Welcome to Skin Therapy Letter US Family Practice Edition
The goal of this novel publication is to improve both diagnostic and therapeutic skills among primary care practitioners with regard to diseases and disorders of the skin, hair, and nails. The Editor and publishers feel that this is a critical educational endeavor, and one designed to improve overall patient care.
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.
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.
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.
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.
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.
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.
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.
Hyperpigmentation and Its Topical Treatments
Post-inflammatory hyperpigmentation, and melasma are common problems that dermatologists see. Various bleaching options are considered.
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).
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Diagnosis and Management of Atopic Dermatitis for Family Physicians: A Clinical Review
Atopic dermatitis (AD) is a chronic and pruritic inflammatory disease that affects a wide age range of patients causing significant impact on their quality of life. There has been a recently updated consensus paper on the treatment of mild-to-moderate AD published by an expert panel of dermatologists and pediatricians. Family physicians are well equipped to manage...
New Classification of Rosacea and Present Therapy for Family Practitioners
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.
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.
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.
Delivery Vehicle Advances in Dermatology
This article review the newer vehicles which include gel, foam, and spray preparations. The newer topical delivery agents have the potential to limit the progression of cutaneous disorders requiring oral systemic therapy, which can expose the patient to greater risk for adverse side-effects.
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.
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.
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.
Fucibet®: What’s Old Is New
Fusidic acid/betamethasone 17-valerate cream (Fucibet®) is a cosmetically acceptable, well tolerated cream which is hydrating and improves the TSS dermatitis score in secondarily infected dermatitis. In addition, it clears bacteria in infected dermatitis better than vehicle suggesting that improving the dermatitis with a steroid might be synergistic, perhaps through a reduction in bacterial load.
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%.
Tazarotene Lotion 0.045% for the Treatment of Acne (FP)
Topical retinoids are recommended as first-line therapy for most patients with acne. Tazarotene 0.045% lotion is a novel formulation that utilizes polymeric emulsion technology to improve tolerability and epidermal penetration.
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.
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?
Topical Management of Rosacea
This article reviews the various subtypes of rosacea, their clinical presentations, and the considerations in choosing the optimal therapeutic options. The importance of tailored treatment is discussed as well as topical therapies.
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.
Chronic Hand Dermatitis: Case-based Approaches to Management
Practical guidelines for the management of Chronic Hand Dermatitis were published in the Skin Therapy Letter, Family Practice Edition (October 2016). This series of cases using Alitretinoin (Toctino®), is a follow on to that publication to put the guidelines into context.
A Review of Therapeutic Options for Head Lice
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.
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®).
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.