Dr. Stephen Trying is a practicing dermatologist at Houston Skin Associates, and has a special interest in infectious diseases. He has reviewed several prominent journals, including Lancet, Journal American Academy of Dermatology, Archives of Dermatology, and Journal of Infectious Diseases and Annals of Internal Medicine.
STL Index for: Stephen K. Tyring
Antibiotic Resistance in Dermatology Part 2: Combating Resistance
The proper and suitable application of antibiotics is crucial in maintaining their effectiveness amidst growing antibiotic resistance. Nevertheless, it is essential for prescribing practitioners to have a heightened understanding of resistance causes and strategies to counteract them.
Antibiotic Resistance in Dermatology Part 1: Mechanisms of Resistance
Awareness of the molecular mechanisms of antibiotic resistance among bacteria is necessary to understand the etiology of antibiotic resistance in dermatology at the most basic level.
Sarecycline: A Narrow-Spectrum Antibiotic
Sarecycline is a novel antibiotic that has shown significant promise in acne treatment due to its narrow-spectrum activity and weight-based dosing.
Janus Kinase and Tyrosine Kinase Inhibitors in Dermatology: A Review of Their Utilization, Safety Profile and Future Applications
Currently, JAK inhibitors are only FDA approved for dermatologic, rheumatologic, and hematologic conditions. Recent studies show the utility of JAK inhibitors in treating atopic dermatitis, psoriasis, psoriatic arthritis, vitiligo, and alopecia areata.
Management of Primary Small-Vessel Vasculitis
Small-vessel vasculitides (SVV) are a group of disorders that occur due to primarily systemic inflammation or as sequelae of an infection, malignancy, or other rheumatic disease.
Management of Ichthyosis: A Brief Review
Ichthyosis management requires a multimodal approach, including topical and oral agents in addition to lifestyle modifications.
Tildrakizumab for Moderate-to-Severe Plaque Psoriasis
Tildrakizumab is a promising therapeutic option for patients with moderate-to-severe chronic plaque psoriasis. The specificity of the drug in targeting the p19 subunit of IL-23 allows for the high efficacy and safety of long-term treatment as demonstrated in clinical trials.
Brief Update on Dermatologic Uses of Methotrexate
Methotrexate has been an important agent in the management of dermatologic conditions for decades. Although first indicated for the treatment of psoriasis, MTX has been shown to be a successful treatment option for a wide array of skin diseases.
Shingrix for Herpes Zoster: A Review
Shingrix®, a new recombinant subunit vaccine, has shown a great deal of promise in the prevention of HZ in adults over the age of 50. The combination of zoster viral glycoprotein E and the AS01B adjuvant system make it a safe, efficacious option for the elderly as well as immunosuppressed individuals.
Topical Diacerein Ointment for Epidermolysis Bullosa Simplex: A Review
This review examines the clinical trials of topical diacerein and its role in Epidermolysis Bullosa Simplex. Diacerein cream was recently US FDA-approved in May 2018 for treatment of patients with EBS.
Glycopyrronium Tosylate (Qbrexza) for Hyperhidrosis
Glycopyrronium tosylate (Qbrexza), a topical anticholinergic therapy, has been shown to be effective in the treatment of primary axillary hyperhidrosis.
Dupilumab for Moderate-to-Severe Atopic Dermatitis
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.
A Review of Guselkumab, an IL-23 Inhibitor, for Moderate-to-Severe 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.
A Review of Brodalumab, an IL-17 Receptor Antagonist, for Moderate-to-Severe Plaque Psoriasis
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.
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.
Interleukin-23 in the Pathogenesis and Treatment of Psoriasis
In the past three decades, major advances have been made in understanding the pathogenesis of psoriasis. This review focuses on the role of IL-23 in psoriasis pathogenesis and the current therapies targeting IL-23 that are being studied in clinical trials.
Recent Approval of Xerese in Canada: 5% Acyclovir and 1% Hydrocortisone Topical Cream in the Treatment of Herpes Labialis
Herpes labialis is a frequently occurring viral infection of the lips and oral mucosa. Clinical data on the efficacy of topical combination acyclovir-hydrocortisone (Xerese™) product in treating herpes labialis are discussed.
An Update on the Clinical Management of Cutaneous Molluscum Contagiosum
Molluscum contagiosum is a poxvirus infection of the skin that is commonly observed in children. This articles discusses the molluscum contagiosum virus (MCV), its pathogenesis, mechanism, and treatment modalities.
Biologic Therapy and Risk of Infection
Biologic compounds are being used more frequently to treat a multitude of systemic inflammatory conditions. This article discusses the increased risk of opportunistic infections of tuberculosis, herpes zoster, Legionella pneumophila, and Listeria monocytogenes.
HPV Vaccine Update: New Indications and Controversies
Human papillomavirus (HPV) has a predilection for infecting epidermal and mucosal surfaces such as those of the anogenital region. This article discusses presentations of HPV infections, and the role of HPV vaccines.
Retapamulin: What is the Role of this Topical Antimicrobial in the Treatment of Bacterial Infections in Atopic Dermatitis?
In atopic dermatitis, the stratum corneum of patients appears to have alterations that predispose them to colonization and invasion by various bacteria. Retapamulin appears to be a much needed antimicrobial option for treating the atopic dermatitis population due to their common carriage of bacterial pathogens.
Safety, Efficacy & Recurrence Rates of Imiquimod Cream 5% for Treatment of Anogenital Warts
Imiquimod 5% cream (Aldara™, Graceway Pharmaceuticals) is an immune response modifier used for the topical treatment of anogenital warts in non-HIV-infected patients. Several randomized controlled trials have demonstrated that imiquimod 5% cream is a safe and efficacious treatment.
IL-12/IL-23 Inhibitors: The Advantages and Disadvantages of this Novel Approach for the Treatment of Psoriasis
Psoriasis is a common chronic inflammatory skin disease that is mediated, in part by the body’s T-cell inflammatory response mechanisms. Current data regarding the efficacy of these agents show they may have the potential to become the new clinical gold standard for biologic therapy to treat psoriasis.
Dermatological Management of Human Immunodeficiency Virus (HIV)
Atypical presentations of typical dermatological conditions are common in human immunodeficiency virus (HIV). This article will focus on three specific topics: eosinophilic folliculitis, psoriasis, and cutaneous mycoses. Their unique presentations in HIV and treatments are discussed.
Vaccines for the Prevention of Human Papillomavirus Infections
HPV vaccines are highly immunogenic and have an excellent safety profile. HPV vaccines promise to offer an exciting contribution to healthcare and cancer prevention. However, many questions remain concerning who to vaccinate, the duration of protection, cost, public acceptance, and the potential for worldwide distribution.
Valacyclovir for the Management of Herpes Viral Infections
The Herpesviridae family (Types 1-8) continues to inflict considerable morbidity and social stigma upon humanity. Once infected with the herpes viruses, especially Types 1-3, they establish permanent residence within our nervous system and reactivate during periods of stress, trauma, and/or other precipitating factors.
Treatment of Postherpetic Neuralgia
Postherpetic neuralgia is a serious complication of herpes zoster that has a predilection for older individuals. Postherpetic neuralgia is often associated with significant morbidity, and it can cause insomnia, fatigue, depression and interference with daily activities in affected individuals.
Famciclovir Therapy (Famvir®) for Herpes Simplex and Herpes Zoster Infections
Genital herpes simplex and herpes zoster infections are common afflictions that are associated with significant morbidity and a decreased quality of life. Famciclovir (Famvir®, Novartis) is an orally administered prodrug of the antiviral agent penciclovir.
Imiquimod Applied Topically: A Novel Immune Response Modifier
Imiquimod (S-26308, R-837) (1-(2-methylpropyl)-1H-imidazo[4,5-c]quinolin-4 amine), an immune response modifier, was approved as a 5% cream (Aldara, 3M Pharmaceuticals) by the US FDA in February 1997, for the treatment of genital and perianal warts.