Family Practice

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.

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.

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.

Psoriasis and eczema can at times be recalcitrant to conservative topical treatment. This article focuses on corticosteroid strength and their appropriate uses for various presentations.

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.

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.

External genital warts (EGW) are a common infection caused primarily by human papillomavirus (HPV) types 6 and 11. This article discusses the impact of EGW on the patient, co-factors for other STIs, and therapies for EGW.

Phosphodiesterase 4 (PDE4) is a key enzyme in the regulation of immune responses of inflammatory diseases through degradation of the second messenger, cyclic adenosine 3',5'-monophosphate (cAMP). Apremilast (APR), a selective PDE4 inhibitor, has been shown to reduce the production of pro-inflammatory cytokines.

There are currently no laboratory tests to diagnose rosacea; it remains a clinical diagnosis. The actual pathophysiology and etiology of rosacea also remain unclear; however, quite recently the spectrum of rosacea has been classified and standardized.

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.

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.

Head lice infestations (Pediculosis capitis) are a worldwide problem with prevalence estimates typically ranging between 1-3% in elementary school aged children. Although this obligate parasite is a nuisance, infestation does not pose a health risk.

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.

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.

For many years, clinicians have expressed ongoing concerns about treatment adherence by patients, especially pertaining to those with chronic skin disorders. Although crucial to effective therapeutic outcomes, the issue of patient adherence has been largely ignored in dermatologic disease management until recently.

Adopting a comprehensive approach that takes into account individual preferences, properties of available treatments, and disease severity can encourage patient adherence and lead to improved treatment outcomes. The key to gaining adherence, is the attention devoted by physicians to establishing effective communication with the patient.

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.

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.

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.

Educate and counsel. Most patients with acne are teenagers who are very self-conscious about their looks and expect immediate treatment results. However, adult acne is becoming more common, and can be very distressing as well.

The multifactorial nature of acne vulgaris often requires a combination of topical and/or oral agents for successful management. Common challenges of this multipronged approach include the potential development of skin irritation, which results in nonadherence, as well as concern over bacterial resistance.

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?

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.

Atopic eczema (or atopic dermatitis) is a common inflammatory skin condition that dermatologists, pediatricians, family physicians, and primary-care providers see on a daily basis. Treatments, mechanism of action, preventative therapies, and the skin barrier are discussed.

Acne vulgaris remains a therapeutic challenge, in large part due to its multifactorial pathophysiology. Evidence for improved and quicker efficacy with safety and longer remission has been noted with combination therapies.

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.

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

Head lice infestations (Pediculosis humanus capitis) are most prevalent during childhood in industrialized countries. It is estimated to occur in about 1-3% of children aged 6-12 years. Greater susceptibility is associated with girls, which is likely attributed to close contact play and the sharing of objects.

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 is a chronic inflammatory skin condition. It has a relapsing course characterized by flare-ups of acute eczema on a background of chronically dry skin. The association of atopic dermatitis (AD) with asthma and allergic rhinitis is referred to as the atopic triad.

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

The best approach is a pragmatic one. The patient with few AK lesions is most conveniently and cost effectively treated with a destructive technique (cryosurgery or curettage with light desiccation). Those with many AKs are candidates for medical therapy (such as 5-fluorouracil, imiquimod or diclofenac).

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.

The proven therapeutic benefits of OCs offer a valuable option to physicians for the treatment of acne. The accumulating evidence on the efficacy and safety of recently available drospirenone-containing hormonal preparations provides dermatologists with a new option for the treatment of acne and other hyperandrogenic disorders.

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.

Almost everyone at some point in his or her life will be troubled with mild acne. It can be related to athletic activities, travel, cosmetics, or hormonal changes. Various treatment options are discussed.

Successful treatment of acne with topical therapy can be achieved with patient education, patient engagement in treatment selection, and counseling on aggravating factors.

Lice have developed resistance to some pediculicides and it is expected that with ongoing use, these pediculicides will probably become less effective.

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.

The panelists for cosmeceuticals at Dermatology Update 2008 included 4 dermatologists: Jeffrey Dover, MD, Charles Lynde, MD, Catherine Zip, MD, and Jason Rivers, MD, who discussed cosmeceuticals and the role they play in current dermatology practice.