care and treatments they need.

Amy Spizuoco, DO, FAOCD, is a dermatopathologist and dermatologist in New York, New York, as well as the owner and founder of True Dermatology, the past president of the American Osteopathic College of Dermatology, and an associate professor at the Icahn School of Medicine at Mount Sinai in New York, New York. Spizuoco spoke at 2 sessions at the conference, one of which was titled “The Story Behind STDs.”

Spizuoco shed light on the misconceptions and stigmas surrounding STDs, particularly within diverse communities. She emphasized the importance of educating both health care providers and patients about the prevalence of STDs across all demographics and the necessity of accurate testing and diagnosis to combat stigmas effectively.

“Everyone is at risk of getting an STD, not particular groups or individuals based on sexual preference,” she said.

Spizuoco’s other session, “Everything You Need to Know About Dermatopathology and the Dermatopathologist,”

 delved into the role of dermatopathology in diagnosing skin diseases in diverse patients. Through biopsy and microscopic analysis, dermatopathologists can provide precise diagnoses, differentiate between various pathogens, and determine the appropriate treatment strategies. Recent advancements in dermatopathology techniques, including specialized stains and immunohistochemical analyses, have significantly enhanced diagnostic accuracy and patient care outcomes.

Spizuoco highlighted the significance of fostering a sensitive and empathetic environment within health care practices, ensuring that patients receive personalized and respectful treatment regardless of their cultural or social identities.

Mona Shahriari, MD, FAAD, is an assistant clinical professor of dermatology at Yale University School of Medicine in New Haven, Connecticut, and the associate director of clinical trials at Central Connecticut Dermatology Research. Shahriari spoke at 2 sessions, “Being Sensitive in an Inclusive Environment”

 and “Special Considerations of Treating Inflammatory Skin Disease in Women.”

Shahriari underscored the importance of clinicians acknowledging their biases and assumptions, fostering an environment where patients feel heard and respected to build trust and enhance treatment adherence.

When treating women with inflammatory skin conditions during their childbearing years, Shahriari highlighted the importance of discussing family planning and contraception as integral components of treatment regimens, considering the potential impacts of uncontrolled inflammation on both the mother and the unborn baby. Shared decision-making emerged as a fundamental aspect of navigating treatment options, ensuring that patients are empowered to make informed choices aligned with their preferences and health needs.

“You want to continue to have conversations about family planning with all women of childbearing potential who are receiving any therapy, whether it’s systemics for inflammatory skin disease, systemics for acne, because 50% of all pregnancies are unplanned, and 80% of patients don’t tell their provider when they’re trying,” she said. “It’s really important to just have those ongoing conversations so patients are aware that there are options out there. If they flare, they should go off certain medications at certain time points. This way, the patient can feel like they have the right knowledge to make the correct decision.”

Shanna Miranti, MPAS, PA-C, is a board-certified physician assistant at Riverchase Dermatology in Naples, Florida, and 

’ summer editor in chief. Her session, “Conquering the Denial Hurdles—Getting Your Patient on the Right Drug,”

 explored the nuances of helping patients access the latest therapies. This access may be hindered due to new processes for specialty medications and prior authorization forms.

“Patients often wait weeks to months to come see us, and they will be paying a specialty co-pay often to see us in our practices. So, we should not just offer our patients generics that have been around for 20, 30, or 50 years, or generics that they may have already tried and failed previously with their primary care physician,” she said. “I think as dermatology providers, we need to remember to actually kind of familiarize ourselves with patients’ formularies.”

Spizuoco A. The story behind STDs. Presented at the 2024 Diversity in Dermatology conference, March 21-24; San Antonio, TX.

Spizuoco A. Everything you need to know about dermatopathology and the dermatopathologist. Presented at the 2024 Diversity in Dermatology conference, March 21-24; San Antonio, TX.

Shahriari M. Being sensitive in an inclusive environment. Presented at the 2024 Diversity in Dermatology conference, March 21-24; San Antonio, TX.

Shahriari M. Special considerations of treating inflammatory skin disease in women. Presented at the 2024 Diversity in Dermatology conference, March 21-24; San Antonio, TX.

Miranti S. Conquering the denial hurdles—getting your patient on the right drug. Presented at the 2024 Diversity in Dermatology conference, March 21-24; San Antonio, TX.

Discover pearls on caring for patients with STDs, using dermatopathology in SOC, managing inflammatory skin conditions in women, and ensuring patients are able to access care needed.

Pearls From the Diversity in Dermatology Conference

, an independent testing lab, recently petitioned the 

 to recall several popular benzoyl peroxide (BPO)-containing acne products, including those from Proactiv, Clinique, and Clearasil, which were found to contain high levels of benzene.

Their testing revealed that some products contained up to 12 times the allowed amount of benzene, with levels increasing even more at higher temperatures meant to simulate product breakdown over time.

The "BPO bombshell," as named by dermatology physician assistant Shanna Miranti, MPAS, PA-C, dropped just days before the American Academy of Dermatology Annual Meeting in San Diego, California. 

In the time since, dermatology clinicians have taken to social media and extensively discussed the topic with their colleagues. What has transpired has been a collective sense of unease--whether with BPO-containing products or Valisure's findings. 

recently spoke with trusted dermatologists and physician assistants and asked them to share their insights and impressions on the findings, including what actions they are encouraging their patients to take in the days to come.

Below, we highlight insights from Adewole (Ade) Adamson, MD, MPP; John Barbieri, MD, MBA, FAAD; Renata Block, MMS, PA-C; Christopher Bunick, MD, PhD; Zoe Diana Draelos, MD; Henry Lim, MD; Shanna Miranti, MPAS, PA-C; and Dustin Portela, DO.

Board-Certified Dermatologist (Austin, TX)

Assistant Professor of Internal Medicine (Division of Dermatology), Dell Medical School at the University of Texas at Austin

"The findings from Valisure need to be put in proper context. The investigators tested the breakdown of benzoyl peroxide to benzene at various temperatures (including body heat) but only showed data for temperatures that are unrealistically high for the way most people store their benzoyl peroxide products. While the findings should be noted, further testing under normal circumstances is required before even suggesting that benzoyl peroxide is unsafe and requires removal from drug store shelves. Bottom line, Valisure has not demonstrated that benzoyl peroxide is unsafe for patients."

Board-Certified Dermatologist (Boston, MA)

Director, Advanced Therapeutics Acne Clinic, Brigham and Women's Hospital

Assistant Professor of Dermatology, Harvard Medical School

"This is an important issue that warrants our attention. We certainly do not want acne patients being exposed to benzene from benzoyl peroxide and should work to develop techniques to better stabilize this important ingredient for acne care. However, we also need to see more data about potential benzene formation under more routine storage conditions, such as room temperature or refrigerated. It is unfortunate that Valisure did not include detailed data about these important questions in the report. It is possible that we can continue to use benzoyl peroxide safely if stored appropriately and not kept for long periods of time. We also must keep in mind that if we stop using benzoyl peroxide, we will be forced to instead use other treatments that might have their own potential risks, such as oral antibiotics or isotretinoin."

Board-Certified Physician Assistant (Munster, IN)

Member, Dermatology Times Editorial Advisory Board

"As someone who has always loved chemistry and research, I understand the reasoning behind the testing, which concerns the safety of the products throughout their lifecycle. However, I have many questions about the testing. I would like more details. Why were these products chosen? Why are products releasing different amounts of benzene (i.e., is there a standard of how stable benzoyl peroxide has to be before it is packaged)? What are the safety requirements for transportation (aka the hot car) and storage of these products before they reach the consumer? Does the packaging matter, or where are they manufactured? What were the levels of benzene before Valisure incubated the products? Finally, who is funding the testing and why? Suppose the results are credible, as they have been with other products tested by the facility. We will need a significant overhaul of the safety of manufacturing, distribution, and quality control of all products on the market. 

Unfortunately, many rumors are being propagated instead of facts, which is disturbing as people are misinformed and misguided. Speculation about the 'why' Valisure even did the testing is surfacing among chemists, dermatologists, and the general public. It is for the safety of the consumer because, in the end, that is who is mainly affected. Many people are confused, worried, and wondering what to do. I have had numerous people reach out to me to obtain the list of products tested and what is recommended in place of these products. Another concern I have seen trending is that many more products and brands are on the market than the ones tested and how people should proceed with the products. Without giving any medical advice, I would suggest waiting to use the list of products until we get more information and a formal response from the FDA. In the meantime, other alternatives, such as OTC sulfur products, salicylic acid, and AHA, can be used. If people are concerned about flaring, I strongly suggest they make an appointment with their dermatology practitioner, who will help guide them and provide reassurance."

Board-Certified Dermatologist (New Haven, CT)

Associate Professor of Dermatology, Yale School of Medicine

Physician-Scientist, Yale School of Medicine

"I want to reiterate first and foremost that there is not a safe level of benzene that can exist in any skin care product, over the counter or prescription. Benzene is highly carcinogenic, and recently we've seen the US Food and Drug Administration agree with this position by taking action to ensure removal of carbomers contaminated with benzene from manufacturing processes.

Here, it is not contamination, rather benzoyl peroxide breaks down into benzene, stimulated to do so by the formulation of the products themselves. What is concerning is that nearly all benzoyl peroxide-containing products tested formed benzene (even the new triple combination topical), often at levels 2 to 1000X higher than the emergency/conditional FDA limit of 2 ppm. To make matters worse, benzoyl peroxide breakdown into benzene was accelerated by exposure to elevated temperatures equivalent to a hot bathroom or car, meaning that patients and consumers must be mindful of how to store their benzoyl peroxide-containing product (not in a car!). Even more concerning, as benzoyl peroxide breaks down into benzene, the gaseous form of benzene was found to penetrate through sealed packaging at levels nearly 1000X higher than EPA lifetime exposure limit (0.4 ppb) for the increased risk of 1 cancer per 100,000 people. Thus, benzoyl peroxide-containing acne products unsuspectedly are also an inhalation risk."

Board-Certified Dermatologist (High Point, NC)

Consulting Professor Dermatology, Duke University School of Medicine in Durham

Dermatology Times Editor in Chief Emeritus

"This is a major issue for dermatology as BPO is one of our most effective acne drugs and has been used for years with great safety. It is well known that BPO is unstable and that it must be specially handled and packaged. I think it needs to be stated that prescription drugs or OTC drugs that contain BPO carry labeling noting how the product is to be properly stored for safety reasons. Subjecting BPO to temperatures above those recommended on the packaging is not appropriate. The current news stores questioning the safety of BPO under heated conditions outside the recommended range resulting in benzene production is not good science and should be disregarded."

Board-Certified Dermatologist (Detroit, MI)

Past President, American Academy of Dermatology

"Clearly this is something that needs to be investigated further. This is a new issue that we all have to deal with. To be cautious, probably one needs to tell our patients that the data is still in flux. If they are concerned, they can use other products.”

Board-Certified Physician Assistant (Naples, FL)

"In response to the BPO bombshell that was dropped just prior to the AAD this year, a lot as practicing dermatology APPs are seeking more information and guidance on how to now counsel our patients. It’s as if a very reputable source came out and told us that ‘exercise is bad for you’. We all innately know that exercise done the wrong way, or overdone could potentially lead to problems, but could it REALLY cause harm? The first rule of medicine is 'Do no harm!' and up until last week… BPO had a pretty good track record. Benzoyl peroxide is currently found in dozens of prescription medication‘s and probably hundreds of different OTC formulations.

Benzoyl peroxide has been used for skin conditions since the early 1900s. It is used in dentistry to whiten teeth, and at the beauty parlor to bleach hair. It’s even used to bleach flour (and fabrics!). It is even on the World Health Organization’s list of essential medications. In dermatology and infectious disease, we have been trained that the presence of benzoyl peroxide can reduce the risk of microbial resistance.

We are trained with evidence based medicine. So many of us now want to see the data. We want to know if benzene is present in these formulations or if the original organic BPO molecule was tested at unnaturally high temperatures and broke down into another chemical structure? How do we preserve this important medicine? Will cold-chain shipping to the pharmacy, and temperature controlled delivery to patients reduce the risk? How can we be sure that OTC formulations that patients are buying on their own have not been exposed to high temperatures? I’m sure I’m not the only provider that wants to know more!"

Board-Certified Dermatologist (Boise, ID)

We spoke with several dermatology experts to gauge their thoughts on Valisure's recent findings of benzene in benzoyl peroxide products--as well as what actions they plan to take moving forward.

Michael Payette, MD, MBA, FAAD

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