Yearly STL Archives: 2016
A Review of Ixekizumab, an Anti-Interleukin-17A Monoclonal Antibody, for Moderate-to-Severe Plaque Psoriasis
Recent advances in our understanding of the innate and adaptive immune systems have led to the identification of interleukin (IL)-17 as a key pro-inflammatory mediator in psoriasis. We review phase 1-3 clinical trials of ixekizumab, for treatment of moderate-to-severe plaque psoriasis.
Update and discussion on onychomycosis (nail fungus) and Efinaconazole 10%. Recent clinical trial results, and discussion about patient safety profile, special cases like diabetic patients, and cure rates.
Update on drugs, approval dates, and comments. Brodalumab for SC injection (Lumicef®), Etanercept-szzs for SC injection (Amjevita™), Propranolol hydrochloride oral solution 3.75 mg/ml (Hemangiol®), Calcipotriol 50 mcg/g + betamethasone dipropionate 0.5 mg/g foam (Enstilar®) are covered.
Actikerall™ (5-Fluorouracil 0.5% and Salicylic Acid 10%) Topical Solution for Patient-directed Treatment of Actinic Keratoses (Family Practice)
Actinic keratosis, a common cutaneous lesion with the potential to transform into squamous cell carcinoma. Recently, a topical formulation Actikerall, combining 0.5% 5-fluorouracil with 10% salicylic acid (5-FU-SA) has been made commercially available in Canada. We discuss their merits.
Phosphodiesterase 4 (PDE4) is a key enzyme in the regulation of immune responses of inflammatory diseases through degradation of the second messenger, cyclic adenosine 3',5'-monophosphate (cAMP). Apremilast (APR), a selective PDE4 inhibitor, has been shown to reduce the production of pro-inflammatory cytokines.
Hand Dermatitis can have a significant impact on quality of life. It may interfere with activities both at work and in the home and can be associated with social and psychological distress. This article provides helpful practical guidance for the general practitioner in the management of patients with Hand Dermatitis.
This update covers Pembrolizumab IV injection (Keytruda®), Hyaluronic acid gel filler (Juvéderm Volbella® XC), Biosimilar of infliximab (Flixabi®), Ceftaroline fosamil for IV infusion (Teflaro®), Dermal filler with calcium hydroxylapatite (CaHA) + integral 0.3% lidocaine (Radiesse® + Lidocaine), Ixekizumab SC injection (Talz®), Adapalene gel 0.1% (Differin® Gel), C1 esterase inhibitor(human) for IV infusion (Berinert®)
Sodium Deoxycholate for contouring the jawlines are discussed. With recent approval in Canada (Belkyra™), and the US (Kybella®) for the treatment of submental fat, this is a timely review of this injectable. Clinical trial results, indications, safety and efficacy are discussed.
Frontal fibrosing alopecia has become one of the most frequently seen causes of scarring alopecia at many specialist hair clinics. It has distinctive features and associations which distinguish it from LPP. Discussion includes familial or genetic factors, etiology, and trials.
Adalimumab (Humira®) is a novel therapy approved by the US Food and Drug Administration, Health Canada, and the European Commission for the treatment of hidradenitis suppurativa (HS). Discussion includes, safety and efficacy in clinical trials.
Update on Betamethasone dipropionate 0.05% spray (Sernivo™), Dapsone 7.5% gel (Aczone®), Cobimetinib + vemurafenib (Cotellic™ + Zelboraf®), Botulinum toxin type A for injection (Bocouture®), Calcipotriol + betamethasone dipropionate foam (Enstilar®), (Talz®), (Inflectra™), (Pruridexin™), and (Dermadexin™)
This update summarizes current concepts, relevance, and therapeutics in psychodermatology, including aspects pertinent to depression, anxiety, obsessive-compulsive, impulse-control, and delusional disorders as described in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
Actikerall™ (5-Fluorouracil 0.5% and Salicylic Acid 10%) Topical Solution for Patient-directed Treatment of Actinic Keratoses
A topical formulation combining 0.5% 5-fluorouracil with 10% salicylic acid (5-FU-SA) was introduced in Europe under the trade name Actikerall™ for the treatment of AKs. Now commercially available in Canada, 5-FU-SA represents a patient applied therapeutic option. Clinical trial data is considered.
Update on (Beteflam™), Human papillomavirus (HPV) 9-valent vaccine, recombinant (Gardasil®9), (Imlygic®), Pembrolizumab IV injection (Keytruda®), Adalimumab SC injection (Humira®), Secukinumab SC injection (Cosentyx®), Ustekinumab SC injection (Stelara®), and Nivolumab + ipilimumab (Opdivo® + Yervoy®).
An overview and update of skin treatments introduced in 2015: Quick overview of drug name, indications and regulatory status. Deoxycholic acid injection, 5-fluorouracil 0.5% + salicylic acid 10% solution, Adapalene 0.3% + benzoyl peroxide 2.5% gel, and more are covered.
Melanoma is an aggressive skin cancer with a generally poor prognosis at Stage III-IV disease. Discussion centres around clinical trial data from phase I-III studies of Nivolumab (Opdivo®), a human monoclonal antibody which prevents immune inhibition by interacting with PD-1 on tumor cells.
Standard therapies for atopic dermatitis have fallen short, prompting efforts to discover novel therapeutics for this disease. Dupilumab, a fully human monoclonal antibody that inhibits the actions of both IL-4 and IL-13, has shown promise.
January and February 2016: Update on drugs, approval dates, and comments. Autologous cell suspension (ReCell® ReGenerCell® ReNovaCell®), Calcipotriene 0.005% + betamethasone dipropionate 0.064% foam (Enstilar®), Ipilimumab (Yervoy®), Talimogene laherparepvec (T-Vec) oncolytic virus therapy (Imlygic™), Cobimetinib + vemurafenib (Cotellic™ + Zelboraf®), Dabrafenib + trametinib (Tafinlar® + Mekinist®), Nivolumab injection (Opdivo®) are covered.
Topical calcineurin inhibitors (TCIs) have been proposed as an alternative, long-term treatment option to topical corticosteroids. Currently, TCIs are only approved for treatment of atopic dermatitis in patients 2 years of age or older. This article reviews the off-label uses of TCIs and their efficacy in the treatment of cutaneous diseases.
Treatment of PIH and melasma is challenging. There are no singular therapies that are efficacious on its own. Management, sun protection, topical lightening therapy and other treatment modalities are considered in this discussion on these growing concerns.
Why is Mohs Surgery considered the world's gold standard treatment for BCC and SCCs? Dr. Bryce Cowan explains the types of cancers that are typically treated with Mohs surgery, and why the procedure has such as high cure rate.
In the third video of the Mohs Surgery series, plastic surgeon Dr. Bryce Cowan explains in further detail the combined process of surgical excision and real-time histological analysis of the excised tissue.
Patients often wonder why Mohs is not the standard treatment for invasive melanoma, the most dangerous of skin cancers. Dr. Cowan explains why the use of Mohs surgery is considered controversial for treating invasive melanomas.
A very common question from patients concerning Mohs Surgery is “Will I need reconstruction surgery?” Dr. Bryce Cowan explains why reconstruction surgery is necessary to optimize the final outcome, and outlines the process and importance of this with some examples.
In Canada, there are only a very limited number of qualified Mohs surgeons at this stage, but that number is growing. The health care system in Canada is run at the provincial level, and currently there are only a limited number of facilities where Mohs surgeons can practice at.
If a patient has skin cancer removed with Mohs Surgery, will they see another cancer, or a recurrence of the same cancer again? Unfortunately, the answer is that yes it's highly likely.
At what age do we start losing volume in the face, and in what areas? Plastic surgeon Dr. Bryce Cowan explains the process of volume loss with age, and how it affects the overall appearance of the face, and how fat grafting can help combat these changes.
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