Family Practice

Read articles from the family practice edition, focused on helping family practitioners about various dermatological conditions.

Suicidal Ideation and Behaviour in Psoriasis, Brodalumab image

A Closer Look at the Data Regarding Suicidal Ideation and Behaviour in Psoriasis Patients:...

When prescribing brodalumab, or any other biologic agent, physicians should screen patients for psychiatric comorbidities. Assessment of risk versus benefit, and having an honest conversation with patients regarding the label, will help provide better patient care for both physical and mental health.

Update on the Management of Chronic Hand Dermatitis

Hand dermatitis (HD) is a common skin disorder affecting individuals of all ages. This article looks into the challenges associated with therapy, side-effects of commonly used treatments, and long-term management plans for HD.
The Treatment of Cystic Acne

The Treatment of Cystic Acne

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.

Acne in the Post-Adolescent Patient

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.
Atopic Dermatitis: Pediatric Use of Crisaborole

Atopic Dermatitis: Pediatric Use of Crisaborole

An overview to AD care and focus our review to topical agents used in AD including topical corticosteroids (TCS) and topical calcineurin inhibitors (TCI) and discuss the newest topical agent accessible in the physician's armamentarium, crisaborole.

Optimal Management of Acne to Prevent P. acnes Resistance

Since multiple factors are involved in the pathophysiology of acne, treatment that counteracts the majority of them can be expected to achieve the best results. When considering the options for reducing the P. acnes population, it is best to choose those that do not encourage resistance patterns.

Topical Efinaconazole in the Management of Toenail Onychomycosis

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.
Tildrakizumab for psoriasis picture

How to Use Halobetasol Propionate and Tazarotene Lotion to Treat Psoriasis

A fixed combination halobetasol propionate and tazarotene lotion (HP/TAZ) was launched in Canada in 2020, to treat moderate to severe plaque psoriasis in adults. With the use of polymeric emulsion technology, there is uniform distribution of HP and TAZ and excipients on the skin and improved skin moisturization.

Drug Treatments for Skin Disease Introduced in 2010

Drug Treatments for Skin Disease Introduced in 2010. Adapalene 0.1% lotion (Differin®), Drospirenone / ethinyl estradiol / levomefolate calcium + levomefolate calcium tablets (Beyaz™) and many other drugs are covered.

A Practical Approach to Classification and Treatment of Scars

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.

External Genital Warts

Most HPV infections are asymptomatic and can spontaneously clear on their own. However if treatment is required, there are a number of antiproliferative, destructive, immunomodulatory modalities available. Combination therapies have been shown to be advantageous.

Diagnosis and Treatment of Lip Conditions for Family Practitioners

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.
image of doctor preparing vaccine

Higher Incidence of HPV-Driven Cancers in Males Calls for an Update to Current HPV...

While the incidence of cervical cancer is decreasing in females, the incidence of oropharyngeal and other HPV-driven cancers is increasing at an alarming rate, especially in males. As such, vaccination efforts should be aimed at addressing...

Management of Recalcitrant Acne

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.

Ceramide-based Moisturizers as Treatment for Pediatric Atopic Dermatitis

Atopic dermatitis (AD) is a chronic inflammatory, xerotic and pruritic skin disease of increasing prevalence affecting 15-30% of children and 2-10% of adults. AD and its associated health consequences present significant challenges to patients, particularly children and their families.

Scaly Rashes of the Feet: Could It Be Fungal?

This article will deal with the diagnosis and treatment of common eruptions on the feet.
picture for Management of Adult Moderate-to-Severe Atopic Dermatitis

Management of Adult Moderate-to-Severe Atopic Dermatitis: A Practical Guide for Primary Care

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.
Topical Formulations in Psoriasis

The Evolution of Topical Formulations in Psoriasis (Family Practice)

Adherence to topical treatment for psoriasis remains a challenge as the daily application creates a significant treatment burden. New topical therapeutic options need to offer a combination of higher efficacy and better patient acceptability, including...
Man applying shaving cream to face

Male Skin Care

For decades, skin care has primarily been considered to be the domain of women, but recently, an increasing number of men are involved. This article delves into similarities and differences in gender as it relates to skincare, and the complexities of skincare for men.

Dermatological Drug Use in Pregnancy

Medications that are considered safe in pregnancy are available for the treatment of common dermatological disorders. Knowledge of these medications is important when considering treatment options for both pregnant patients, and women of childbearing potential.

An Update on Medical Therapies for Chemical Exfoliation

Chemical exfoliation has been used for decades to reverse the signs of aging skin and provide a cosmetic benefit. This article reviews various peeling methods and strengths, and their therapeutic potential.

New Developments in the Science Behind Anti-Aging Skin Care Products

This article delves into new development and research into cosmeceuticals, their potential role, and the importance of educating patients on realistic expectations. Various potential benefits are discussed using an evidence based vantage.

New Evidence for the Treatment and Management of Actinic Keratoses

Cutaneous concerns continue to be a significant part of family and specialty practices, as increasingly, patients are seeking medical consultation for the management of photodamage, actinic keratoses, and nonmelanoma skin cancer (NMSC), which is now a global epidemic.
Oral Therapy for the Treatment of Rosacea

Oral Therapy for the Treatment of Rosacea

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.
Non-melanoma Skin Cancers

Management of Non-melanoma Skin Cancers in Canada

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.

Cosmeceuticals: A Practical Approach

The cosmeceutical industry has undergone phenomenal growth over the past decade. Acquiring a basic knowledge of the major classes of active ingredients that are found in cosmeceuticals will enable healthcare professionals to provide accurate and educational information to consumers.

New Seal of Approval Initiative to Assess Skin Care Product Claims

Personal care in Canada is a $5 billion industry that offers thousands of competing products, many of which make skin care-related claims. Advertisers inundate us with messages about what their products can do for us, but how can we be sure that the products we buy will actually live up to their claims?

Update on Broad-Spectrum Sunscreens

The new generation of sunscreens serve an important role in overall skin protection from the sun. However, they should be used in conjunction with other sun protection measures such as sun protective clothing, hats, and sunglasses.
image for actikerall actinic keratoses

Actikerall™ (5-Fluorouracil 0.5% and Salicylic Acid 10%) Topical Solution for Patient-directed Treatment of Actinic...

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.

Optimizing Topical Acne Therapy

Acne vulgaris is a disease of the pilosebaceous follicle characterized by non-inflammatory (open and closed comedones) and inflammatory lesions. Its pathogenesis is multifactorial - the interplay of hormonal, bacterial, and immunological (inflammatory) factors results in the formation of acne lesions.

Management of Unwanted Facial Hair (Reprint from FP 7.2)

(Reprint from STL FP 7.2) Facial hair can be a distressing, chronic problem for many women. This article discusses assessment, treatment options, side-effects, and costs. Combination therapy and its benefits are also covered.
What's New in Acne Treatment in Canada?

What’s New in Acne Treatment in Canada?

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.

Update on the Management of Actinic Keratoses

Actinic keratoses (AKs), or solar keratoses, are pre-malignant cutaneous lesions that predominantly manifest in sun-exposed areas. They are one of the most common skin conditions seen by dermatologists, preceded only by acne vulgaris and dermatitis.

New Science to Support 50 Years of Colloidal Oatmeal Use in Dermatological Practice

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.

Topical Acne Treatment

Management of the patients’ expectations and compliance are crucial aspects of acne treatment. Disease chronicity and long-term treatment should be discussed at length during the initial consultation.

Chronic Idiopathic Urticaria: Treatment with Omalizumab (Family Practice)

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.

Skin Conditions and the Sun

The skin has evolved to protect us from the harmful effects of ultraviolet light. Sunscreens were first developed to prevent sunburns by blocking UVB; they allowed us to prolong our time in the sun, but that resulted in increased exposure to UVA.

Non-Pharmacologic Management of Atopic Dermatitis

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.

Review of Management Options for Genital Herpes Infections

Genital herpes is a common sexually transmitted infection caused by the herpes simplex virus (HSV). This article discusses an overview of HSV, diagnosis and workup, as well as treatment options for management of genital herpes.

Common Bacterial Skin Infections

Recognition and appropriate treatment of these common bacterial skin infections, while at times challenging, can be very rewarding for both the physician and the patient. Selecting the right therapy from the beginning should help minimize complications, reduce the number of hospitalizations, and may also help reduce the climbing incidence of bacterial resistance.

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