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Nohria A, Desai D, Klein EJ, Senna MM, Aguh C, Farah RS, Bordone L, Krueger LD, Mesinkovska N, Cummins D, Lo Sicco KI. The overturn of Roe v Wade: Google searches for teratogenic medications following the U.S. Supreme Court ruling. Int J Womens Dermatol 2024; 10:e139. [PMID: 38572267 PMCID: PMC10986908 DOI: 10.1097/jw9.0000000000000139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 02/25/2024] [Indexed: 04/05/2024] Open
Affiliation(s)
- Ambika Nohria
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York City, New York
| | - Deesha Desai
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York City, New York
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Elizabeth J. Klein
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York City, New York
| | - Maryanne M. Senna
- Department of Dermatology, Lahey Hospital & Medical Center, Burlington, Massachusetts
| | - Crystal Aguh
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Ronda S. Farah
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota
| | - Lindsey Bordone
- Department of Dermatology, Columbia University Irving Medical Center, New York City, New York
| | - Loren D. Krueger
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
| | - Natasha Mesinkovska
- Department of Dermatology, University of California Irvine, Irvine, California
| | - Donna Cummins
- The Dermatology Centre, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Manchester, United Kingdom
| | - Kristen I. Lo Sicco
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York City, New York
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Festok RA, Ahuja AS, Chen JY, Chu L, Barron J, Case K, Thompson E, Chen SC, Weiss J, Swerlick RA, Escoffery C, Yeung H. Barriers and Facilitators Affecting Long-Term Antibiotic Prescriptions for Acne Treatment. JAMA Dermatol 2024; 160:535-543. [PMID: 38568616 PMCID: PMC10993164 DOI: 10.1001/jamadermatol.2024.0203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 01/27/2024] [Indexed: 04/06/2024]
Abstract
Importance Dermatologists prescribe more oral antibiotics per clinician than clinicians in any other specialty. Despite clinical guidelines that recommend limitation of long-term oral antibiotic treatments for acne to less than 3 months, there is little evidence to guide the design and implementation of an antibiotic stewardship program in clinical practice. Objective To identify salient barriers and facilitators to long-term antibiotic prescriptions for acne treatment. Design, Setting, and Participants This qualitative study assessed data collected from stakeholders (including dermatologists, infectious disease physicians, dermatology resident physicians, and nonphysician clinicians) via an online survey and semistructured video interviews between March and August 2021. Data analyses were performed from August 12, 2021, to January 20, 2024. Main Outcomes and Measures Online survey and qualitative video interviews developed with the Theoretical Domains Framework. Thematic analyses were used to identify salient themes on barriers and facilitators to long-term antibiotic prescriptions for acne treatment. Results Among 30 participants (14 [47%] males and 16 [53%] females) who completed the study requirements and were included in the analysis, knowledge of antibiotic guideline recommendations was high and antibiotic stewardship was believed to be a professional responsibility. Five salient themes were to be affecting long-term antibiotic prescriptions: perceived lack of evidence to justify change in dermatologic practice, difficulty navigating patient demands and satisfaction, discomfort with discussing contraception, iPLEDGE-related barriers, and the absence of an effective system to measure progress on antibiotic stewardship. Conclusions and Relevance The findings of this qualitative study indicate that multiple salient factors affect long-term antibiotic prescribing practices for acne treatment. These factors should be considered in the design and implementation of any future outpatient antibiotic stewardship program for clinical dermatology.
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Affiliation(s)
- Ronnie A. Festok
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
| | - Avni S. Ahuja
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
| | - Jared Y. Chen
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
| | - Lena Chu
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
| | - Jason Barron
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
| | - Katherine Case
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
| | - Elaine Thompson
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
| | - Suephy C. Chen
- Department of Dermatology, Duke University School of Medicine, Durham, North Carolina
- Division of Dermatology, Durham VA Medical Center, Durham, North Carolina
| | - Jonathan Weiss
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
| | - Robert A. Swerlick
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
| | - Cam Escoffery
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
| | - Howa Yeung
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
- Associate Editor, JAMA Dermatology
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Holla S, Zamil DH, Paidisetty PS, Wang LK, Katta R. Using Artificial Intelligence to Assess the Teratogenic Risk of Vitamin A Supplements. Cureus 2023; 15:e45931. [PMID: 37885558 PMCID: PMC10599455 DOI: 10.7759/cureus.45931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2023] [Indexed: 10/28/2023] Open
Abstract
Vitamin A in high doses has been found to be highly teratogenic, leading to severe fetal abnormalities if exposure occurs during pregnancy. Hence, prescription vitamin A acne medications like isotretinoin are highly regulated via programs such as iPledge, which intend to avert fetal exposure to isotretinoin and to educate healthcare providers, pharmacists, and patients about the significant risks associated with isotretinoin and its appropriate usage conditions. However, over-the-counter (OTC) vitamin A supplements are not subject to these requirements, and calculating the vitamin A content of these supplements can be difficult due to the lack of Food and Drug Administration (FDA) regulations and inconsistencies in labeling. If the necessary information is provided, ChatGPT, a generative artificial intelligence (AI) tool, can help the general public calculate the vitamin A content of supplements. Nonetheless, supplement manufacturers do not always provide the data necessary for these calculations.
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Affiliation(s)
- Swathi Holla
- Dermatology, Baylor College of Medicine, Houston, USA
| | - Dina H Zamil
- Dermatology, Baylor College of Medicine, Houston, USA
| | - Praneet S Paidisetty
- Dermatology, McGovern Medical School, The University of Texas Health Science Center, Houston, USA
| | - Leonard K Wang
- Dermatology, John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, USA
| | - Rajani Katta
- Dermatology, McGovern Medical School, The University of Texas Health Science Center, Houston, USA
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Ding RL, Zheng Y, Bu J. Physiological and Psychological Effects of Isotretinoin in the Treatment of Patients with Acne: A Narrative Review. Clin Cosmet Investig Dermatol 2023; 16:1843-1854. [PMID: 37483471 PMCID: PMC10362870 DOI: 10.2147/ccid.s416267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 07/08/2023] [Indexed: 07/25/2023]
Abstract
Isotretinoin (ISO) is a powerful vitamin A derivative that offers the potential for treatment of permanent remission of acne; however, its potential side effects on both physiological and psychological aspects limit its application. This article reviews the side effects of ISO from physiological and psychological aspects in detail, to better screen the suitable population of ISO and improve the efficiency of clinical treatment. Our findings indicate that ISO may cause teratogenicity, skin reactions, ocular reactions, changes in blood indicators, and occasional acne fulminans. To optimize clinical treatment, more attention should be paid to identifying the specific conditions under which these reactions occur, how severe they are, and how they subside to alleviate patient concerns. Regarding the controversial issue of psychological side effects caused by ISO, researchers should shift their focus to the psychological problems that acne itself may cause.
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Affiliation(s)
- Rui-Lian Ding
- Hospital for Skin Disease, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu, People’s Republic of China
| | - Yu Zheng
- Hospital for Skin Disease, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu, People’s Republic of China
| | - Jin Bu
- Hospital for Skin Disease, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu, People’s Republic of China
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Abdelmaksoud A, Wollina U, Lotti T, Temiz SA. Isotretinoin and pregnancy termination: an overview. Int J Dermatol 2023; 62:e255-e256. [PMID: 36582022 DOI: 10.1111/ijd.16570] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 11/30/2022] [Accepted: 12/13/2022] [Indexed: 12/31/2022]
Affiliation(s)
- Ayman Abdelmaksoud
- Mansoura Dermatology, Venerology and Leprology Hospital, Mansoura, Egypt.,Department of Dermatology, University of Studies Guglielmo Marconi, Rome, Italy
| | - Uwe Wollina
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital, Dresden, Germany
| | - Torello Lotti
- University of Rome G. Marconi, Rome, Italy.,Department of Dermatology and Communicable Diseases, First Medical State Moscow University I. M. Sechenev, Moscow, Russia
| | - Selami A Temiz
- Department of Dermatology, Necmettin Erbakan University Meram Medical Faculty, Konya, Turkey
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Zamil DH, Wang LK, Paidisetty PS, Asad U, Ren V. Teratogenic, unregulated, vitamin A acne supplements, and Roe v Wade: Response to "The Supreme Court abortion ban impact on dermatology". J Am Acad Dermatol 2023; 88:e289. [PMID: 36780948 DOI: 10.1016/j.jaad.2022.12.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 12/27/2022] [Accepted: 12/29/2022] [Indexed: 02/13/2023]
Affiliation(s)
- Dina H Zamil
- School of Medicine, Baylor College of Medicine, Houston, Texas.
| | - Leonard K Wang
- John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, Texas, Galveston, Texas
| | - Praneet S Paidisetty
- McGovern Medical School, The University of Texas Health Science Center, Houston, Texas
| | - Usman Asad
- Department of Dermatology, Baylor College of Medicine, Houston, Texas
| | - Vicky Ren
- Department of Dermatology, Baylor College of Medicine, Houston, Texas
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Khanna R, Khanna R, Larson AR. Implications of the Dobbs decision on marginalized populations: Letter in reply to "The Supreme Court abortion ban impact on dermatology". J Am Acad Dermatol 2022; 88:e287-e288. [PMID: 36528269 DOI: 10.1016/j.jaad.2022.10.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/05/2022] [Accepted: 10/05/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Rayva Khanna
- Department of Internal Medicine, Medstar Washington Hospital Center, Washington, District of Columbia.
| | - Raveena Khanna
- Department of Dermatology, Howard University College of Medicine, Washington, District of Columbia
| | - Allison R Larson
- Department of Dermatology, Medstar Washington Hospital Center, Georgetown University Hospital, Washington, District of Columbia
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