Family Practice

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.

Malassezia are lipophilic yeasts that are normal commensals on the skin surface. There are seven species of these yeasts, which were previously called Pityrosporum. The conditions described in this article are either caused by the Malassezia itself or from some kind of immunological or toxic reaction to the organism.

There is a growing demand for the removal of unwanted facial and body hair in both men and women. This article reviews chemical depilatories and other modalities, their method of action, characteristics, advantages and disadvantages.

This paper focuses on a comprehensive and practical approach to classifying and managing scars in terms of colour and texture, and discusses topical treatments accessible to family physicians in more detail.

Skin conditions are commonly found on the lips. Surrounding skin and mucosal surfaces may be involved, and hair problems may be present. Lesions can be single or multiple. Conditions can be localized or diffuse, with other features found upon physical examination that help to make a diagnosis.

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.

Novel uses of old medications and new formulations of systemic medications have broadened the therapeutic armamentarium for treating rosacea patients. It is of primary importance to offer patients safe and effective therapies for this chronic and incurable condition, improving both the clinical and psychosocial consequences of rosacea.

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.

Atopic dermatitis (AD) or eczema is a chronic, relapsing skin condition that can lead to xerosis, pruritus, and patches of dermatitis. Coping with the physical and emotional aspects of AD can significantly impact the quality of life. It is most common in childhood, as many patients seem to outgrow the condition by adulthood.

Cystic acne is characterized by the formation of cysts enclosing a mixture of keratin and sebum in varying proportions. It is the most severe of the four main types of acne, which are comedonal, papular, pustular, and cystic. Identification and treatment options are discussed.

Psoriasis and eczema, especially atopic eczema, are two of the most common cutaneous conditions seen by family physicians and dermatologists. This article discusses the etiology of psoriasis and eczema, immunologic abnormalities, and the role of immune mediators.

There have been important advances in our understanding of acne scarring. Acne scars can resolve, and their evolution is determined by a balance between matrix repair and degradation. Timely, effective management of acne can minimize risk of subsequent acne scarring.

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.

The focus of this review is to delve deeper into the use of Biacna® Gel, a fixed-dose clindamycin/tretinoin combination product, for the treatment of acne.

Psoriasis remains a therapeutic challenge. Involvement of the scalp can be minimal (“dandruff”) or more significant and difficult to manage. Gentle treatment, reducing trauma, and treating the inflammation and pruritus will improve therapeutic results.

Psoriasis and eczema, especially atopic eczema, are two of the most common cutaneous conditions seen by family physicians and dermatologists. This article focuses on corticosteroids of varying strengths and their suggested indications.

A summary of the most comprehensive and up to date guideline for treating non-melanoma skin cancer in Canada. Background, primary prevention, actinic keratosis, managing basal cell carcinoma, and squamous cell carcinoma, are covered.

This article review the newer vehicles which include gel, foam, and spray preparations. The newer topical delivery agents have the potential to limit the progression of cutaneous disorders requiring oral systemic therapy, which can expose the patient to greater risk for adverse side-effects.

Seborrheic dermatitis is a common cutaneous disorder occurring in at least 3%–5% of the population. We discuss new treatment formulations and protocols.

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.

As baby boomers get older, they have shown an increasing interest in maintaining a youthful appearance. As a result, there has been a corresponding increase in topical antiaging formulations, which are commonly referred to as cosmeceuticals.

Acne treatment success involves a comprehensive approach that addresses diagnostic confounders, appropriate therapeutic options and patient adherence. Ongoing education and counselling will assist in meeting patient expectations and establishing a favourable rapport that promotes adherence.

This article will deal with the diagnosis and treatment of common eruptions on the feet.

Colloidal oatmeal has been used for centuries in skin care as a soothing agent to relieve itch and irritation. Its use, efficacy, and mechanism of action are discussed.

Patients suffering from scalp psoriasis frequently seek medical care because of the persistent discomfort and social embarrassment caused by the visible flakes that are shed onto clothing. However, the presence of hair makes it challenging to apply medication to the scalp.

Post-inflammatory hyperpigmentation, and melasma are common problems that dermatologists see. Various bleaching options are considered.

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.

Acne vulgaris is the most common skin disorder affecting children and young adults in North America. This article discusses combination therapy, and simplifying treatment plans in order to increase patient adherence, which is often a critical problem in treating acne.

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.

Fusidic acid/betamethasone 17-valerate cream (Fucibet®) is a cosmetically acceptable, well tolerated cream which is hydrating and improves the TSS dermatitis score in secondarily infected dermatitis. In addition, it clears bacteria in infected dermatitis better than vehicle suggesting that improving the dermatitis with a steroid might be synergistic, perhaps through a reduction in bacterial load.

Atopic dermatitis (AD) is a chronic and pruritic inflammatory disease that affects a wide age range of patients causing significant impact on their quality of life. There has been a recently updated consensus paper on the treatment of mild-to-moderate AD published by an expert panel of dermatologists and pediatricians. Family physicians are well equipped to manage...

Chronic idiopathic urticaria (CIU) is a common autoimmune skin condition characterized by spontaneously recurring hives for six weeks or longer. We review the mechanisms of action of omalizumab, efficacy, cost and potential side effect profile for treating CIU.

This article reviews the various subtypes of rosacea, their clinical presentations, and the considerations in choosing the optimal therapeutic options. The importance of tailored treatment is discussed as well as topical therapies.

This paper examines the pathogenesis of atopic dermatitis, the skin barrier, and the role that ceramides can play in therapy.

A new topical retinoid, trifarotene, the first fourth-generation retinoid, is now available in Canada for the treatment of moderate facial and truncal acne.

Evolving understanding of the role of hormones in acne, along with a growing body of data from clinical trials, calls for a reappraisal of the role of hormonal therapy for acne.

Acne vulgaris (AV) is among the most common dermatological disorders seen by dermatologists. Emerging evidence suggests that acne is associated with epidermal barrier impairments, and this article reviews the role of moisturizing, sun protection, and patient specific skincare advice for acne patients.

Onychomycosis, also known as tinea unguium, is a progressive fungal infection of the nails resulting in discoloration, nail plate thickening, and onycholysis. Efinaconazole 10% solution is an effective and convenient topical antifungal treatment for onychomycosis, with toenail mycological cure rates between 53.4% and 55.2% and complete cure rates between 15.2% and 17.8%.

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.

Psoriasis is a chronic inflammatory cutaneous disorder that can significantly affect patient quality of life (QoL). This article discusses immunologic abnormalities, immune mediators, and the possible pathogenesis of psoriasis.