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Researchers say a new skin cancer treatment that uses radiation to kill benign tumors with a single application of cream could be a viable alternative to surgery.

The Food and Drug Administration has approved prescription-strength lotion Sklice (Sanofi Pasteur) for the treatment of head lice in children ages 6 months and older.

The Food and Drug Administration has created the first shortcut to the U.S. market for “biosimilar” medicines - cheaper versions of expensive and complex biologic drugs such as infliximab for rheumatoid arthritis, etanercept for plaque psoriasis and psoriatic arthritis, and erythropoietin for anemia.

A new study has identified key signals that regulate protective and sometimes pathological skin inflammation, and also identifies a “gatekeeper” that, when lost, can cause inflammatory skin disease in the absence of injury or infection.

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Biologic drugs have proven to be of benefit for diseases where there is no indicated treatment, such as for immunobullous diseases. "Pemphigus vulgaris with rituximab (Rituxan, Genentech) has been a major advance, although this is not a formally approved indication for the drug," says Alan Menter, M.D., chief, dermatology, and chairman, residency program, Baylor University Medical Center, Dallas.

Politicians on Capitol Hill once again have dermatologists - and all physicians who serve Medicare patients - wondering what in the name of common sense they are going to do. Just before Christmas, Congress delayed a 27.4 percent Medicare fee cut from its original Jan. 1 implementation date. The cut is now scheduled, barring any further congressional action, to take effect Feb. 29.

Even though botulinum toxin type A is one of the most potent neurotoxins known, its injection into muscles for the reduction of hyperfunctional lines is one of the safest procedures being performed in cosmetic dermatology. And the favorable risk-to-benefit profile of the toxin is fueling its use in an expanding number of off-label applications, says Thomas E. Rohrer, M.D.

Biologic therapies can help patients with dermatologic conditions, providing anti-inflammatory benefits without significant effects on other organ systems, says Steven R. Feldman, M.D., Ph.D., professor of dermatology, pathology and public health sciences, Wake Forest Baptist Medical Center, Winston-Salem, N.C.

In 2009, the federal government launched its Electronic Prescribing (eRx) Incentive Program. Although this program (which was authorized in the Medicare Improvements for Patients and Providers Act of 2008/MIPPA) is now three years old, physicians remain confused about the details. Fortunately, the eRx Incentive Program is straightforward.

Analyzing 18th and 19th century (Victorian-era) paintings can help dermatologists think beyond their established habits and preconceptions in the search for visual and other diagnostic clues, says Irwin Braverman, M.D., professor of dermatology, Yale School of Medicine.

Implementation of the final regulations from the Food and Drug Administration for sunscreen testing and labeling should enable consumer selection of effective sunscreen products. More work is still needed, however, to better educate the public about the damaging effects of UV exposure and to motivate appropriate sunscreen use, says Vincent A. DeLeo, M.D.

New safety profile data continues to emerge on biologics used in psoriasis. Among the findings: Today's biologics do not appear to increase serious infection risk; the drugs' short-term cancer risk profile is promising; but concerns remain about long-term cancer risk with all biologics and cardiovascular risk with interleukin-12/23, ustekinumab (Stelara, Janssen Biotech).

Drugs, by definition, are not safe. Exactly how safe a drug must be is a topic of much controversy. However, it is hard to determine the safety of many drugs because the inclusion/exclusion criteria for study protocols requires that the drug be studied in persons who are not pregnant or lactating and who are usually above the age of 12, and in those who have normal test results and normal physical exams.

A naturally secreted, embryonic-like human cell conditioned media (hCCM) used as a follicle holding solution (FHS) holds promise for improving outcomes of hair transplantation surgery, according to clinical trial findings reported by Neil S. Sadick, M.D., at the 2011 annual meeting of the American Society for Dermatologic Surgery.

Dermatologists are increasingly turning to "extenders" - physician assistants and nurse practitioners - to combat a shortage of doctors in the specialty. These mid-level providers and the physicians who hire them say teamwork and training are among the keys for successful collaborations.

Beginning in 2003, with approval of human collagen and in the following years the introduction of products containing hyaluronic acid, calcium hydroxylapatite, poly-L-lactic acid and more, it's no surprise that fillers have taken on an ever-increasing role in aesthetic dermatology. On Call wondered whether dermatologists' treatment techniques have changed as a result of the growing array of product options, and if so, how.

The p53 gene is very important in dermatology for the prevention of skin cancer. P53 is the gene that is activated when viable epidermal skin cells are damaged by UV radiation. UV radiation strikes the skin and is first transformed to heat by an organic sunscreen and possibly reflected by an inorganic sunscreen. If the sunscreen fails to diffuse all of the damaging UV radiation, keratinocytes function to reflect and scatter the radiation.

Born into an accomplished dermatology family, Ethan Lerner, M.D., has had to ask himself if he had any choice but to join the specialty. His father, the late Aaron B. Lerner, M.D., former professor and chairman of the Yale University dermatology department, discovered melatonin and developed transplantation therapy for vitiligo.

The unique needs of infants with severe atopic dermatitis require special attention. As such, says Mary Wu Chang, M.D., associate clinical professor of dermatology and pediatrics, University of Connecticut School of Medicine, "This is not something you can handle in a 15-minute visit."

Future management of actinic keratosis (AK) and nonmelanoma skin cancer (NMSC) will involve creative uses of conventional therapies, particularly in multimodal regimens, and it will be expanded by recent advances in chemotherapy, according to Theodore Rosen, M.D., who spoke at the 30th annual Fall Clinical Dermatology Conference.

Biosimilars are designed to mimic biologic agents, but they are not precise duplicates of these drugs. Biosimilars may prove useful for treating skin conditions such as psoriasis, but clinicians are waiting for guidance on the drugs from the Food and Drug Administration, which was still pending at press time.

Dr. Doe has practiced dermatology for more than three decades and has seen many of his patients become quite elderly. He is saddened by the senility of some of these patients, and he is worried about their ability to consent to various office-provided procedures. One of his patients with dementia has a brother who holds a power of attorney that becomes effective when the described patient is no longer able to make decisions for himself.