Yearly STL Archives: 2017

Acne is among the most common dermatological conditions seen in primary care. In this article, we provide a guide to address a growing need by primary care physicians to have a logical and practical approach to treating various forms of acne.

A group of dermatologists with extensive experience in managing pediatric and adult patients with atopic dermatitis developed practical recommendations for the management of atopic dermatitis based on expert consensus opinion and the best available medical evidence.

Truncal acne refers to AV affecting the chest and/or back, a common presentation in acne patients. This article offers guidance in clinical differentiation of truncal acne from other acneiform diseases and provides management recommendations.

Despite a rising prevalence, effective and safe therapeutics for patients with moderate-to-severe AD are limited due to toxicity and side effects. Dupilumab, an interleukin (IL)-4 and IL-13 antagonist that limits type 2 T helper (Th2) driven inflammatory activity, is a promising therapeutic option.

Use of azelaic acid was associated with a significant reduction in inflammatory lesions, which persisted beyond the active treatment phase. Overall, azelaic acid 15% gel is an appropriate initial topical therapy for the treatment of moderate facial rosacea.

November-December 2017 Update on drugs includes Adalimumab-adbm for SC injection Cyltezo™, Adalimumab biosimilar Imraldi®, Cemiplimab REGN2810, Oral migalastat Galafold™, and Secnidazole oral granules Solosec™

For the purposes of this article, the focus will be on the topical treatment of post-adolescent mild to moderate acne. A selection of over-the-counter and prescription based topical treatments are discussed below.

Onychomycosis is a fungal infection of the nail caused by dermatophytes, yeasts, or non-dermatophyte molds. Here we discuss using topical Efinaconazole in the management of toenail onychomycosis.

Recent studies have demonstrated the role of Vitamin B Derivative (Nicotinamide), in both topical and oral forms, as a chemopreventive agent against skin cancer.

Epidermal growth factor receptor (EGFR) inhibitors are part of an emerging class of anticancer medicines known as "targeted therapy". Adverse effects of such treatments are thought to be less severe, but can still be significant.

September-October 2017 Update on drugs include Isopropyl myristate solution Resultz®, Delafloxacin oral and IV formulations Baxdela™, Plasma-derived concentrate of C1 esterase inhibitor SC (human) Haegarda®, Oral dimethyl fumarate Skilarence®, Abatacept for IV or SC injection Orencia®, Consentyx®, Tremfya™, Yervoy® and Benlysta®.

Practical guidelines for the management of Chronic Hand Dermatitis were published in the Skin Therapy Letter, Family Practice Edition (October 2016). This series of cases using Alitretinoin (Toctino®), is a follow on to that publication to put the guidelines into context.

Secukinumab demonstrates rapid and robust clinical improvement accompanied by a favorable short- term safety profile. The results of the phase III trials continue to reinforce the theory that the IL-17 pathway is an essential target in psoriasis and psoriatic arthritis treatment.

Hepatitis B virus (HBV) and hepatitis C virus (HCV) potentially impact the clinician's ability to manage patients with immunosuppressive medications such as biological therapy. In light of recent literature reviews, patients with HBV and HCV should be referred to a hepatologist.

This drug update covers Infliximab-abda for IV infusion Renflexis®, Ozenoxacin 1% cream Ozanex™, Standardized allergen extract of house dust mites sublingual tablet Acarizax®, Doxycycline hyclate immediate release tablet, and UVB Phototherapy SystemClarify™ Home Light Therapy System.

Psoriasis is a chronic condition that affects the well-being and quality of life of patients. The disease is associated with an increased risk of depression and suicidality, which may not be fully understood by the general population.

A triad approach to the treatment of acne and rosacea has been recommended. This integrated management approach includes patient education, selection of therapeutic agents, and initiation of an appropriate skin care regime. Appropriate skin care recommendations for patients with acne and rosacea will be discussed.

Update on Dupilumab for SC injection Dupixent®, Dupilumab for SC injection, Avelumab for IV injection Bavencio®, Hyaluronic acidbased injectable dermal filler Juvéderm®, Biosimilar to adalimumab for SC injection Amgevita™ Vollure™ XC, Adalimumab for SC injection Humira®, and Amgevita™.

A recently published clinical pathway for Toe Onychomycosis is used as the basis for the management strategy presented here, and follows a pathway reflective of the therapeutic options available in Canada.

Atopic dermatitis (AD) is a chronic, relapsing, pruritic, inflammatory condition involving the skin which can have a significant impact on the quality of life. This article will guide the family practitioner on how to manage adults with moderate-to-severe AD and when to refer for specialist management.

Physicians will be particularly reassured if the suggested guidelines are supported by scientific evidence. This new Canadian clinical guideline for the treatment of acne was developed taking into account new data published up to March 2015, as well as expert opinion and clinical experience.

Tofacitinib is an oral immunosuppressant approved for the treatment of rheumatoid arthritis (RA) and is currently undergoing investigation (Phase III trials) for treating chronic plaque psoriasis.

Psoriasis is thought to arise from a combination of pathogenic factors including genetic susceptibility and environmental exacerbation. This article reviews the current status of guselkumab as a therapy for moderate-to-severe plaque psoriasis.

Drug update on Oxymetazoline hydrochloride 1% cream Rhofade™, Brodalumab for SC injection Siliq™, Cryolipolysis for upper arm fat reduction CoolAdvantage™, Petite applicator for CoolSculpting® Zeltiq®, Wound healing device WoundShiel™

The list covers new skin treatments for Actinic Keratosis, Hemangioma, Hidradenitis Suppurativa, as well as Anti-acne Agents, Antibacterial Agents, Anti-cancer Agents, Dermal Fillers, Neuromodulator and other treatments and drugs.

Psoriasis is a chronic immune-mediated inflammatory disease with epidermal hyperplasia. Interleukin (IL)-17 signaling has a central role in its pathogenesis, and is being looked at as a target. The rationale for IL-17 inhibitors, clinical trial results of new drugs like Brodalumab are included.

In this review, we summarize the most common immunosuppressant medications currently used in dermatology, and provide recommendations for infection screening prior to initiating treatment.

Update on drugs, approval dates, and comments for Nivolumab + ipilimumab (Opdivo® + Yervoy®), Etanercept for SC injection (Enbre®), Crisaborole 2% ointment (Eucrisa™ ), Hyaluronic acid dermal fillers Restylane® (Refyne Restylane® Defyne).