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Itch Treatments

San Francisco - A better understanding of the pathophysiologic mediators of itch has led to some novel and promising approaches to its successful treatment, Gil Yosipovitch, M.D., said at the annual meeting of the American Academy of Dermatology. Several exciting systemic therapies approved for the treatment of various neurologically mediated disorders now show potential in the treatment of itch.

Pain in the Mouth

San Francisco - Aphthous stomatitis (canker sores) often are not considered to be anything more than a nuisance, but patients who suffer from complex aphthosis experience considerable pain and limitations to normal activities, like eating and talking.

San Francisco - Clinical research is not only an indispensable research activity with the potential to improve the quality of healthcare, Wilma F. Bergfeld, M.D., said at the annual meeting of the American Academy of Dermatology. There have been changes in international and FDA regulations that physicians need to stay abreast of, including changes in international and federal regulations and guidelines for research involving women and children.

Photo Remedy

San Francisco - Phototherapy is effective for a host of skin conditions, but many dermatologists reserve it only for what it is best known for: psoriasis.

San Francisco - Results from premarketing clinical trials indicate that the usual efalizumab (Raptiva) dosage for the treatment of psoriasis will involve ongoing therapy with 1 mg/kg in the vast majority of patients, but alternate dosing regimens for fine-tuning management may benefit certain subgroups of patients, Kim A. Papp, M.D., said at the annual meeting of the American Academy of Dermatology.

Psoriasis Summit

San Francisco - While the 2002 Psoriasis Therapies Educational Summit Meeting successfully fostered various educational programs about new and emerging modalities for psoriasis treatment, many questions still linger, Jeffrey P. Callen, M.D., told attendees of the annual meeting of the American Academy of Dermatology. Specifically, questions regarding the use of biologic agents remain unable to be answered, Dr. Callen said.

Arising Allergies

San Francisco - Oatmeal, sunscreen ingredients, and newer plastic products are causing some of the latest allergies confronting dermatologists. The number of patients experiencing sensitivity to these products can be expected to increase, Robert L. Rietschel, M.D., said.

San Francisco - Consumer interest in alternative and complementary medicines continues to grow; hence, dermatologists need to be knowledgeable about herbal remedies and query patients carefully about their use. Some agents have the potential to cause adverse effects or serious drug interactions, Mary Ruth Buchness, M.D., said at the annual meeting of the American Academy of Dermatology.

San Francisco - Low and ultra-low doses of isotretinoin are an effective therapy for many acne patients. This safer and cheaper solution can even be used continuously.

Filler vs. Filler

San Diego - Legal disputes between companies regarding assumptions of patent right and licensing normally are not important to physicians using the products, but a recent action initiated by Artes Medical against competitor BioForm Inc. suggests a dispute could reach the user-level.

Monkeypox Emerges

Marshfield, Wis. - A dermatologist here played a key role in what became the index case for the first reported outbreak of monkeypox virus in the Western Hemisphere.

Q. I've heard so many horror stories about other dermatologists not being able to retire when they wanted to for financial reasons. What can I do to avoid that situation?

After treatment with the new biologic agents, patient-reported outcomes measuring quality of life were evaluated, since psoriasis has been shown to have a significantly negative impact on patients' physical, psychological, and social functioning.22 Because the condition can affect the ability to perform normal work activities and often causes absence from work, psoriasis can negatively affect a person's job and income.

An open-label study was undertaken to evaluate the safety, tolerability, and efficacy of continuous efalizumab therapy in patients achieving PASI 50 or an OLS grade of Mild, Minimal, or Clear at 12 weeks of therapy.

Efalizumab is a humanized IgG monoclonal antibody directed against the alpha chain of LFA-1 (CD11a) expressed on the surface of T cells.11 Efalizumab blocks the interaction between LFA-1 and ICAM-1 on APCs, vascular endothelial cells, and cells in the dermis and epidermis.

In order to understand the clinical relevance of T-cell-specific agents in the treatment of psoriasis, dermatologists first must understand the role of T cells in the pathogenesis of psoriasis. Before the mid-1980s, psoriasis was believed to be predominantly a disease of abnormal regulation of keratinocyte growth and differentiation.

San Francisco - Two research projects have serendipitously led one researcher to a third study - with an unanticipated result.

Allergen Watchdogs

San Francisco - Supplemental patch testing for allergens not included in TRUE Test is necessary, albeit less convenient, for dermatologists, according to Erin M. Warshaw, M.D.

San Francisco - A randomized, two-center study conducted at the University of Cincinnati and Oregon Health & Science University suggests that topical bexarotene gel (Targretin) 1 percent monotherapy may be a promising new treatment for severe chronic hand dermatitis.

Pondering Pruritus

San Francisco - A fuller understanding of the pathophysiologic processes of pruritus associated with atopic dermatitis (AD) may yield effective new therapies, Martin Steinhoff, M.D., Ph.D. said at the annual meeting of the American Academy of Dermatology.

San Francisco - Bacitracin, the widely used topical antibiotic, has been named "Contact Allergen of 2003."

At first glance, it appears to be a routine office chore. You have a position to fill, so you or one of your employees must interview the applicants and select the most promising individual.

San Francisco - Injected silicone may not be as safe as many physicians believe. Long-term complications are popping up, even in patients who were treated appropriately by trained physicians using good techniques and clean, unadulterated material.

San Francisco -- Topical application of a moisture-based formulation containing Total Soy can significantly reduce the appearance of male beard hair on the face and neck, according to the results of a double-blind, randomized, placebo-controlled study.

San Francisco - Physicians require proper training in order to inject botulinum toxin appropriately. The treatment can be a safe and relatively straightforward way of treating fine lines, but in the wrong hands, results may be far from satisfactory.

Cosmetic Conundrums

Q. What is the practical difference between a cosmetic and a drug? A. This is a very interesting question. At face value the question seems somewhat simplistic, since all dermatologists know that a drug requires a prescription and a cosmetic does not.

Tissue Engineering

San Francisco - Tissue engineered skin has been a significant advance for wound care and holds future promise for enhancing treatment of other dermatologic problems and even as a drug delivery system, Robert S. Kirsner, M.D., said at the American Academy of Dermatology.

No Pain, Some Gain

Maui, Hawaii - Topical anesthetics represent the state-of-the-art for minimizing pain and anxiety in procedures ranging from filler injections and chemical peels to those used in pediatric dermatology, Lawrence F. Eichenfield, M.D., said at the annual Hawaii Dermatology Seminar, sponsored by the Skin Disease Education Foundation.

San Francisco - Topical ALA (5-aminolevulinic acid HCl) photodynamic therapy using a nonlaser blue light source is a safe and effective treatment for multiple actinic keratoses when applied to a 25 cm2 area of skin or scalp containing lesions, according to a Phase II multicenter study.

Boston - Combined cytotoxic and antiangiogenic therapies may have synergistic effects in treating advanced Kaposi's sarcoma in patients with AIDS, according to Richard F. Little, M.P.H., M.D., senior clinical investigator, HIV and AIDS malignancy branch, Center for Cancer Research, National Cancer Institute.