Family Practice

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

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%.

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.

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.

Therapeutic Options for Vitiligo

Vitiligo is a disease that presents with depigmented skin and is associated with significant psychosocial effects. Disease progression can be unpredictable and management is challenging. This article discusses etiology, management, and treatment options.
Collage image of Colloidal Oatmeal and woman using cream on her skin

Colloidal Oatmeal use in Dermatology

Patients often seek natural approaches to treating skin disease. Colloidal oatmeal has been used for decades to improve atopic dermatitis and soothe other pruritic and xerotic dermatologic conditions.
image of silk fabric and dry skin

The Role and Topical Management of Staphylococcus aureus in Atopic Dermatitis (Family Practice)

Atopic dermatitis (AD), or eczema, is a common, chronic, relapsing, genetically determined inflammatory skin disorder. This article discusses the role of Staphylococcus aureus (S. aureus) as a factor to consider.

Topical Treatment for Acne: A Case Study

Since patient compliance is a concern, a great deal of attention must be given to the methods available to minimize the chance of irritation. In the opinion of the author, this may be the single most important factor influencing the success of topical therapy in acne.

Management of Unwanted Facial Hair

Unwanted facial hair is a common, frustrating condition that affects up to 25% of women. This article review impact on patient QOL, treatment options ranging from shaving, waxing, threading, and bleaching to electrolysis, and laser therapy.

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.

Skin Barrier Repair in the Management of Atopic Dermatitis

The term “atopy” was first coined by Cooke and Coca in 1923, derived from the Greek word atopos, which means out of place and denotes an immune reaction that is “strange or eccentric”. Atopic dermatitis (AD) is a chronic, waxing and waning, often symmetric inflammatory eruption that is characterized by pruritus and xerosis.

The Forgotten HPV: External Genital Warts

HPV is a very common sexually transmitted disease that is associated with a number of benign, premalignant, and frankly malignant lesions of the anogenital tract. The majority of HPV infections are asymptomatic and are spontaneously cleared by a predominantly cell-mediated immune response.

The Health Controversies of Parabens

Parabens are preservatives used in a variety of personal care, cosmetic, pharmaceutical and food products. Discovery of parabens in the breast tissue of patients with breast cancer has raised public concern over their use. This article discusses the controversy, research, regulations, and possible alternatives.
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.
Skin Treatments

Clinical Management of Recurrent Herpes Labialis

This article reviews HSV infections around the lips (herpes labialis), and clinical trial data of a new formulation of topical 5% acyclovir with 1% hydrocortisone cream (Xerese®).

The Red Face and Its Management

Red face is commonly seen, can be transient and come and go (flushing), or be persistent. Sometimes it can be scaly (dermatitis), or there may be papules and pustules (rosacea) present. Red face is occasionally seen in infants or neonates.

Advances in Acne Management and Patient Adherence

Acne vulgaris is a multifactorial disease characterized by different types of lesions at various stages of development. Treatment options, such as light based therapy and systemic therapy, as well as CIS-Isotretinoin (Epuris™) that increases absorption are discussed as well as patient adherence.
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...

A Simple Algorithm for the Treatment of Dermatophyte Toenail Onychomycosis

There has been much discussion about the optimal treatment for onychomycosis. We propose a simple algorithmic approach to aid in the selection of therapy for dermatophyte toenail onychomycosis and present a balance between efficacy and risk of therapy.

Long-term Management of Psoriasis: Flexible Therapeutic Regimens Providing Safe and Effective Outcomes

Psoriasis is a chronic, inflammatory skin condition prone to periods of skin flaring. As our understanding of the etiology of psoriasis becomes clearer, the treatment regimes can be better tailored to control the disease and address psychological fears of patients.
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.
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®).
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.

Rosacea: An Update on Medical Therapies (Family Practice)

Rosacea is a common, chronic cutaneous condition that affects the face. This article reviews a variety of treatments for treatments for rosacea, including topical and systemic therapies.
Picture of skin affected by psoriasis and people waiting for treatment in a clinic

The Impact and Treatment of Psoriasis in Manitoba Dermatology Clinics: The Case for Calcipotriol-Betamethasone...

In a small real-world patient case review study, dermatologists tested the efficacy, safety and patient preference of Enstilar®, a calcipotriol-betamethasone dipropionate (Cal/BD).

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.

Clinical Management of External Genital Warts

External genital warts (EGW) is a common sexually transmitted infection (STI) affecting millions of individuals worldwide. It is likely the most frequent STI in both Canada and the US. Treatment options and vaccination is 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.

Topical Management of Psoriasis and the Role of Vitamin D3 Analogues

Psoriasis is a chronic, recurrent, immune-mediated, papulosquamous skin condition characterized by rapid proliferation of keratinocytes. This article focuses on the role of vitamin D analogues in the treatment of psoriasis.
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.

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.

Adherence Optimization in Acne Management

Acne is a common dermatological condition found in about 85% of adolescents and young adults. Acne can have significant psychological, social or physical impacts. This article delves into the importance of patinet adherence and therapeutic strategies.
Malassezia Infections of the Skin

Advances in Topical Acne Therapy: New Molecules, Vehicles and Delivery Mechanisms

Acne vulgaris is a multifactorial disease characterized by different types of lesions at various stages of development. The most frequently used therapeutic agents for acne are topical. This article focuses on the role of vehicles and advancements in this area.
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.
Melanoma Gene Expression Testing

Ruling out Melanoma: A Practical Guide to Improving Performance Through Non-Invasive Gene Expression...

In this article, we summarize a large body of literature on such a tool (a non-invasive adhesive patch based gene expression test for LINC and PRAME) and provide a guide to primary care physicians on how to use this tool to improve pigmented lesion management by biopsying less while at the same time reducing the chance of missing melanomas.

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.

Moisturizers: An Essential Component in Eczema Management

Atopic dermatitis (AD) or eczema is a chronic, relapsing form of skin inflammation that is attributable to multiple pathogenic, genetic, and environmental factors, as well as a dysfunctional epidermal barrier. Immune responses involved in AD culminate in dry skin, pruritus, and IgE mediated sensitization to food and environmental allergens.

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.

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.

A Summary of Approved Topical Treatments for Rosacea

Today, diagnosing and treating rosacea remains a challenge. More studies are necessary to provide additional insight on drugs currently available as well as possible future agents. The ultimate goal is to provide each patient with a treatment regimen best suited for his or her individual needs.
Crisaborole in Atopic Dermatitis

Optimal Use of Crisaborole in Atopic Dermatitis – An Expert Guidance Document

Mild to moderate atopic dermatitis (AD) is often controlled by behavioral measures such as skincare and avoidance of triggers in addition to topical treatments such as topical corticosteroids (TCS), topical calcineurin inhibitors (TCI), and crisaborole, a phosphodiesterase-4 inhibitor (PDE4-I).

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