Family Practice

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

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.
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.

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.
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.
Hormonal Treatment of Acne in Canada: Clinical Update

Hormonal Treatment of Acne in Canada: Clinical Update and Case-Based Treatment Approaches

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.
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.

Topical Management of Recalcitrant Psoriasis and Eczema

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.

Head Lice: A Review of Topical Therapies and Rising Pediculicidal Resistance

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.

Hormonal Agents Approved for Treatment of Acne

Hormonal agents are important, effective therapeutic options for women across the spectrum of acne severity. The three preparations approved in Canada for this indication have safety profiles similar to conventional oral contraceptives.
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.

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%.

Actinic Keratoses

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).

Topical Treatment Adherence for Psoriasis

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.

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.

Topical Calcineurin Inhibitors—Efficacy and Safety in Atopic Dermatitis

TCIs have an important place in the therapeutic armamentarium for AD. They are approved as second line agents for individuals >2 years of age, and have a good safety profile when used short-term or intermittently long-term.

Tips for Maximizing the Effectiveness of Topical Acne Therapy

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

The Role of Cosmeceuticals in Anti-Aging Therapy

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.
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.

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.

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.

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.

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.

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.

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.
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.

Topical Antipsoriatic Treatments in 2007

Advancements in topical antipsoriatic therapies have provided safer and more effective treatment options, especially when used in combination. Consequently, much research is underway to investigate novel treatment combinations for psoriasis in the hope that it will provide further enhancements in efficacy.

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.

Topical Management of Recalcitrant Psoriasis & Eczema

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.

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.

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.

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.

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.

Cosmeceuticals: A Panel Discussion About Educating the Public

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.

Hyperpigmentation and Its Topical Treatments

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

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.
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®).

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.

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