Family Practice

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

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.

Psoriasis Vulgaris

Psoriasis has a greater mental and physical impact than myocardial infarction, hypertension, diabetes mellitus, arthritis, and cancer; only depression had a greater mental impact, and congestive heart failure a greater physical impact.

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?

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.

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.

Atopic Dermatitis: A Practical Guide to Management

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.

Treatment Options for Excessive Sweating and Hyperhidrosis

For most patients, antiperspirants containing aluminium salts are the first-line treatments. Other therapeutic options, especially for those with hyperhidrosis, include botulinum toxin injection, systemic anticholinergics, iontophoresis and surgery.

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.

Efinaconazole in the Treatment of Onychomycosis: Managing Patient Expectations and Promoting Compliance

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%.
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.

Topical Acne Therapy Advances in 2011

Acne vulgaris is a common disorder of the pilosebaceous follicle with multiple pathogenic factors. Topics like antibiotic treatment, antibiotic resistant, topical agents, are covered.
How to Create a Great Algorithm

How to Create a Great Algorithm

Medical algorithms are created, yet there is a paucity of information about how such algorithms should be created and the optimal way to develop an excellent algorithm. Well constructed medical algorithms have the potential to improve and standardize medical decisions, enhance adherence to better guidelines and improve patient care.

Natural Topical Retinoids with Emphasis on Tretinoin for the Treatment of Acne

Topical retinoids are the cornerstone of acne therapy and they can be used across the entire spectrum of acne severity. Selecting the most suitable retinoid formulation, as well as dispensing proper advice in terms of drug application, can improve patient compliance.

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.
Chronic Urticaria Practice Guidelines

Chronic Urticaria: Following Practice Guidelines (Family Practice)

Recently updated and revised international guidelines suggest a step-wise approach to the management of chronic spontaneous urticaria. These guidelines suggest that first-line therapy should be second-generation non-impairing, non-sedating H1-antihistamines such as bilastine (BLEXTEN®).

Atopic Eczema

Eczema diagnosis, treatments, and management techniques are discussed. Diagnostic features, treatments both topical and oral, infection control, and a note on calcineurin inhibitors.

Androgenetic Alopecia: A Review of Topical Agents for Hair Growth Promotion (Family Practice)

Hair loss is a common dermatological problem that affects a large segment of the population both physically and psychologically. This article focuses on androgenetic alopecia (AGA) or male pattern hair loss, as well as the common treatments, Minoxidil and other topical treatments.

Hair Care

Implementing basic proper hair care is essential to maintaining healthy hair. Furthermore, minimizing exposure to chemical agents, inadvisable grooming techniques, and prolonged exposure to environmental elements, will promote healthier hair and avoid unnecessary hair loss.

HPV Vaccines

The National Advisory Committee on Immunization (NACI) recently released its recommendations for the use of the quadrivalent vaccine, which include: For use in females 9-26 years of age. The recommendations for the use of the bivalent vaccine will be available following its approval in Canada.
A Review of Brodalumab

Management of Onychomycosis

Diagnosis of onychomycosis can only be established with a positive culture or observation of fungus in the nail clippings. Consideration should be given to cost and possible complications before starting treatment. Recurrent disease is a problem even after a complete cure.

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.

Update on Topical Approaches for Managing Scalp Psoriasis

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.

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.
Acne Clindamycin/Tretinoin Preparation

Management of Acne Using a Fixed Dose Clindamycin/Tretinoin Preparation

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.
Bilastine – A Novel Antihistamine for Allergic Rhinitis and Chronic Spontaneous Urticaria

Bilastine – A Novel Antihistamine for Allergic Rhinitis and Chronic Spontaneous Urticaria

Bilastine has a proven, long-term safety record with use by over 71 million patients in over 104 countries. This article describes the evolution from first generation antihistamines, second generation antihistamines, and where Bilastine comes in.
picture of girl with acne face using topical cream

Trifarotene: A New Topical Retinoid for the Treatment of Acne Vulgaris

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

A Review of Therapeutic Options for Genital Warts

Condylomata acuminata (genital or venereal warts) pose a significant health concern, especially amongst young adults. External genital warts (EGWs) are caused by infection with the human papillomavirus (HPV), the same virus that causes the majority of cervical cancers.

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.

Atopic Dermatitis: The Skin Barrier and the Role of Ceramides

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

Topical Approaches in Combination Therapy for Acne (FP Edition)

Acne vulgaris is a chronic inflammatory cutaneous disease involving the pilosebaceous unit. This article discusses pathophysiology, sebum production, keratinization, and the role of P.acnes in acne formation.

Seborrheic Dermatitis: New Formulations for Treatment

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

Therapeutic Moisturizers in Eczema and Xerosis Management

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.

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.
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.
Sunscreen image

Sun Protection Using Sunscreens

There are benefits and risks to sunlight exposure of the skin. This article covers a variety of topics, including the effects of UVA and UVB, vitamin D, skin tone, skin cancer risk, and SPF.

Onychomycosis Diagnosis and Emerging Therapy

Onychomycosis is a common nail disorder for which successful treatment can be clinically challenging. Diagnosis, treatment, and management using various modalities are discussed.

Actinic Keratosis: A Practical Overview

Actinic keratosis (AK) is a prevalent skin condition that warrants 5.2 million office visits in the US each year. Various treatments for AK, both local and field therapy, and their appropriate use are discussed in this article.
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.

New Systemic Treatments for Psoriasis

Biologics are one of the more effective and relatively safe options for long-term control of psoriasis. They have reduced the time needed to clear the signs of chronic disease, and are effective in maintaining a disease-free state for longer durations. Biologics can safely be used with other treatment modalities (i.e., methotrexate, cyclosporine, acitretin and hydroxyurea).

Adjunctive Skin Care 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.

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