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Seminars in Cutaneous Medicine and Surgery

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https://read.qxmd.com/read/30605493/align-psa-advancing-a-multidisciplinary-approach-in-psa
#1
Eric W Baum, Sergio Schwartzman
Psoriasis is a chronic skin condition that is associated with several comorbidities and co-manifestations that reduce patient quality of life. Psoriatic arthritis (PsA) is a form of spondyloarthritis that is associated with psoriasis and typically involves peripheral disease, axial disease, enthesitis, dactylitis, and skin and nail lesions. Psoriatic arthritis is associated with a substantial psychosocial and functional burden and can lead to irreversible joint damage if left untreated. Early and accurate diagnosis of PsA is critical...
December 2018: Seminars in Cutaneous Medicine and Surgery
https://read.qxmd.com/read/30475935/melasma-update-on-management
#2
Amanda K Suggs, Selina S Hamill, Paul M Friedman
Melasma is a common, acquired, chronic cutaneous pigment disorder that is often difficult to treat and has a high recurrence rate. The goal of a melasma treatment regimen is to decrease pigment production and increase elimination. Topical tyrosinase inhibitors block melanin synthesis and thereby reduce pigment production. Peels and laserand light-based devices increase melanin elimination. A multimodality treatment approach targeting both pigment production and elimination is necessary to achieve equilibrium and disease remission...
December 2018: Seminars in Cutaneous Medicine and Surgery
https://read.qxmd.com/read/30475934/vaginal-rejuvenation-whose-turf
#3
Laura Schilling, Nazanin Saedi
Many medical conditions can cross over the territories of various specialties. These conditions may benefit from, or even require, a multidisciplinary approach. While ideally this leads to a collaborative and coveted patient-centered care model, it can also give rise to competitive turf wars. A popular topic that has entered the turf wars is vaginal rejuvenation. Vaginal rejuvenation through light- and energy-based devices is a rapidly expanding field, quickly gaining the attention of dermatologists and gynecologists alike...
December 2018: Seminars in Cutaneous Medicine and Surgery
https://read.qxmd.com/read/30475933/the-vaginal-wellness-consultation-for-treatment-with-energy-based-devices
#4
Misha D Miller
No abstract text is available yet for this article.
December 2018: Seminars in Cutaneous Medicine and Surgery
https://read.qxmd.com/read/30475932/vaginal-wellness-whose-turf-is-it
#5
Min-Wei Christine Lee
Dermatologists were the pioneers in the development of laser technology and have the most experience using these lasers to treat the external genitalia for many cutaneous disorders. Dermatologists who have experience and expertise using lasers and devices, are already using them to treat the external genitalia, and are comfortable performing female gynecologic exams may want to explore the wide range of options that are available to treat the functional and aesthetic needs of the female population. Dermatologists should work with obstetricians and gynecologists to ensure that patients are proper candidates for the procedures...
December 2018: Seminars in Cutaneous Medicine and Surgery
https://read.qxmd.com/read/30475931/aesthetic-consideration-in-women-s-health-introduction
#6
Lauren Meshkov Bonati, Mona Sadeghpour, Nicola A Quatrano
No abstract text is available yet for this article.
December 2018: Seminars in Cutaneous Medicine and Surgery
https://read.qxmd.com/read/30475930/updates-on-the-understanding-and-treatment-of-cellulite
#7
Sara Hogan, Mara Weinstein Velez, Michael S Kaminer
Cellulite is a common dermatologic condition and frequent cause of cosmetic concern among women. This paper aims to update what is known about the pathogenesis of cellulite and reviews targeted treatment modalities that address its underlying components of microvascular dysfunction, endocrine-mediated inflammation, and connective tissue fibrosclerosis.
December 2018: Seminars in Cutaneous Medicine and Surgery
https://read.qxmd.com/read/30475929/aesthetic-considerations-in-female-skin-of-color-what-you-need-to-know
#8
Michelle Henry, Neil Sadick
The world is flat when it comes to aesthetic treatments, meaning women and men from all walks of life, regardless of culture and ethnicity or even socioeconomic status, are seeking ways to improve their appearance, prevent aging, and rejuvenate their skin. Year after year, statistics show a steady increase in people of color undergoing aesthetic treatments, with neurotoxins, fillers, laser resurfacing, and body contouring being the most sought-after procedures. When treating this cohort of patients, however, dermatologists need to be sensitized to how a patient's ethnicity affects facial structure, the tissue reaction to treatments, and patient's specific expectations for recommended therapies...
December 2018: Seminars in Cutaneous Medicine and Surgery
https://read.qxmd.com/read/30475928/treatment-of-female-pattern-hair-loss-with-combination-therapy
#9
Rosalynn R Conic, Shilpi Khetarpal, Wilma Bergfeld
Female pattern hair loss (FPHL) is a common nonscarring alopecia characterized by progressive loss of terminal hairs. FPHL is a major concern for women and has a high impact on quality of life. Therapeutic regimen is often challenging and requires multiple combinations of topical, systemic, and interventional therapies to control hair loss and produce satisfactory hair regrowth. This article reviews common treatments of FPHL and their efficacy.
December 2018: Seminars in Cutaneous Medicine and Surgery
https://read.qxmd.com/read/30475927/common-allergens-present-in-personal-care-products-identification-diagnosis-and-management
#10
Margaret Chou, Daniela Mikhaylov, Tamara Lazic Strugar
The incidence of allergic contact dermatitis (ACD) reactions to personal care products has progressively increased, affecting women more so than men. Fragrances and preservatives are the major sensitizers behind cosmetic-induced ACD, due to their ubiquitous presence in these products, though emulsifiers, ultraviolet filters, and botanical allergens have been implicated as well. While patch testing is the standard for diagnosing ACD, many cosmetic-specific antigens are not currently included within the commercially available kits...
December 2018: Seminars in Cutaneous Medicine and Surgery
https://read.qxmd.com/read/30475926/device-based-treatment-for-vaginal-wellness
#11
Macrene Alexiades
Genitourinary syndrome of menopause (GSM), encompassing the disorders of atrophic vaginitis, urinary incontinence, and pelvic prolapse, affects the majority of postmenopausal women, as well as patients who are undergoing breast cancer treatement, post-ovarectomy, post-radiation, and breast-feeding. There is a need for better treatment options for these common conditions that adversely affect physical function and quality of life and that are often underserved by existing options. Lasers have been used to treat genitourinary tissue for over 40 years, and over the past decade, several lasers and radiofrequency devices have been developed and clinically tested for the treatment of GSM, with an accumulating body of evidence demonstrating their safety and efficacy...
December 2018: Seminars in Cutaneous Medicine and Surgery
https://read.qxmd.com/read/30215638/jak-stat-signaling-pathway-inhibition-a-role-for-treatment-of-various-dermatologic-diseases
#12
Jared Kahn, Sandhya Chowdary Deverapalli, David Rosmarin
Cutaneous inflammatory conditions such as psoriasis, atopic dermatitis, alopecia areata, vitiligo, and connective tissue diseases often remain a challenge to treat. Although there is an in-depth understanding of the clinical presentation of these diseases, much less is known regarding the pathophysiology. This has limited the effective treatment options for patients. A more detailed understanding of the pathogenesis of each disease will lead to newer targeted medications with less morbidity. Though there are different pathways involved in these diseases, the Janus Kinase (JAK)-Signal Transducer and Activator of Transcription proteins (STAT) signaling pathway is common to them all...
September 2018: Seminars in Cutaneous Medicine and Surgery
https://read.qxmd.com/read/30215637/novel-therapies-in-the-treatment-of-atopic-dermatitis
#13
Connie S Zhong, Sarina B Elmariah
Atopic dermatitis (AD) is a common cutaneous condition characterized by epidermal barrier disruption, severe skin inflammation, and pruritus. As a result of our growing understanding of disease pathogenesis, the therapeutic armamentarium to manage AD is rapidly expanding. Moving beyond broadly immunosuppressive agents, newer therapies for AD offer more targeted immunomodulation in the forms of phosphodiesterase 4 inhibitors, Janus kinase inhibitors, and anticytokine monoclonal antibodies. While such therapies are generally considered safer than traditional immunosuppressive agents that have been used off label for AD for decades, they are not without risk entirely...
September 2018: Seminars in Cutaneous Medicine and Surgery
https://read.qxmd.com/read/30215636/overview-and-update-on-biologic-therapy-for-moderate-to-severe-hidradenitis-suppurativa
#14
Martina L Porter, Nicole M Golbari, Stephen J Lockwood, Alexa B Kimball
Hidradenitis suppurativa (HS) is a frequently devastating inflammatory skin disorder. Although many treatments have been tried and tested to date, there is only one Food and Drug Administration-approved treatment option, adalimumab, which is currently indicated for moderateto- severe HS. Our understanding of the management of HS with biologic agents and with nonantibiotic and/ or antimicrobial systemic therapies continues to evolve. In this article, we summarize the existing data on biologics and other small-molecule systemic agents, as well as share our personal experiences with the pharmacological management of HS in the clinical setting...
September 2018: Seminars in Cutaneous Medicine and Surgery
https://read.qxmd.com/read/30215635/targeted-therapies-for-psoriatic-arthritis-an-update-for-the-dermatologist
#15
Scott A Elman, Michael Weinblatt, Joseph F Merola
Dermatologists are on the front line to identify psoriatic arthritis (PsA) in their patients with psoriasis. PsA is a prevalent and underdiagnosed disease with potential long-term complications and sequelae for patients. Targeted biologics have transformed the landscape of psoriasis and PsA therapy. These medications variably treat clinical manifestations of psoriatic disease: skin psoriasis, peripheral and axial arthritis, enthesitis, and nail disease. With many new medications either on the market or currently being evaluated by the Food and Drug Administration, the purpose of this article is to review PsA for the dermatologist, to identify the current therapies that are available, and to help select which patients may benefit from these medications...
September 2018: Seminars in Cutaneous Medicine and Surgery
https://read.qxmd.com/read/30215634/targeted-therapies-for-pediatric-psoriasis
#16
Gene Schwartz, Amy S Paller
Children who are recalcitrant to topical therapy for their moderate to severe plaque psoriasis and/or highly visible lesions may be candidates for systemic therapy. Methotrexate has been the most commonly used systemic agent in children. However, at least 25% of patients are now treated with biologics, especially tumor necrosis factor-α inhibitors, and their use is expanding as their availability, demonstrated safety and efficacy, and practitioner experience are increasing. In the United States, etanercept is Food and Drug Administration approved for ages 6 years and older and ustekinumab for 12 years of age and older...
September 2018: Seminars in Cutaneous Medicine and Surgery
https://read.qxmd.com/read/30215633/oral-small-molecules-for-psoriasis
#17
Sanminder Singh, April W Armstrong
Psoriasis is chronic inflammatory skin condition that imposes a significant physical and psychosocial burden on patients. Moderate to severe psoriasis often requires systemic treatments, including oral systemic therapies and biologics. An addition to the treatment repository for psoriasis is oral small molecules, which include apremilast, tofacitinib, and ponesimod. Of these 3 medications, only apremilast is currently approved for the treatment of psoriasis. Long-term safety data for apremilast suggest that it has a tolerable safety profile and leads to significant improvement in patients with psoriasis; however, there are few head-to-head comparisons with other oral systemic medications...
September 2018: Seminars in Cutaneous Medicine and Surgery
https://read.qxmd.com/read/30215632/il-23-inhibitors-for-moderate-to-severe-psoriasis
#18
Erin Ibler, Kenneth B Gordon
Since the identification of high levels of interleukin 23 (IL- 23) in psoriasis lesional skin, as well as finding that IL-23 was the most important source of the p40 subunit shared by IL-12 and IL-23, significant effort has been made in identifying potential new drugs that specifically block the unique IL-23 p19 subunit. At this time, 2 inhibitors of IL-23 p19 have been approved by the United States Food and Drug Administration, guselkumab and tildrakizumab. Two other agents, risankizumab and mirikizumab, have completed phase 3 and phase 2 of development, respectively...
September 2018: Seminars in Cutaneous Medicine and Surgery
https://read.qxmd.com/read/30215631/il-17-inhibitors-for-psoriasis
#19
So Yeon Paek, Jillian Frieder, Dario Kivelevitch, M Alan Menter
The role of the Th17/interleukin (IL)-23 pathway has been well elucidated in psoriasis. The IL-17 family includes 6 cytokines: IL-17A, IL-17B, IL-17C, IL-17D, IL-17E, and IL-17F. Two monoclonal antibodies targeting IL-17A (secukinumab, ixekizumab) and one antibody against the IL-17 receptor (brodalumab) have been approved for the treatment of moderate-to-severe plaque psoriasis. Clinical efficacy, safety, and tolerability of each agent is reviewed.
September 2018: Seminars in Cutaneous Medicine and Surgery
https://read.qxmd.com/read/30215630/ustekinumab-for-the-treatment-of-psoriasis-an-evidence-update
#20
Zenas Zn Yiu, Richard B Warren
Ustekinumab is an interleukin-12/23 inhibitor used for the treatment of moderate-to-severe psoriasis. Here, we review new evidence since ustekinumab was licensed for relative efficacy in comparison with other biologic therapies from head-to-head randomized controlled trials and network meta-analyses for the treatment of psoriasis. We also review observational data emerging from psoriasis registries reporting the effectiveness and safety of ustekinumab. Overall, new evidence suggests that ustekinumab has a favorable balance between efficacy/effectiveness, safety, and tolerability and should remain a first-line biologic therapy option for patients with severe psoriasis at present...
September 2018: Seminars in Cutaneous Medicine and Surgery
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