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Alexis A, Del Rosso JQ, Forman S, Martorell A, Browning J, Laquer V, Desai SR, York JP, Chavda R, Dhawan S, Moore AY, Stein-Gold L. Importance of treating acne sequelae in skin of color: 6-month phase IV study of trifarotene with an appropriate skincare routine including UV protection in acne-induced post-inflammatory hyperpigmentation. Int J Dermatol 2024. [PMID: 38685118 DOI: 10.1111/ijd.17189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Acne-induced hyperpigmentation (AIH) may accompany acne vulgaris (AV) inflammation in all skin phototypes. Trifarotene has shown depigmenting properties in vivo. This study evaluated trifarotene plus skincare because it is increasingly recognized that holistic AV management should include skincare and treatments. METHODS This is a phase IV double-blind, parallel-group study of patients (13-35 years) with moderate AV and AIH treated with trifarotene (N = 60) or vehicle (N = 63) plus skincare regimen (moisturizer, cleanser, and sunscreen) for 24 weeks. Assessments included the AIH overall disease severity (ODS) score, post-AV hyperpigmentation index (PAHPI), exit interviews, photography, and acne assessments. Standard safety assessments were included. RESULTS Trifarotene 50 μg/g cream improved significantly from baseline in ODS score versus vehicle (-1.6 vs. -1.1, P = 0.03) at Week 12, but scores were comparable between groups at Week 24 (primary endpoint). Trifarotene had a better reduction in PAHPI score at Week 24 (-18.9% vs. -11.3% vehicle, P < 0.01). Lesion count reductions were higher with trifarotene at Week 12 versus vehicle (P < 0.001) and at Week 24 (P < 0.05), as were IGA success rates versus vehicle at Weeks 12 (P < 0.05) and 24 (P < 0.05). Patients agreed that the skincare regimen contributed to less irritation, making treatment adherence easier. Photography showed improvements in pigmentation and erythema across all skin types. AEs were more common in the vehicle group versus trifarotene (30.2 vs. 16.7%, respectively). CONCLUSIONS In all skin phototypes, there was more rapid improvement in the ODS and PAHPI scores with trifarotene by Weeks 12 and 24, respectively. The combination of trifarotene and skincare correlated with high patient satisfaction and adherence to the treatment protocol.
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Affiliation(s)
- Andrew Alexis
- Department of Dermatology, Weill Cornell Medical College, New York, NY, USA
| | | | | | | | | | - Vivian Laquer
- First OC Dermatology Research Inc., Fountain Valley, CA, USA
| | - Seemal R Desai
- Innovative Dermatology, Plano, TX, USA
- Department of Dermatology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | | | - Sunil Dhawan
- Center for Dermatology, Clinical Research, Inc., Fremont, CA, USA
| | - Angela Y Moore
- Baylor University Medical Center, Dallas, TX, USA
- Arlington Research Center, Arlington, TX, USA
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Jackson JM, Alexis A, Zirwas M, Taylor S. Unmet needs for patients with seborrheic dermatitis. J Am Acad Dermatol 2024; 90:597-604. [PMID: 36538948 DOI: 10.1016/j.jaad.2022.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 12/07/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022]
Abstract
Seborrheic dermatitis (SD) is a common skin disease with signs and symptoms that may vary by skin color, associated medical conditions, environmental factors, and vehicle preference. Diagnosis of SD is based on presence of flaky, "greasy" patches, and/or thin plaques accompanied by erythema of the scalp, face, ears, chest, and groin and is associated with pruritus in many patients. The presentation may vary in different skin types and hyper- or hypopigmentation may occur, with or without erythema and minimal or no scaling. While the pathogenesis is not certain, 3 key factors generally agreed upon include lipid secretion by sebaceous glands, Malassezia spp. colonization, and some form of immunologic dysregulation that predisposes the patient to SD. Treatment involves reducing proliferation of, and inflammatory response to, Malassezia spp. Topical therapies, including antifungal agents and low potency corticosteroids, are the mainstay of treatment but may be limited by efficacy and side effects. Few novel treatments for SD are currently being studied; however, clinical trials assessing the use of topical phosphodiesterase-4 inhibitors have been completed. Improving outcomes in SD requires recognizing patient-specific manifestations/locations of the disease, including increased awareness of how it affects people of all skin types.
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Affiliation(s)
- J Mark Jackson
- University of Louisville, Division of Dermatology, Forefront Dermatology, Louisville, Kentucky.
| | | | - Matthew Zirwas
- Dermatologists of the Central States, Probity Medical Research, and Ohio University, Bexley, Ohio
| | - Susan Taylor
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
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Silverberg JI, Horeczko J, Alexis A. Development of an Eczema Area and Severity Index Atlas for Diverse Skin Types. Dermatitis 2024; 35:173-177. [PMID: 37279030 DOI: 10.1089/derm.2023.0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Background: Current guidance for using Eczema Area and Severity Index (EASI) implementation is limited to lighter skin phototypes. We developed an EASI lesion severity atlas and refined guidance for investigators and clinicians to use across diverse patient populations. Methods: A review was performed of clinical images from internal atopic dermatitis (AD) photorepositories. Representative images of the 4 AD signs included in EASI were selected for different physician-assessed skin phototypes. Images were excluded if they had low resolution, poor focus, or lighting. Discrepancies regarding skin pigmentation and AD severity were resolved by consensus between authors. Results: Over 3000 clinical photographs were reviewed. Final images were selected using an iterative review process and consensus. Two different versions of the atlas were created across 6 physician-assessed phototypes (I-VI) and 3 skin complexions (light, medium, and dark). We propose guidance language for erythema to reflect the range of colors encountered across different skin complexions (shades of red, purple, and brown). Conclusion: We created a photographic atlas and updated guidance language for implementing EASI in diverse populations, including those with higher skin phototypes.
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Affiliation(s)
- Jonathan I Silverberg
- From the Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Joshua Horeczko
- Georgetown University School of Medicine, Washington, District of Columbia, USA
| | - Andrew Alexis
- Department of Dermatology, Weill Cornell Medical College, New York, New York, USA
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Harvey VM, Alexis A, Okeke CAV, McKinley-Grant L, Taylor SC, Desai SR, Jaleel T, Heath CR, Kang S, Vashi N, Lester J, Vasquez R, Rodrigues M, Elbuluk N, Hamzavi I, Kwatra SG, Sundaram H, Cobb C, Brown SG, Kohli I, Callender VD. Integrating skin color assessments into clinical practice and research: A review of current approaches. J Am Acad Dermatol 2024:S0190-9622(24)00215-9. [PMID: 38342247 DOI: 10.1016/j.jaad.2024.01.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 01/26/2024] [Accepted: 01/28/2024] [Indexed: 02/13/2024]
Abstract
Skin color classification can have importance in skin health, pigmentary disorders, and oncologic condition assessments. It is also critical for evaluating disease course and response to a variety of therapeutic interventions and aids in accurate classification of participants in clinical research studies. A panel of dermatologists conducted a literature review to assess the strengths and limitations of existing classification scales, as well as to compare their preferences and utilities. We identified 17 skin classification systems utilized in dermatologic settings. These systems include a range of parameters such as UV light reactivity, race, ethnicity, and degree of pigmentation. The Fitzpatrick skin type classification is most widely used and validated. However it has numerous limitations including its conflation with race, ethnicity, and skin color. There is a lack of validation data available for the remaining scales. There are significant deficiencies in current skin classification instruments. Consensus-based initiatives to drive the development of validated and reliable tools are critically needed.
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Affiliation(s)
- Valerie M Harvey
- Director, Hampton Roads Center for Dermatology, Newport News, Virginia; President, Skin of Color Society, Newport News, Virginia.
| | - Andrew Alexis
- Clinical Dermatology, Weill Cornell Medical College, New York, New York
| | - Chidubem A V Okeke
- Department of Dermatology, Howard University College of Medicine, Washington, District of Columbia
| | - Lynn McKinley-Grant
- Department of Dermatology, Howard University College of Medicine, Washington, District of Columbia
| | - Susan C Taylor
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Seemal R Desai
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas; Innovative Dermatology, Dallas, Texas
| | - Tarannum Jaleel
- Department of Dermatology, Duke University School of Medicine, Durham, North Carolina
| | - Candrice R Heath
- Department of Dermatology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Sewon Kang
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Neelam Vashi
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts
| | - Jenna Lester
- Department of Dermatology, School of Medicine, University of California, San Francisco, California
| | | | - Michelle Rodrigues
- Department of Dermatology, Royal Children's Hospital, Victoria, Australia
| | - Nada Elbuluk
- Department of Dermatology, Keck Medicine, University of Southern California, Los Angeles, California
| | - Iltefat Hamzavi
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | - Shawn G Kwatra
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Hema Sundaram
- Private Practice, Rockville, Maryland; Private Practice, Fairfax, Virginia; Musculoskeletal and Dermatological Sciences, School of Biological Sciences, University of Manchester, Manchester, United Kingdom
| | - Caryn Cobb
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Stafford G Brown
- Department of Internal Medicine, Eastern Virginia Medical School, Norfolk, Virginia
| | - Indermeet Kohli
- The Henry W Lim, MD, Division of Photobiology and Photomedicine, Department of Dermatology, Henry Ford Health, Detroit, Michigan; Department of Physics and Astronomy, Wayne State University, Detroit, Michigan
| | - Valerie D Callender
- Department of Dermatology, Howard University College of Medicine, Washington, District of Columbia
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McMichael A, Callender V, Woolery-Lloyd H, Hinkley K, See K, Garrelts A, Alexis A. Outcomes for Psoriasis by Self-Identified Racial Groups in Ixekizumab Clinical Trials: A Pooled Analysis. J Drugs Dermatol 2024; 23:17-22. [PMID: 38306141 DOI: 10.36849/jdd.7672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
BACKGROUND Biologics have shown promising outcomes in psoriasis clinical trials. However, there is a paucity of data exploring the potential differences in outcomes between self-identified racial groups. OBJECTIVE To evaluate treatment response to ixekizumab in patients with psoriasis across different self-identified racial subgroups. METHODS This study analyzed pooled data from 5 clinical studies (UNCOVER-1, UNCOVER-2, UNCOVER-3, IXORA-R, and IXORA-S) with patients of different self-identified racial subgroups, who were treated with an on-label dose of ixekizumab for psoriasis through 12 weeks. Treatment response to ixekizumab was assessed using the Psoriasis Area and Severity Index (PASI) and static Physician’s Global Assessment response rates. Patient Global Assessment of Disease Severity, Itch Numeric Rating Scale, Skin Pain Visual Analog Scale, and Dermatology Life Quality Index were used to evaluate the patient-reported outcomes (PROs) and impact on quality of life (QoL). RESULTS A total of 1825 ixekizumab-treated patients from 5 pooled studies were included. Consistent with the clinical outcomes from the overall population, all self-identified racial groups showed rapid improvement in PASI through Week 12, although the response was somewhat slower in American Indian/Alaska Native patients. Differences in PROs and QoL assessments were observed among racial groups, especially in patients who identified as Black/African American and American Indian/Alaska Native. CONCLUSION Ixekizumab is effective through 12 weeks of treatment for psoriasis across different self-identified racial groups. Sample sizes for some racial groups were small (N≤12), therefore, further research is required to understand potential differences in psoriasis treatment with ixekizumab between various racial groups.J Drugs Dermatol. 2024;23(2):17-22. doi:10.36849/JDD.7672.
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Layton AM, Alexis A, Baldwin H, Bettoli V, Del Rosso J, Dirschka T, Dréno B, Gold LS, Harper J, Ko JY, Al Nuaimi K, Oon HH, Rajagopalan M, Rocha M, See JA, Weiss J, Tan J. The Personalized Acne Treatment Tool - Recommendations to facilitate a patient-centered approach to acne management from the Personalizing Acne: Consensus of Experts. JAAD Int 2023; 12:60-69. [PMID: 37274381 PMCID: PMC10236180 DOI: 10.1016/j.jdin.2023.03.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2023] [Indexed: 06/06/2023] Open
Abstract
Background Acne, a commonly treated skin disease, requires patient-centered management due to its varying presentations, chronicity, and impact on health-related quality of life. Despite this, evidence-based clinical guidelines focus primarily on clinical severity of facial acne, omitting important patient- and disease-related factors, including ongoing management. Objectives To generate recommendations to support patient-centered acne management, which incorporate priority and prognostic factors beyond conventional clinical severity, traditionally defined by grading the appearance and extent of visible lesions. Methods The Personalizing Acne: Consensus of Experts consisted of 17 dermatologists who used a modified Delphi approach to reach consensus on statements regarding patient- and treatment-related factors pertaining to patient-centered acne management. Consensus was defined as ≥75% voting "agree" or "strongly agree." Results Recommendations based on factors such as acne sequelae, location of acne, high burden of disease, and individual patient features were generated and incorporated into the Personalized Acne Treatment Tool. Limitations Recommendations are based on expert opinion, which may differ from patients' perspectives. Regional variations in healthcare systems may not be represented. Conclusions The Personalizing Acne: Consensus of Experts panel provided practical recommendations to facilitate individualized management of acne, based on patient features, which can be implemented to improve treatment outcomes, adherence, and patient satisfaction.
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Affiliation(s)
- Alison M. Layton
- Skin Research Centre, York University, York, UK
- Harrogate and District NHS Foundation Trust, Harrogate, UK
| | | | - Hilary Baldwin
- Robert Wood Johnson Medical Center, New Brunswick, New Jersey
- The Acne Treatment and Research Center, Brooklyn, New York
| | - Vincenzo Bettoli
- Dermatology Unit – Teaching Hospital, Azienda Ospedaliera, University of Ferrara, Ferrara, Italy
| | - James Del Rosso
- Advanced Dermatology and Cosmetic Surgery, Maitland, Florida
- JDR Dermatology Research, Las Vegas, Nevada
| | | | | | | | - Julie Harper
- Dermatology and Skin Care Center of Birmingham, Birmingham, Alabama
| | - Joo Yeon Ko
- Department of Dermatology, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Khaled Al Nuaimi
- Faculty of Medicine, Sharjah University, Sharjah, United Arab Emirates
| | - Hazel H. Oon
- Division of Dermatology, National Skin Centre, Singapore
| | | | - Marco Rocha
- Federal University of São Paulo, São Paulo, Brazil
| | - Jo-Ann See
- Central Sydney Dermatology, Sydney, New South Wales, Australia
| | | | - Jerry Tan
- Windsor Clinical Research Inc, Windsor, Ontario, Canada
- Department of Medicine, University of Western Ontario, Windsor, Ontario, Canada
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Silverberg JI, Shi VY, Alexis A, Pierce E, Cronin A, McLean RR, Roberts-Toler C, Rueda MJ, Atwater AR, Simpson E. Racial and Ethnic Differences in Sociodemographic, Clinical, and Treatment Characteristics Among Patients with Atopic Dermatitis in the United States and Canada: Real-World Data from the CorEvitas Atopic Dermatitis Registry. Dermatol Ther (Heidelb) 2023; 13:2045-2061. [PMID: 37481484 PMCID: PMC10442294 DOI: 10.1007/s13555-023-00980-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 07/07/2023] [Indexed: 07/24/2023] Open
Abstract
INTRODUCTION This real-world, cross-sectional study compared sociodemographic, clinical and treatment characteristics, and patient-reported outcomes (PROs) among racial/ethnic groups in patients with atopic dermatitis (AD) who are candidates for systemic therapy. METHODS This study included adults with dermatologist- or dermatology practitioner-diagnosed AD enrolled in the CorEvitas AD Registry (July 2020-July 2021). All patients initiated systemic therapy within 12 months prior to or at enrollment or had moderate-to-severe AD (vIGA-AD® ≥ 3 and Eczema Area and Severity Index [EASI] ≥ 12) at enrollment. Patients were categorized into five mutually exclusive racial/ethnic groups: non-Hispanic White, Black, Asian, Other/Multiracial, and Hispanic (any race). Patient, clinical, and treatment characteristics were captured at enrollment. Differences in means or proportions of characteristics among racial/ethnic groups were descriptively summarized using effect sizes. Adjusted prevalence ratios and mean differences were estimated (White race/ethnicity group as the reference category) with 95% confidence intervals (CI). RESULTS Among 1288 patients, 64% (n = 822) were White, 13% (n = 167) Black, 10% (n = 129) Asian, 8% (n = 97) Hispanic, and 6% (n = 73) Other/Multiracial. In adjusted analyses, statistically more severe EASI lichenification was noted among Black compared with White patients at the head and neck (mean difference, 0.21, [95% CI 0.06, 0.36]; p = 0.01), trunk (0.32, [0.17, 0.47]; p < 0.001), upper extremities (0.27, [0.09, 0.44]; p = 0.008), and lower extremities (0.39, [0.21, 0.57]; p < 0.001). Statistically more severe EASI lichenification was observed among Asian vs White patients in certain areas (mean difference, head and neck, 0.22 [0.04, 0.39], p = 0.01; trunk, 0.25 [0.07, 0.43], p < 0.001; lower extremities, 0.22 [0.01, 0.43], p < 0.001) and SCORing for AD lichenification (mean difference: 0.34 [0.15, 0.52]; p < 0.001). Significantly higher mean pruritus over the past 7 days for Black (mean difference: 0.63 [0.01, 1.26] and Hispanic patients (0.60 [0.11, 1.09]; p = 0.03) vs White patients was observed. Among AD clinical features, the prevalence of facial erythema was significantly lower among Black compared with White patients (prevalence ratio = 0.38, [0.22, 0.67]; p = 0.007). CONCLUSION Racial/ethnic differences exist in sociodemographic, clinical and treatment characteristics, disease severity, and PROs among real-world AD patients who are candidates for systemic therapy. Recognizing these variations may be of critical importance for dermatologists for the design and delivery of targeted/personalized medicine approaches.
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Affiliation(s)
- Jonathan I Silverberg
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Vivian Y Shi
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - Evangeline Pierce
- Eli Lilly and Company, 893 S. Delaware Street, Indianapolis, IN, 46225, USA.
| | | | | | | | - Maria J Rueda
- Eli Lilly and Company, 893 S. Delaware Street, Indianapolis, IN, 46225, USA
| | - Amber R Atwater
- Eli Lilly and Company, 893 S. Delaware Street, Indianapolis, IN, 46225, USA
| | - Eric Simpson
- Oregon Health and Science University, Portland, OR, USA
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Piffoux M, Delpon G, Ducrot C, Alexis A, Allignet B, Dupraz C, Egnell M, Kernec M, Milewski C, Rivera S, Vitré J, Ali D, Supiot S. Insights on the carbon footprint of radiotherapy in France. Cancer Radiother 2023; 27:487-490. [PMID: 37558609 DOI: 10.1016/j.canrad.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 07/20/2023] [Accepted: 07/20/2023] [Indexed: 08/11/2023]
Abstract
The French healthcare system is responsible for 8% of the national footprint. Achieving a net zero emissions scenario will require a 4-5 fold decrease of carbon emissions in the coming years. The carbon footprint of radiation therapy has not been specifically studied to date. In this review we summarize the content of the carbon footprint dedicated session at the annual meeting of the French society of radiation oncology (SFRO). We discuss the French healthcare system carbon footprint and its major drivers and our work on the estimation of the carbon footprint of external beam radiation therapy in the French setting. We developed a dedicated methodology to estimate the carbon footprint related to radiation therapies, and describe the main drivers of emissions based on a single centre as an example, namely patient's rides, accelerators acquisition and maintenance and data storage. Based on the carbon footprint calculated in our centres, we propose mitigation strategies and an estimation of their respective potential. Our results may be extrapolated to other occidental settings by adapting emission factors (kilograms of carbon per item or euro) to other national settings. External beam radiation therapy has a major carbon footprint that may be mitigated in many ways that may impact how radiation therapy treatments are delivered, as well as the national organization of the radiotherapy sector. This needs to be taken into account when thinking about the future of radiotherapy.
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Affiliation(s)
- M Piffoux
- Département d'oncologie médicale, hospices civils de Lyon, Citohl, Lyon, France; Direction de la recherche clinique et de l'innovation, centre Léon-Bérard, Lyon, France.
| | - G Delpon
- Département de physique médicale, Institut de cancérologie de l'Ouest centre René-Gauducheau, Saint-Herblain, France; Laboratoire Subatech, UMR 6457 CNRS-IN2P3, IMT Atlantique, Nantes, France
| | - C Ducrot
- Département de chirurgie orthopédique, hôpital Femme-Mère-Enfant, hospices civils de Lyon, Bron, France; Laboratoire mort cellulaire et cancers de l'enfant, U1052, Inserm, U5286, CNRS, centre de recherche en cancérologie de Lyon, Lyon, France
| | - A Alexis
- Département de physique médicale, Institut de cancérologie de l'Ouest centre René-Gauducheau, Saint-Herblain, France
| | - B Allignet
- Département de radiothérapie, centre Léon-Bérard, Lyon, France; Insa-Lyon, université Claude-Bernard Lyon-1, laboratoire Creatis UMR 5220, U1294, Lyon, France; Université Jean-Monnet, Saint-Étienne, France
| | - C Dupraz
- Direction de la recherche clinique et de l'innovation, centre Léon-Bérard, Lyon, France
| | - M Egnell
- The Shift Project, Paris, France
| | - M Kernec
- The Shift Project, Paris, France
| | - C Milewski
- Institut Gustave-Roussy, Villejuif, France
| | - S Rivera
- Institut Gustave-Roussy, Villejuif, France
| | - J Vitré
- Institut Gustave-Roussy, Villejuif, France
| | - D Ali
- Centre de radiothérapie de Versailles, Versailles, France
| | - S Supiot
- Département de radiothérapie, Institut de cancérologie de l'Ouest centre René-Gauducheau, Saint-Herblain, France; Laboratoire US2B, CNRS UMR 6286, université de Nantes, Nantes, France
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Wollenberg A, Kircik L, Simpson E, Brinker D, Katoh N, Rueda MJ, Issa M, Yang F, Feely M, Alexis A. Pooled Analysis of Baricitinib Tolerability in Patients With Atopic Dermatitis in Relation to Acne, Headache, and Gastrointestinal Events From 8 Clinical Trials. Dermatitis 2023; 34:308-314. [PMID: 36749121 PMCID: PMC10357532 DOI: 10.1089/derm.2022.0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Background: Tolerability issues including acne, nausea, and headache have been reported with Janus kinase (JAK) inhibitors for moderate-to-severe atopic dermatitis (AD). Objectives: To report outcomes of tolerability adverse events (AEs) for baricitinib, a JAK1/JAK2 inhibitor, in patients with moderate-to-severe AD. Methods: Acne, headache, and gastrointestinal AEs are reported from placebo-controlled and long-term extensions of pooled data in the baricitinib AD clinical trial program. Proportions of patients with AEs, incidence rates (IRs)/100 patient-years at risk, and median time to onset/duration of AEs were calculated. Results: In 2531 patients treated with baricitinib, most AEs were mild to moderate in severity. Headache was the most common AE of tolerability (median of 14-26 days after first dose of baricitinib, lasting ≤3 days). IRs of acne were <5 in any group lasting up to a median of 90 days with no severe AEs. Diarrhea was the most common gastrointestinal AE, lasting a median of ≤7 days. There were few study drug interruptions (n = 6) and permanent discontinuations (n = 5) for tolerability AEs. Conclusions: For the AEs of tolerability analyzed, baricitinib appears to be well tolerated. Overall, the frequency of these AEs in patients being treated for moderate-to-severe AD was low with few leading to study drug interruption or permanent discontinuation. Clinical Trial Registration number: NCT02576938; NCT03334396; NCT03334422; NCT03428100; NCT03435081; NCT03733301; NCT03334435; NCT03559270.
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Affiliation(s)
- Andreas Wollenberg
- From the Department of Dermatology and Allergy University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
- Department of Dermatology, Free University Brussels, University Hospital Brussels, Brussels, Belgium
| | - Leon Kircik
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Eric Simpson
- Oregon Health & Science University, Portland, Oregon, USA
| | | | - Norito Katoh
- Department of Dermatology Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | - Maher Issa
- Eli Lilly and Company, Indianapolis, Indiana, USA
| | - Fan Yang
- Eli Lilly and Company, Indianapolis, Indiana, USA
| | - Meghan Feely
- Eli Lilly and Company, Indianapolis, Indiana, USA
- Icahn School of Medicine, Mount Sinai, New York, New York, USA
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10
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Taylor S, Elbuluk N, Grimes P, Chien A, Hamzavi I, Alexis A, Gonzalez N, Weiss J, Kang S, Desai SR. TREATMENT RECOMMENDATIONS FOR ACNE-ASSOCIATED HYPERPIGMENTATION: RESULTS OF A DELPHI CONSENSUS PROCESS AND LITERATURE REVIEW. J Am Acad Dermatol 2023:S0190-9622(23)00366-3. [PMID: 36924935 DOI: 10.1016/j.jaad.2023.02.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 03/17/2023]
Abstract
Acne vulgaris can be associated with hyperpigmentation, particularly in individuals with skin of color. This acne-induced macular hyperpigmentation (AMH), also called post-inflammatory hyperpigmentation or PIH, is often long-lasting and negatively impacts quality of life. Large-scale randomized controlled clinical trials regarding treatment of acne and AMH are lacking. For this reason, evidence-based treatment recommendations cannot be made. Yet AMH is a common condition, and it is important for clinicians to have guidance on management strategies. The authors, a group of 10 board-certified dermatologists, conducted a modified Delphi consensus process to reach consensus on first-line therapy for AMH and whether therapeutic choices may change in different patient sub-groups. We reached consensus that most patients with acne and AMH should receive early and efficacious acne treatment with a topical retinoid and benzoyl peroxide. Therapies aimed at addressing AMH - including hydroquinone, azelaic acid, chemical peel, or antioxidants - may also be considered to enhance the effect of the treatment regimen on acne and pigmentation. Chemical peels may be used as adjunctive or second-line therapy. This publication details the results of the Delphi process, reviews relevant literature in providing recommendations for AMH and discusses appropriate treatment options.
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Affiliation(s)
- Susan Taylor
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Nada Elbuluk
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles
| | - Pearl Grimes
- Department of Dermatology, David Geffen School of Medicine, University of California - Los Angeles, CA
| | - Anna Chien
- 9 Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | | | - Andrew Alexis
- Department of Dermatology, Weill Cornell Medicine, New York, NY
| | | | - Jonathan Weiss
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA
| | - Sewon Kang
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Seemal R Desai
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX; Innovative Dermatology, Plano, TX
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11
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Schachner L, Alexis A, Andriessen A, Baldwin H, Cork M, Kirsner R, Woolery-Lloyd H. Supplement Individual Article: The Importance of a Healthy Skin Barrier From the Cradle to the Grave Using Ceramide-Containing Cleansers and Moisturizers: A Review and Consensus. J Drugs Dermatol 2023; 22:SF344607s3-SF344607s14. [PMID: 36745380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Inflammatory skin disorders compromise skin barrier health. Early and daily skincare use aims to maintain a life-long healthy skin barrier. Racial/ethnic and age variations in skin barrier properties, cultural differences, and clinical presentation of the inflammatory skin disorder influence the choice of treatment and skin care. Ceramide-containing skin care may play a role in restoring and maintaining a healthy skin barrier. METHODS A panel of 6 dermatologists met to develop consensus statements based on their 8 previous publications on promoting skin barrier health throughout life using ceramide-containing skin care. The publications covered skin barrier integrity in the newborn and infant, and the role of the skin barrier in mitigating atopic dermatitis (AD); racial/ethnic variations in the skin barrier and implications for skin care; the role of the skin barrier in inflammatory skin conditions including acne, AD and psoriasis in skin of color (SOC) populations; skin barrier integrity in patients with rosacea; and xerosis in patients with diabetes mellitus. The panel synthesized the 8 publications, selected information from a literature review, and their expert opinions and experiences to create the statements. The consensus was reached through a modified Delphi method where the panel met face-to-face and followed up virtually. RESULTS The panel adopted 6 consensus statements highlighting the importance of skin care in restoring/maintaining a healthy skin barrier in the populations mentioned above. Skin care suited to this role is gentle, has near-physiologic pH, is pleasant to use, and contains ceramides. This type of skin care can promote a healthy skin barrier and attenuate or delay inflammatory skin conditions. CONCLUSIONS Adjunctive daily skin care throughout life promotes a healthy skin barrier and is beneficial in managing various inflammatory skin disorders in all populations. However, when choosing optimal treatment and skin care, physicians should consider variations in age, skin properties, presentation of the condition, and cultural differences. J Drugs Dermatol. 2023;22:2(Suppl 1):s3-14.
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12
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Liu J, Cices A, Kaufman B, Sanabria-Gonzalez I, Alexis A. Efficacy and Safety of Calcipotriene/Betamethasone Dipropionate Foam in the Treatment of Psoriasis in Skin of Color. J Drugs Dermatol 2023; 22:165-173. [PMID: 36745370 DOI: 10.36849/jdd.6910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND There is a paucity of data on usage of topical medications in patients with darker phototypes. This single-center, randomized, double-blinded, vehicle-controlled clinical study investigated the efficacy of a combination calcipotriene/betamethasone dipropionate (Cal/BD) aerosol foam 0.005%/0.064% in the treatment of psoriasis vulgaris in Fitzpatrick skin types IV to VI. METHODS 25 adult subjects were randomized 4:1 to Cal/BD foam or foam vehicle once daily for 4 weeks followed by 4 weeks of open label treatment. From week 4 to week 8, subjects randomized to Cal/BD foam once daily switched to Cal/BD foam twice weekly for 4 weeks, while those randomized to vehicle applied Cal/BD foam once daily. RESULTS At week 4, 4/19 (21%) of Cal/BD foam patients achieved clear/almost clear Investigator Global Assessment (IGA) status with ≥2 grade improvement compared with 0/5 (0%) of vehicle patients (P=0.54). 12/19 (63%) of Cal/BD foam patients achieved a 50% reduction in Psoriasis Area and Severity Index (PASI 50) at week 4, compared with 0/5 (0%) of vehicle patients (P=0.04). Mean changes in melanin index at week 4 indicate a trend toward increased pigmentation in Cal/BD foam patients and decreased pigmentation in foam vehicle patients (P=0.30). All adverse events were mild and deemed unrelated to treatment by the investigators. LIMITATIONS The sample size was small and underpowered to detect statistically significant changes in most endpoints. CONCLUSION Cal/BD foam was safe and well tolerated in plaque psoriasis patients with skin of color. Larger studies involving skin of color populations with psoriasis are warranted. Pigmentary changes (hyper- and hypopigmentation) in lesional skin were observed. J Drugs Dermatol. 2023;22(2): 165-173.doi:10.36849/JDD.6910.
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13
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Narla S, Heath CR, Alexis A, Silverberg JI. Racial disparities in dermatology. Arch Dermatol Res 2022; 315:1215-1223. [PMID: 36508020 PMCID: PMC9743121 DOI: 10.1007/s00403-022-02507-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 12/04/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022]
Abstract
Significant racial/ethnic disparities in dermatologic care and their subsequent impact on dermatologic conditions were recently reported. Contributing factors include socioeconomic factors, gaps in educational exposure, and underrepresentation of minority groups in the dermatologic workforce. In 2021, the American Academy of Dermatology (AAD) announced its three-year plan to expand diversity, equity, and inclusion in dermatology. One way to reduce disparities in dermatology is for every dermatologist, regardless of race or ethnicity, to receive adequate education in diseases, treatments, health equity, and tailored approaches to delivering dermatologic care with cultural humility. In addition, a diverse dermatologic workforce-especially at the level of residency program educators and organizational leaders-will contribute to improved cross-cultural understanding, more inclusive research efforts, and improved treatment approaches for conditions that are more prevalent or nuanced in certain racial/ethnic populations. Finally, the dermatology and broader healthcare community needs to acknowledge and educate ourselves on the health impacts of racism.
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Affiliation(s)
- Shanthi Narla
- Department of Dermatology, St. Luke’s University Health Network, Easton, PA 18045 USA
| | - Candrice R. Heath
- Department of Dermatology, Lewis Katz School of Medicine, Temple University Hospital, Philadelphia, PA 19140 USA
| | - Andrew Alexis
- Department of Dermatology, Weill Cornell Medicine, New York, NY 10075 USA
| | - Jonathan I. Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Suite 2B-430, 2150 Pennsylvania Avenue, Washington, DC 20037 USA
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14
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Alexis A, Peebles JK. Diversity, equity, and inclusion: The visionary future of JAAD. J Am Acad Dermatol 2022; 87:1275-1276. [PMID: 36375716 DOI: 10.1016/j.jaad.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022]
Affiliation(s)
- Andrew Alexis
- Department of Dermatology, Weill Cornell Medicine, New York, New York
| | - J Klint Peebles
- Department of Dermatology, Kaiser Permanente Mid-Atlantic Permanente Medical Group, Rockville, MD.
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15
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El-Kashlan N, Alexis A. Disparities in Dermatology: A Reflection. J Clin Aesthet Dermatol 2022; 15:27-29. [PMID: 36381186 PMCID: PMC9651153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
We share a passion for advancing racial and ethnic equity in science, medicine, and health. The aim of our manuscript is to illuminate longstanding racial disparities engrained within the American healthcare system and practice of medicine with a special focus on racial and ethnic diversity within the field of dermatology. We highlight crucial contributory factors that have perpetuated racial and ethnic disparities within the field, such as disparities in provider background, access to care, and resident education. We propose necessary and practical interventions that can improve representation, education, and research, and ultimately lead to improved patient outcomes and dermatological care.
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Affiliation(s)
- Nour El-Kashlan
- Dr. El-Kashlan is with the Department of Dermatology at Icahn School of Medicine at Mount Sinai in New York, New York
| | - Andrew Alexis
- Dr. Alexis is with the Department of Dermatology at Weill Cornell Medical College at Cornell University in Ithaca, New York
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16
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Alexis A, Woolery-Lloyd H, Andriessen A, Kang S, Rodriguez D, Callender V. Racial/Ethnic Variations in Acne: A Practical Algorithm for Treatment and Maintenance, Including Skincare Recommendations for Skin of Color Patients With Acne. J Drugs Dermatol 2022; 21:s13223-s132214. [PMID: 36342741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
BACKGROUND Racial/ethnic differences in the clinical presentation, sequelae, and desired treatment outcomes for acne have been reported. Post-inflammatory hyperpigmentation (PIH) frequently occurs in patients with richly pigmented skin complexions and can frequently be the most bothersome aspect of acne in this population. METHODS The project used a modified Delphi hybrid process comprising face-to-face discussions followed by an online follow-up. A structured literature search was conducted to identify publications on racial/ethnic differences in the clinical presentation, sequelae, and desired treatment outcomes for skin of color (SOC) patients with acne . The advisors subsequently convened to review the results and draft an algorithm for the treatment and maintenance, including skincare recommendations, for SOC patients with acne. Online, the panel reviewed and adopted the algorithm using published evidence coupled with the panel's expert opinion and clinical experience. RESULTS Studies suggest that strategies for improving outcomes in patients with acne who have SOC include: the early initiation and maintenance of treatment regimens; careful consideration of the tolerability of active ingredients, vehicle formulations, and dosing; and the use of skin care (eg, pH balanced, non-irritating cleansers, and non-comedogenic moisturizers) to minimize irritation or dryness. CONCLUSION Acne treatment in patients with SOC involves unique therapeutic considerations, including management of PIH through efficacious longitudinal acne treatment, prevention of irritation, and potential active treatment of PIH. Skincare products are recommended as an adjunct to prescription therapy to maximize tolerability and may also play a role in maintenance therapy. J Drugs Dermatol. 2022;21:11(Suppl 2):s3-14.
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17
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Jelousi S, Sharma D, Alexis A, Murase JE. The Impact of Global Health Disparities on Atopic Dermatitis in Displaced Populations: Narrowing the Health Equity Gap for Patients with Skin of Color. Dermatol Ther (Heidelb) 2022; 12:2679-2689. [PMID: 36261772 DOI: 10.1007/s13555-022-00823-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 09/26/2022] [Indexed: 11/03/2022] Open
Abstract
Atopic dermatitis (AD) is a relatively common inflammatory skin disease marked by eczematous lesions and pruritus often leading to significant morbidity and quality of life impairment for those affected. Recent studies have shown that patients with skin of color (SOC) carry a larger disease burden than patients of European descent. In the USA, these disparities are partly due to structural, environmental, and interpersonal racism. From a global perspective, there is a paucity of research on the burden of atopic dermatitis and other inflammatory skin diseases experienced by the record numbers of refugees, migrants, and asylum seekers around the world. Although it is still unclear whether the true prevalence of AD in displaced communities is higher compared with the general population, those who are displaced suffer from unique risk factors that render them especially vulnerable. In this review, we outline a number of factors contributing to AD susceptibility and/or aggravation in displaced communities. These include poor living conditions, climate change events, psychological stress, and lack of access to medical care and health-related behaviors.
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Affiliation(s)
- Sami Jelousi
- San Francisco School of Medicine, University of California, San Francisco, CA, USA
| | - Divya Sharma
- Department of Medicine, OhioHealth Riverside Methodist Hospital, Columbus, OH, USA
| | - Andrew Alexis
- Department of Dermatology, Weill Cornell Medicine, New York, NY, USA
| | - Jenny E Murase
- Department of Dermatology, University of California, San Francisco, CA, USA. .,Department of Dermatology, Palo Alto Foundation Medical Group, 701 East El Camino Real (31-104), Mountain View, CA, 94040, USA.
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18
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Alexis A, Woolery-Lloyd H, Andriessen A, Koo J, McMichael A, Han G. Evolving Concepts in Psoriasis: Special Considerations for Patients With Skin of Color, Skin Barrier Dysfunction, and the Role of Adjunctive Skin Care. J Drugs Dermatol 2022; 21:1054-1060. [DOI: 10.36849/jdd.7090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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19
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Gold M, Alexis A, Andriessen A, Chilukuri S, Goldberg D, Grover K, Hu S, Lorenc Z, Mandy S, Woolery-Lloyd H. Supplement Individual Article: Algorithm for Pre-/Post-Procedure Measures in Racial/Ethnic Populations Treated With Facial Lasers, Nonenergy Devices, or Injectables. J Drugs Dermatol 2022; 21:SF3509903-SF35099011. [PMID: 36219060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Cosmetic procedures with lasers, nonenergy devices, and injectables are increasing in popularity among patients with skin of color. Published algorithms address measures to reduce side effects related to aesthetic procedures; however, none focus on reducing adverse events in skin of color. METHODS An expert panel of dermatologists and plastic surgeons conducted face-to-face and online meetings to develop an algorithm for measures before, during, and after using aesthetic devices (energy and nonenergy-based) and injectable treatments based on the best available evidence for skin of color. Published algorithms and literature searches for aesthetic procedures provided guidance for the current algorithm. A modified Delphi method was used to reach a consensus to apply outcomes of literature searches, along with expert opinion, resulting in the current algorithm. RESULTS The four sections of the algorithm outline an approach to optimize outcomes with specific before, during, and after procedure considerations. Pre-procedural consultation includes the development of a specific treatment plan based on individual patient goals and risk profile (including history and signs that may predict a higher risk for pigmentary or scarring complications). Before the procedure, sun avoidance and sunscreen use are emphasized; herpes simplex virus 1 prophylaxis and bleaching agents are administered if indicated. During the procedure, skin cleansing products are addressed, along with judicious techniques to minimize unintended cutaneous injury or inflammation. Post-procedural sunscreen and gentle skincare that may include skin-lightening agents or formulations designed to prevent infection and promote optimum healing are advised. CONCLUSIONS The algorithm strives to optimize treatment outcomes for patients with skin of color by providing their physicians with guidance on measures before, during, and after office-based medical aesthetic procedures. J Drugs Dermatol. 2022;21:9(Suppl 1):s3-10.
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20
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Del Rosso JQ, Lain E, York JP, Alexis A. Trifarotene 0.005% Cream in the Treatment of Facial and Truncal Acne Vulgaris in Patients with Skin of Color: a Case Series. Dermatol Ther (Heidelb) 2022; 12:2189-2200. [PMID: 35994159 PMCID: PMC9464295 DOI: 10.1007/s13555-022-00788-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 07/29/2022] [Indexed: 11/30/2022] Open
Abstract
The clinical appearance of acne vulgaris (AV) and the response to therapeutic agents may vary in people with skin of color (SoC) compared with those with lighter skin types. Given the heightened potential for postinflammatory hyperpigmentation and keloid development, effective and timely AV treatment in patients with SoC is especially important. However, these patients are frequently underrepresented in clinical trials, and SoC photographs are generally underrepresented in dermatology. Trifarotene 0.005% cream is a retinoid approved for the once-daily topical treatment of AV, and was studied in large-scale clinical trials that assessed the treatment of AV on both the face and trunk. For severe AV, a topical retinoid may be used in combination with an oral antibiotic, such as doxycycline. Five subjects covering Fitzpatrick skin phototypes III, IV, V, and VI were selected from two larger studies to visually demonstrate treatment of clinically diagnosed AV with trifarotene 0.005% cream. Two subjects received 24 weeks of treatment with trifarotene 0.005% cream for moderate AV on the face and trunk, while three subjects received 12 weeks of treatment with trifarotene 0.005% cream in association with 120 mg oral doxycycline with modified polymer coating for severe facial AV. This case series supports the favorable efficacy and safety of facial and truncal AV treatment with trifarotene 0.005% cream, with or without oral doxycycline, in subjects with SoC (phototypes III–VI).
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Affiliation(s)
- James Q Del Rosso
- JDR Dermatology Research/Thomas Dermatology, Las Vegas, NV, USA. .,Advanced Dermatology and Cosmetic Surgery, Maitland, FL, USA.
| | - Edward Lain
- Austin Institute for Clinical Research, Pflugerville, TX, USA
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21
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Alexis A, Bhutani T, McMichael A, Choi O, Chan D, Rowland K, Gao L, Park-Wyllie L, Rodriguez A, Kindred C, Desai S. 694 Study design of a phase 3b, multicenter, randomized, double-blind, placebo-controlled trial of guselkumab (GUS) in patients with skin of color who have moderate to severe plaque and/or scalp psoriasis (VISIBLE). J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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22
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Alexis A, Woolery-Lloyd H, Andriessen A, Desai S, Han G, Rodriguez D. Improving Rosacea Outcomes in Skin of Color Patients: A Review on the Nuances in the Treatment and the Use of Cleansers and Moisturizers. J Drugs Dermatol 2022; 21:574-580. [DOI: 10.36849/jdd.6838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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23
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Alexis A, Woolery-Lloyd H, Andriessen A, Callender V, Gonzalez M, Heath C, Han G. Insights in Skin of Color Patients With Atopic Dermatitis and the Role of Skincare in Improving Outcomes. J Drugs Dermatol 2022; 21:462-470. [DOI: 10.36849/jdd.6609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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Wilson BN, Alexis A, Murase JE. Art of prevention: Atopic dermatitis in women and families of color-prevalence, recognition, and prevention. Int J Womens Dermatol 2022; 8:e014. [PMID: 35620034 PMCID: PMC9112389 DOI: 10.1097/jw9.0000000000000014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 12/01/2021] [Indexed: 12/03/2022] Open
Abstract
Atopic dermatitis (AD) is one of the most common skin conditions encountered by dermatologists. Skin of color (SOC) patients, in particular, are 50% more likely to visit a dermatologist for AD than non-SOC patients. While the misdiagnosis of AD in SOC patients is rare, the misinterpretation of severity or undertreatment of disease experienced by this patient population is a common occurrence. Herein, we present this Art of Prevention piece focused on the epidemiology, presentation, treatment, and management of AD in skin of color patients.
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Affiliation(s)
- Britney N. Wilson
- School of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Andrew Alexis
- Department of Dermatology, Weill Cornell Medical College, New York, New York
| | - Jenny E. Murase
- Department of Dermatology, University of California, San Francisco, San Francisco, California
- Department of Dermatology, Palo Alto Foundation Medical Group, Mountain View, California
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25
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Wilson BN, McMichael A, Alexis A, Agbai O, Elbuluk N, Callender V, Burgess CM, Taylor SC. Telemedicine Alopecia Assessment: Highlighting Patients With Skin of Color. Cutis 2022; 109:40-42. [PMID: 35180055 DOI: 10.12788/cutis.0419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Alopecia has been one of the more common concerns reported at teledermatology (TD) visits during the COVID-19 pandemic. In light of the growing use of TD, a team of experts were consulted to develop workflows for virtual hair and scalp examinations, with particular consideration for skin of color patients.
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Affiliation(s)
- Britney N Wilson
- Ms. Wilson is from Rutgers New Jersey Medical School, Newark, New Jersey. Dr. McMichael is from the Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina. Dr. Alexis is from the Department of Dermatology, Weill Cornell Medicine, New York, New York. Dr. Agbai is from the Department of Dermatology, UC Davis School of Medicine, Sacramento, California. Dr. Elbuluk is from the Department of Dermatology, University of Southern California, Los Angeles. Dr. Callender is from private practice, Glenn Dale, Maryland. Dr. Burgess is from Howard University College of Medicine, Washington, DC, and private practice, Glenn Dale. Dr. Taylor is from the Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Amy McMichael
- Ms. Wilson is from Rutgers New Jersey Medical School, Newark, New Jersey. Dr. McMichael is from the Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina. Dr. Alexis is from the Department of Dermatology, Weill Cornell Medicine, New York, New York. Dr. Agbai is from the Department of Dermatology, UC Davis School of Medicine, Sacramento, California. Dr. Elbuluk is from the Department of Dermatology, University of Southern California, Los Angeles. Dr. Callender is from private practice, Glenn Dale, Maryland. Dr. Burgess is from Howard University College of Medicine, Washington, DC, and private practice, Glenn Dale. Dr. Taylor is from the Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Andrew Alexis
- Ms. Wilson is from Rutgers New Jersey Medical School, Newark, New Jersey. Dr. McMichael is from the Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina. Dr. Alexis is from the Department of Dermatology, Weill Cornell Medicine, New York, New York. Dr. Agbai is from the Department of Dermatology, UC Davis School of Medicine, Sacramento, California. Dr. Elbuluk is from the Department of Dermatology, University of Southern California, Los Angeles. Dr. Callender is from private practice, Glenn Dale, Maryland. Dr. Burgess is from Howard University College of Medicine, Washington, DC, and private practice, Glenn Dale. Dr. Taylor is from the Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Oma Agbai
- Ms. Wilson is from Rutgers New Jersey Medical School, Newark, New Jersey. Dr. McMichael is from the Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina. Dr. Alexis is from the Department of Dermatology, Weill Cornell Medicine, New York, New York. Dr. Agbai is from the Department of Dermatology, UC Davis School of Medicine, Sacramento, California. Dr. Elbuluk is from the Department of Dermatology, University of Southern California, Los Angeles. Dr. Callender is from private practice, Glenn Dale, Maryland. Dr. Burgess is from Howard University College of Medicine, Washington, DC, and private practice, Glenn Dale. Dr. Taylor is from the Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Nada Elbuluk
- Ms. Wilson is from Rutgers New Jersey Medical School, Newark, New Jersey. Dr. McMichael is from the Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina. Dr. Alexis is from the Department of Dermatology, Weill Cornell Medicine, New York, New York. Dr. Agbai is from the Department of Dermatology, UC Davis School of Medicine, Sacramento, California. Dr. Elbuluk is from the Department of Dermatology, University of Southern California, Los Angeles. Dr. Callender is from private practice, Glenn Dale, Maryland. Dr. Burgess is from Howard University College of Medicine, Washington, DC, and private practice, Glenn Dale. Dr. Taylor is from the Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Valerie Callender
- Ms. Wilson is from Rutgers New Jersey Medical School, Newark, New Jersey. Dr. McMichael is from the Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina. Dr. Alexis is from the Department of Dermatology, Weill Cornell Medicine, New York, New York. Dr. Agbai is from the Department of Dermatology, UC Davis School of Medicine, Sacramento, California. Dr. Elbuluk is from the Department of Dermatology, University of Southern California, Los Angeles. Dr. Callender is from private practice, Glenn Dale, Maryland. Dr. Burgess is from Howard University College of Medicine, Washington, DC, and private practice, Glenn Dale. Dr. Taylor is from the Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Cheryl M Burgess
- Ms. Wilson is from Rutgers New Jersey Medical School, Newark, New Jersey. Dr. McMichael is from the Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina. Dr. Alexis is from the Department of Dermatology, Weill Cornell Medicine, New York, New York. Dr. Agbai is from the Department of Dermatology, UC Davis School of Medicine, Sacramento, California. Dr. Elbuluk is from the Department of Dermatology, University of Southern California, Los Angeles. Dr. Callender is from private practice, Glenn Dale, Maryland. Dr. Burgess is from Howard University College of Medicine, Washington, DC, and private practice, Glenn Dale. Dr. Taylor is from the Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Susan C Taylor
- Ms. Wilson is from Rutgers New Jersey Medical School, Newark, New Jersey. Dr. McMichael is from the Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina. Dr. Alexis is from the Department of Dermatology, Weill Cornell Medicine, New York, New York. Dr. Agbai is from the Department of Dermatology, UC Davis School of Medicine, Sacramento, California. Dr. Elbuluk is from the Department of Dermatology, University of Southern California, Los Angeles. Dr. Callender is from private practice, Glenn Dale, Maryland. Dr. Burgess is from Howard University College of Medicine, Washington, DC, and private practice, Glenn Dale. Dr. Taylor is from the Perelman School of Medicine, University of Pennsylvania, Philadelphia
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Kaundinya T, Rakita U, Guraya A, Abboud DM, Croce E, Thyssen JP, Alexis A, Silverberg JI. Differences in Psychometric Properties of Clinician- and Patient-Reported Outcome Measures for Atopic Dermatitis by Race and Skin Tone: A Systematic Review. J Invest Dermatol 2022; 142:364-381. [PMID: 34352262 PMCID: PMC8792149 DOI: 10.1016/j.jid.2021.06.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/22/2021] [Accepted: 06/28/2021] [Indexed: 02/03/2023]
Abstract
The psychometric validity and reliability of widely used atopic dermatitis (AD) outcome measures across different races and ethnicities are unclear. We describe the rates of reporting race, ethnicity, and skin tone in studies testing the psychometric properties of AD outcome measures and compare the psychometric analyses across race, ethnicity, and skin tone. We systematically reviewed MEDLINE and EMBASE for studies reporting psychometric properties of clinician-reported or patient-reported outcome measures in AD (International Prospective Register of Systematic Reviews: CRD42021239614). Overall, 16,100 nonduplicate articles were screened; 165 met inclusion criteria. Race and/or ethnicity were reported in 55 (33.3%) studies; of those, race was assessed by self-report in 10 studies (6.1%) or was unspecified in 45 (27.3%). A total of 16 studies (9.7%) evaluated psychometric property differences by race, and only five (4.4%) of those did not recognize it as a limitation. Properties assessed across race, ethnicity, or skin tone were differential item functioning, convergent validity feasibility, inter-rater reliability, intrarater reliability, test‒retest reliability, and known-groups validity. Multiple instruments demonstrated performance differences across ethnoracial groups. This review highlights the paucity of race/ethnicity consideration for psychometric property testing in AD outcome measurement instruments. More AD outcomes instruments should be validated in diverse populations.
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Affiliation(s)
- Trisha Kaundinya
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Uros Rakita
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
| | - Armaan Guraya
- Chicago College of Osteopathic Medicine, Midwestern University, Chicago, Illinois, USA
| | | | - Emily Croce
- School of Nursing, The University of Texas at Austin, Austin, Texas, USA; Pediatric and Adolescent Dermatology, Dell Children's Medical Group, Austin, Texas, USA
| | - Jacob P Thyssen
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Andrew Alexis
- Dermatology, Weill Cornell Medicine, Cornell University, New York, New York, USA
| | - Jonathan I Silverberg
- Department of Dermatology, School of Medicine and Health Sciences, George Washington University, Washington, District of Columbia, USA.
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Tan J, Alexis A, Baldwin H, Beissert S, Bettoli V, Del Rosso J, Dréno B, Gold LS, Harper J, Lynde C, Thiboutot D, Weiss J, Layton AM. The Personalised Acne Care Pathway-Recommendations to guide longitudinal management from the Personalising Acne: Consensus of Experts. JAAD Int 2021; 5:101-111. [PMID: 34816135 PMCID: PMC8593752 DOI: 10.1016/j.jdin.2021.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Acne is a chronic disease with a varying presentation that requires long-term management. Despite this, the clinical guidelines for acne offer limited guidance to facilitate personalized or longitudinal management of patients. OBJECTIVES To generate recommendations to support comprehensive, personalized, long-term patient management that address all presentations of acne and its current and potential future burden. METHODS The Personalising Acne: Consensus of Experts panel consisted of 13 dermatologists who used a modified Delphi approach to reach consensus on statements related to longitudinal acne management. The consensus was defined as ≥75% voting "agree" or "strongly agree." All voting was electronic and blinded. RESULTS Key management domains, consisting of distinct considerations, points to discuss with patients, and "pivot points" were identified and incorporated into the Personalised Acne Care Pathway. Long-term treatment goals and expectations and risk of (or fears about) sequelae are highlighted as particularly important to discuss frequently with patients. LIMITATIONS Recommendations are based on expert opinion, which could potentially differ from patients' perspectives. Regional variations in health care systems may not have been captured. CONCLUSIONS The Personalised Acne Care Pathway provides practical recommendations to facilitate the longitudinal management of acne, which can be used by health care professionals to optimize and personalize care throughout the patient journey.
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Affiliation(s)
- Jerry Tan
- Windsor Clinical Research Inc, Windsor, Ontario, Canada
- Department of Medicine, University of Western Ontario, Windsor Campus, Ontario, Canada
| | | | - Hilary Baldwin
- Robert Wood Johnson Medical Center, New Brunswick, New Jersey
- The Acne Treatment and Research Center, Brooklyn, New York
| | - Stefan Beissert
- Department of Dermatology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Vincenzo Bettoli
- Dermatology Unit – Teaching Hospital, Azienda Ospedaliera, University of Ferrara, Ferrara, Italy
| | - James Del Rosso
- Thomas Dermatology, Las Vegas, Nevada
- JDR Dermatology Research, Las Vegas, Nevada
| | - Brigitte Dréno
- Dermato-cancérology Department, CHU Nantes, University of Nantes, Nantes, France
| | | | - Julie Harper
- Dermatology and Skin Care Center of Birmingham, Birmingham, Alabama
| | - Charles Lynde
- University of Toronto, Department of Medicine, Markham, Ontario, Canada
- Lynderm Research Inc, Markham, Ontario, Canada
| | - Diane Thiboutot
- Department of Dermatology, Pennsylvania State University College of Medicine, Hershey, Philadelphia
| | | | - Alison M. Layton
- Hull York Medical School, University of York, York, United Kingdom
- Harrogate and District NHS Foundation Trust, Harrogate, United Kingdom
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Tan J, Alexis A, Baldwin H, Beissert S, Bettoli V, Del Rosso J, Dréno B, Gold LS, Harper J, Lynde C, Thiboutot D, Weiss J, Layton AM. Gaps and recommendations for clinical management of truncal acne from the Personalising Acne: Consensus of Experts panel. JAAD Int 2021; 5:33-40. [PMID: 34816132 PMCID: PMC8593751 DOI: 10.1016/j.jdin.2021.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2021] [Indexed: 11/30/2022] Open
Abstract
Background Truncal acne is common and burdensome for patients; however, there is paucity of evidence and guidance for the management of truncal acne. Currently, clinical practice guidelines provide very little guidance on the assessment or management of truncal acne. Objectives To identify unmet needs in truncal acne and make recommendations to address clinical and management gaps using an international consensus. Methods The Personalising Acne: Consensus of Experts panel consisted of 13 dermatologists, who used a modified Delphi approach to reach a consensus on statements related to clinically relevant aspects of truncal acne evaluation and management. A consensus was defined as ≥75% of the panelists voting “agree” or “strongly agree.” The voting was electronic and blinded. Results The panel identified gaps and made recommendations related to truncal acne identification, assessment, and grading; the evaluation of the impact on patients; and treatment goals and factors to be considered for its management. Limitations The recommendations are based on expert opinion, in the absence of high-quality evidence. Conclusions We highlighted addressing not just facial acne but also truncal acne during patient consultations. The recommendations made herein may help facilitate the care of patients who present with truncal acne, with or without facial acne.
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Affiliation(s)
- Jerry Tan
- Windsor Clinical Research Inc, Windsor, Ontario, Canada
- Department of Medicine, University of Western Ontario, Windsor Campus, Windsor, Ontario, Canada
- Correspondence to: Jerry Tan, MD, Windsor Clinical Research Inc, 2224 Walker Rd, Suite 300, Windsor, Ontario, N8W 5L7, Canada.
| | | | - Hilary Baldwin
- Robert Wood Johnson Medical Center, New Brunswick, New Jersey
- The Acne Treatment and Research Center, Brooklyn, New York
| | - Stefan Beissert
- Department of Dermatology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Vincenzo Bettoli
- Dermatology Unit – Teaching Hospital, Azienda Ospedaliera, University of Ferrara, Ferrara, Italy
| | - James Del Rosso
- Thomas Dermatology, Las Vegas, Nevada
- JDR Dermatology Research, Las Vegas, Nevada
| | - Brigitte Dréno
- Dermato-cancérology Department, CHU Nantes, University of Nantes, Nantes, France
| | | | - Julie Harper
- Dermatology and Skin Care Center of Birmingham, Birmingham, Alabama
| | - Charles Lynde
- Department of Medicine, University of Toronto, Markham, Ontario, Canada
- Lynderm Research Inc, Markham, Ontario, Canada
| | - Diane Thiboutot
- Department of Dermatology, Pennsylvania State University College of Medicine, Hershey, Philadelphia
| | | | - Alison M. Layton
- Hull York Medical School, University of York, York, United Kingdom
- Harrogate and District NHS Foundation Trust, United Kingdom
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Layton A, Alexis A, Baldwin H, Beissert S, Bettoli V, Del Rosso J, Dréno B, Gold LS, Harper J, Lynde C, Thiboutot D, Weiss J, Tan J. Identifying gaps and providing recommendations to address shortcomings in the investigation of acne sequelae by the Personalising Acne: Consensus of Experts panel. JAAD Int 2021; 5:41-48. [PMID: 34816133 PMCID: PMC8593750 DOI: 10.1016/j.jdin.2021.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2021] [Indexed: 11/24/2022] Open
Abstract
Background The physical sequelae of acne include erythema, hyperpigmentation, and scarring, which are highly burdensome for patients. Early, effective treatment can potentially limit and prevent sequelae development, but there is a need for guidance for and evidence of prevention-oriented management to improve patient outcomes. Objective To identify unmet needs of acne sequelae and generate expert recommendations to address gaps in clinical guidance. Methods The Personalizing Acne: Consensus of Experts panel of 13 dermatologists used a modified Delphi approach to achieve a consensus on the clinical aspects of acne sequelae. A consensus was defined as ≥75% of the dermatologists voting "agree" or "strongly agree." All voting was electronic and blinded. Results The panel identified gaps in current guidance and made recommendations related to acne sequelae. These included identification and classification of sequelae, pertinent points to consider for patient consultations, and management aimed at reducing the development of sequelae. Limitations The recommendations are based on expert opinion and made in the absence of high-quality evidence. Conclusions The identified gaps should help inform future research and guideline development for acne sequelae. The consensus-based recommendations should also support the process of consultations throughout the patient journey, helping to reduce the development and burden of acne sequelae through improved risk factor recognition, early discussion, and appropriate management.
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Affiliation(s)
- Alison Layton
- Hull York Medical School, University of York, York, United Kingdom.,Harrogate and District NHS Foundation Trust, Harrogate, United Kingdom
| | | | - Hilary Baldwin
- Robert Wood Johnson Medical Center, New Brunswick, New Jersey.,The Acne Treatment and Research Center, Brooklyn, New York
| | - Stefan Beissert
- Department of Dermatology, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Vincenzo Bettoli
- Dermatology Unit - Teaching Hospital, Azienda Ospedaliera, University of Ferrara, Ferrara, Italy
| | - James Del Rosso
- Thomas Dermatology, Las Vegas, Nevada.,JDR Dermatology Research, Las Vegas, Nevada
| | - Brigitte Dréno
- Dermato-cancérology Department, CHU Nantes, University of Nantes, Nantes, France
| | | | - Julie Harper
- Dermatology and Skin Care Center of Birmingham, Birmingham, Alabama
| | - Charles Lynde
- Department of Medicine, University of Toronto, Ontario, Canada.,Lynderm Research Inc, Ontario, Canada
| | - Diane Thiboutot
- Department of Dermatology, Pennsylvania State University College of Medicine, Hershey, Philadelphia
| | | | - Jerry Tan
- Windsor Clinical Research Inc, Ontario, Canada.,Department of Medicine, University of Western Ontario, Ontario, Canada
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Elbuluk N, Grimes P, Chien A, Hamzavi I, Alexis A, Taylor S, Gonzalez N, Weiss J, Desai SR, Kang S. The Pathogenesis and Management of Acne-Induced Post-inflammatory Hyperpigmentation. Am J Clin Dermatol 2021; 22:829-836. [PMID: 34468934 DOI: 10.1007/s40257-021-00633-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2021] [Indexed: 12/11/2022]
Abstract
Acne vulgaris is a common inflammatory disease. Among patients with darker skin phototypes (Fitzpatrick III-VI), the inflammatory processes of acne stimulate excess melanogenesis and abnormal melanin deposition, leading to pigmentary sequelae known as post-inflammatory hyperpigmentation and post-inflammatory erythema in all skin tones, although post-inflammatory hyperpigmentation is more common in darker skin and post-inflammatory erythema in lighter skin. These pigmentary alterations can be long lasting and are often more distressing to patients than the active acne lesions. This article discusses what is known about acne-related pigmentation, much of which is extrapolated from general study of nonspecific pigment deposition. Because dyspigmentation poses both a significant clinical concern to patients and a therapeutic challenge to clinicians, we formed a working group consisting of pigmentary experts with the aim of increasing awareness and education of acne-related pigmentary sequelae.
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Affiliation(s)
- Nada Elbuluk
- Department of Dermatology, Keck School of Medicine, University of Southern California, 830 S Flower Street, Suite 100, Los Angeles, CA, 90017, USA.
| | - Pearl Grimes
- Department of Dermatology, David Geffen School of Medicine, University of California - Los Angeles, CA, Los Angeles, USA
| | - Anna Chien
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Iltefat Hamzavi
- Department of Dermatology, Henry Ford Hospital, Detroit, MI, USA
| | - Andrew Alexis
- Department of Dermatology, Weill Cornell Medicine, New York, NY, USA
| | - Susan Taylor
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Jonathan Weiss
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA
- Georgia Dermatology Partners and Gwinnett Clinical Research Center, Snellville, GA, USA
| | - Seemal R Desai
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Innovative Dermatology, Plano, TX, USA
| | - Sewon Kang
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Graber E, Baldwin H, Harper J, Alexis A, Gold LS, Hebert A, Fried R, Rieder E, Kircik L, Del Rosso J, Kasujee I, Grada A. LB756 Patient-reported outcomes for sarecycline effectiveness in Acne Vulgaris in real-world settings: PROSES study protocol. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.07.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Adotama P, Papac N, Alexis A, Wysong A, Collins L. Common Dermatologic Procedures and the Associated Complications Unique to Skin of Color. Dermatol Surg 2021; 47:355-359. [PMID: 34328287 DOI: 10.1097/dss.0000000000002813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The skin of color (SOC) population in the United States continues to grow, and these patients are undergoing various cosmetic and surgical procedures at increasing rates. There is a paucity of data on the potential complications associated with surgical and cosmetic procedures in this patient population. OBJECTIVE We aim to educate dermatologic surgeons and clinicians on surgical and cosmetic procedures in patients of color and increase awareness of the potential complications unique to this patient population. MATERIALS AND METHODS A thorough PubMed literature search was performed to conduct this review. RESULTS There are a number of complications in SOC that require special attention, including keloids, postoperative infections, postinflammatory hyperpigmentation, and hypopigmentation. There are also various precautions to consider when performing cosmetic procedures, such as neurotoxin and filler injections, laser therapy, microneedling, and chemical peels. CONCLUSION Dermatologists should be aware of the potential cosmetic and surgical complications of this growing patient population to provide optimal evidence-based medical care.
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Affiliation(s)
- Prince Adotama
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Nicole Papac
- Department of Dermatology, University of Oklahoma Health Sciences Center, College of Medicine, Oklahoma City, Oklahoma
| | - Andrew Alexis
- Department of Dermatology, Icahn School of Medicine, New York, New York
| | - Ashley Wysong
- Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Lindsey Collins
- Department of Dermatology, University of Oklahoma Health Sciences Center, College of Medicine, Oklahoma City, Oklahoma
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Dreno B, Amici JM, Demessant-Flavigny AL, Wright C, Taieb C, Desai SR, Alexis A. The Impact of Acne, Atopic Dermatitis, Skin Toxicities and Scars on Quality of Life and the Importance of a Holistic Treatment Approach. Clin Cosmet Investig Dermatol 2021; 14:623-632. [PMID: 34163201 PMCID: PMC8213955 DOI: 10.2147/ccid.s315846] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 05/15/2021] [Indexed: 01/15/2023]
Abstract
Skin conditions such as acne, atopic dermatitis, skin toxicity from oncology treatment, and scars are among the most common health conditions and negatively impact quality of life (QoL). Yet the physician perception of this impact often varies greatly from the patient perception. This is important because patient illness perception is closely linked with seeking help and treatment adherence behaviors. The objective of this review is to better understand the impact of these four highly prevalent skin conditions on QoL including their health-related economic factors to improve treatment outcomes. The literature search included literature published on QoL with acne, atopic dermatitis, scars (from any cause) and skin toxicities on PubMed between 2015 and 2020. We found that patients with skin conditions have a much higher frequency of altered QoL and psychological distress than those without. Also, skin conditions negatively impact self-image and can cause feelings of isolation, loneliness, lower self-esteem, and lower body satisfaction. Additionally, physical discomfort adds to the psychological distress. These physical and psychological impacts are an enormous financial burden on patients, their families and society. We found evidence that holistic treatment including treating the skin condition itself, providing wider peer and psychological support as well as shared decision-making, therapeutic patient education and dermatologist involvement improves outcomes. Holistic history-taking, checklists, or the use of more formal QoL scoring tools can be incorporated into routine consultations to better assess patient well-being and provide clinicians with important information for adapting treatment to individual patient requirements. In conclusion, this review highlights the overall impact of skin conditions (including psychological and QoL impacts) and the importance of providing holistic care to optimize treatment outcomes. A comprehensive QoL screening tool would be useful to help provide patient-centered treatment.
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Affiliation(s)
- Brigitte Dreno
- Dermatology Department, CHU Nantes, CIC 1413, CRCINA, Nantes University, Nantes, Pays de la Loire, France
| | - Jean Michel Amici
- Dermatology Department, Bordeaux University Hospital, Bordeaux, Nouvelle-Aquitaine, France
| | | | - Charlotte Wright
- Speak the Speech Consulting, Asnières-sur-Seine, Ile-de-France, France
| | - Charles Taieb
- Patients Priority Department, European Market Maintenance Assessment, Fontenay Sousbois, Ile-de-France, France
| | - Seemal R Desai
- Department of Dermatology, The University of Texas Southwestern Medical Center & Innovative Dermatology, Dallas, TX, USA
| | - Andrew Alexis
- Skin of Color Center, Mount Sinai St. Luke’s and Mount Sinai West, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Baldwin H, Alexis A, Andriessen A, Berson D, Farris P, Harper J, Lain E, Marchbein S, Stein Gold L, Tan J. Evidence of Barrier Deficiency in Rosacea and the Importance of Integrating OTC Skincare Products into Treatment Regimens. J Drugs Dermatol 2021. [DOI: 10.36849/jdd.5861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Lio P, Boguniewicz M, Alexis A, Lebwohl M, Reich K, Pink A, Kabashima K, Bissonnette R, Nowicki R, Valdez H, Zhang F, DiBonaventura M, Clibborn C, Cameron M. Depth and Rapidity of Response With Abrocitinib and Dupilumab in Patients With Moderate-to-Severe Atopic Dermatitis (AD) in JADE COMPARE. J Allergy Clin Immunol 2021. [DOI: 10.1016/j.jaci.2020.12.159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Alexis A, Soong W, De Bruin-Weller M, Barbarot S, Weidinger S, Antinew J, Biswas P, Valdez H, Clibborn C, Yin N. P552 RAPIDITY OF EFFICACY RESPONSE WITH ABROCITINIB VERSUS DUPILUMAB IN THE HEAD–NECK REGION (JADE COMPARE). Ann Allergy Asthma Immunol 2020. [DOI: 10.1016/j.anai.2020.08.170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kaufman B, Alexis A. Randomized, Double-Blinded, Split-Face Study Comparing the Efficacy and Tolerability of Two Topical Products for Melasma. J Drugs Dermatol 2020. [DOI: 10.36849/jdd.2020.5353] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Bouaziz JD, Silverberg J, Pinter A, Pulka G, Poulin Y, Wollenberg A, Murrel D, Alexis A, Lindsey L, Ahmad F, Piketty C, Clucas A. Étude de phase 2b sur némolizumab chez des patients adultes présentant une dermatite atopique modérée à sévère associée à un prurit sévère. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Dréno B, Alexis A, Chuberre B, Marinovich M. Safety of titanium dioxide nanoparticles in cosmetics. J Eur Acad Dermatol Venereol 2019; 33 Suppl 7:34-46. [DOI: 10.1111/jdv.15943] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 09/03/2019] [Indexed: 12/31/2022]
Affiliation(s)
- B. Dréno
- Onco‐Dermatology Department CHU Nantes CRCINA University Nantes Nantes France
| | - A. Alexis
- Department of Dermatology Icahn School of Medicine at Mount Sinai New York NY USA
| | - B. Chuberre
- L'Oréal Cosmetique Active International Levallois‐Perret France
| | - M. Marinovich
- Department of Pharmacological and Biomolecular Sciences University of Milan Milan Italy
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Alexis A, Boyd C, Callender V, Downie J, Sangha S. Understanding the Female African American Facial Aesthetic Patient. J Drugs Dermatol 2019; 18:858-866.. [PMID: 31524341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND: The patient populations seeking facial aesthetic treatments is expanding in terms of racial, ethnic, and cultural diversity. While treatment of facial aging patterns among white women is well-documented, far less information describes the aesthetic needs of the African American patient. OBJECTIVE: An online study was conducted to survey facial aesthetic concerns and treatment priorities among US-based population of African American women. MATERIALS AND METHODS: A total of 401 female African American participants ages 30 to 65 years reported their attitudes toward facial aging, current facial conditions, most bothersome facial areas and areas most/least likely to be treated first, awareness of treatment options and their consideration rates, and motives and barriers factoring into consideration of injectable treatments. RESULTS: Uneven skin tone/color (57%) and dark circles under the eyes (48%) were the most frequently-reported facial concerns. Other common bothersome facial areas affected by signs of aging were the submental area, periorbital area, forehead lines, and chin. Similarly, areas given greater priority with respect to future treatment included the periorbital area, submental area, and forehead lines. With advancing age, priorities heightened for the mid and lower facial areas, which included the nasolabial folds, chin, and oral commissures. Although the majority of participants would consider injectables, cost, and safety/side effects were cited as frequent concerns. CONCLUSION: For African American women, concerns about facial aging may be less about fine lines and wrinkles caused by increasing skin laxity, and more about pigmentary concerns and shifts in underlying soft tissue volume. J Drugs Dermatol. 2019;18(9):858-866.
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Silverberg JI, Pinter A, Pulka G, Poulin Y, Bouaziz JD, Wollenberg A, Murrell DF, Alexis A, Lindsey L, Ahmad F, Piketty C, Clucas A. Phase 2B randomized study of nemolizumab in adults with moderate-to-severe atopic dermatitis and severe pruritus. J Allergy Clin Immunol 2019; 145:173-182. [PMID: 31449914 DOI: 10.1016/j.jaci.2019.08.013] [Citation(s) in RCA: 161] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 07/31/2019] [Accepted: 08/13/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Nemolizumab targets the IL-31 receptor α subunit involved in atopic dermatitis (AD) pathogenesis. OBJECTIVE We sought to evaluate a new dosing strategy of nemolizumab in patients with AD. METHODS We performed a 24-week, randomized, double-blind, multicenter study of nemolizumab (10, 30, and 90 mg) subcutaneous injections every 4 weeks versus placebo, with topical corticosteroids in adults with moderate-to-severe AD, severe pruritus, and inadequate control with topical treatment (n = 226). The Eczema Area and Severity Index (EASI), the peak pruritus (PP) numeric rating scale (NRS), and the Investigator's Global Assessment (IGA) were assessed. Standard safety assessments were performed. RESULTS Nemolizumab improved EASI, IGA, and/or NRS-itch scores, with the 30-mg dose being most effective. Nemolizumab (30 mg) reduced EASI scores versus placebo at week 24 (-68.8% vs -52.1%, P = .016); significant differences were observed by week 8 (P ≤ .01). With significant improvement (P = .028) as early as week 4, IGA 0/1 rates were higher for 30 mg of nemolizumab versus placebo at week 16 (33.3% vs 12.3%, P = .008) but not week 24 because of an increased placebo/topical corticosteroid effect (36.8% vs 21.1%, P = .06). PP-NRS scores were improved for 30 mg of nemolizumab versus placebo at week 16 (-68.6% vs -34.3%, P < .0001) and week 24 (-67.3% vs -35.8%, P < .0001), with a difference by week 1 (P < .001). NRS response rates (≥4-point decrease) were greater for 30 mg of nemolizumab versus placebo at week 16 (P ≤ .001) and week 24 (P ≤ .01). Nemolizumab was safe and well tolerated. The most common adverse events were nasopharyngitis and upper respiratory tract infection. CONCLUSIONS Nemolizumab resulted in rapid and sustained improvements in cutaneous signs of inflammation and pruritus in patients with AD, with maximal efficacy observed at 30 mg. Nemolizumab had an acceptable safety profile.
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Affiliation(s)
- Jonathan I Silverberg
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Ill.
| | - Andreas Pinter
- Department of Dermatology, Venereology, and Allergology, Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
| | - Grazyna Pulka
- School of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Yves Poulin
- Department of Medicine, Université Laval, Quebec City, Quebec, Canada
| | - Jean-David Bouaziz
- Department of Dermatology, Paris VII Sorbonne Paris Cité University Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Andreas Wollenberg
- Department of Dermatology and Allergology, Ludwig-Maximilians-Universität, Munich, Germany
| | - Dédée F Murrell
- Department of Dermatology, St George Clinical School, University of New South Wales, Sydney, Australia
| | - Andrew Alexis
- Department of Dermatology, Icahn School of Medicine, Mount Sinai, New York, NY
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Tolliver S, Shipp D, Alexis A, Kaffenberger BH. A descriptive study of black women with and without hair loss and their perception of dermatologists. Int J Dermatol 2019; 58:e182-e184. [PMID: 31148157 DOI: 10.1111/ijd.14502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 04/14/2019] [Accepted: 04/29/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Starling Tolliver
- Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Desmond Shipp
- Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Andrew Alexis
- Division of Dermatology, Deparment of Internal Medicine, Mount Sinai Beth Israel, New York, NY, USA
| | - Benjamin H Kaffenberger
- Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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Takeshita J, Augustin M, de Jong E, Lafferty K, Langholff W, Langley R, Leonardi C, Menter A, Alexis A. 857 Psoriasis-related quality-of-life differs by race/ethnicity. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Benn EKT, Deshpande R, Dotson-Newman O, Gordon S, Scott M, Amarasiriwardena C, Khan IA, Wang YH, Alexis A, Kaufman B, Moran H, Wen C, Charles CAD, Younger NOM, Mohamed N, Liu B. Skin Bleaching Among African and Afro-Caribbean Women in New York City: Primary Findings from a P30 Pilot Study. Dermatol Ther (Heidelb) 2019; 9:355-367. [PMID: 31020513 PMCID: PMC6522580 DOI: 10.1007/s13555-019-0297-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION The application of skin bleaching products to inhibit melanogenesis is a common practice within the African diaspora. Despite the adverse health effects of skin bleaching, rigorous studies investigating skin bleaching behavior among these populations in the United States are limited. In our P30 pilot study, we explored predictors of skin bleaching practice intensity among African and Afro-Caribbean women. METHODS In collaboration with our Community Engagement Core, we conducted a cross-sectional study to investigate the relationship between demographic and psychosocial predictors and skin-bleaching-related practice patterns among African and Afro-Caribbean women in New York City. RESULTS Among the 76 participants recruited, the median age at the initiation of skin bleaching was 19.5 (16-25) years, yielding a median duration of 13.5 (6-23) years. Although pregnant women were not actively recruited for the study, 13.2% (n = 10) of the participants used skin bleaching products while pregnant or possibly breastfeeding. Nativeness and education were associated with various components of skin bleaching practice intensity, including duration of skin bleaching, daily use of products, and bleaching of the entire body. Participants' perceived skin-color-related quality of life was not associated with skin bleaching practice intensity. CONCLUSION Skin bleaching is a habitual practice that likely requires culturally sensitive interventions to promote behavioral change. The existence of prenatal and postnatal exposure to mercury, hydroquinone, and other potentially harmful chemicals in skin bleaching products highlights an urgent need to explore the adverse effects of skin bleaching practices on birth outcomes and the growth and neurodevelopment of young babies.
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Affiliation(s)
- Emma K T Benn
- Department of Population Health Science and Policy and Center for Biostatistics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Richa Deshpande
- Department of Population Health Science and Policy and Center for Biostatistics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ogonnaya Dotson-Newman
- Community Engagement Core (CEC), Mount Sinai Skin Bleaching P30 Pilot Study, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sharon Gordon
- Community Engagement Core (CEC), Mount Sinai Skin Bleaching P30 Pilot Study, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Marian Scott
- Community Engagement Core (CEC), Mount Sinai Skin Bleaching P30 Pilot Study, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Chitra Amarasiriwardena
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ikhlas A Khan
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, Oxford, MS, USA
| | - Yan-Hong Wang
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, Oxford, MS, USA
| | - Andrew Alexis
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Bridget Kaufman
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Hector Moran
- Hunter College, City University of New York, New York, NY, USA
| | - Chi Wen
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Christopher A D Charles
- Department of Government, University of the West Indies, Mona, Kingston 7, Jamaica
- Psychology Department, The Graduate Center, City University of New York, New York, USA
| | - Novie O M Younger
- Epidemiology Research Unit, Tropical Medicine Research Institute, University of the West Indies, Mona, Kingston 7, Jamaica
| | - Nihal Mohamed
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Bian Liu
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health Science and Policy and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Alexis A, Del Rosso JQ, Desai SR, Downie JB, Draelos ZD, Feser C, Forconi R, Fowler JF, Gold M, Kaufman-Janette J, Lain E, Lee M, Ling M, Shamban AT, Werschler WP, Daniels A. BPX-01 Minocycline Topical Gel Shows Promise for the Treatment of Moderate-to-severe Inflammatory Acne Vulgaris. J Clin Aesthet Dermatol 2018; 11:25-35. [PMID: 30588271 PMCID: PMC6303111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Background and objectives: Acne vulgaris is a highly prevalent and multifactorial skin disorder that can adversely impact health-related quality of life. Factors that contribute to the pathogenesis of acne include pilosebaceous proliferation of proinflammatory Propionibacterium acnes (P. acnes) bacteria, presence of circulating androgens, excess sebum production, abnormal follicular keratinization, and multiple inflammatory cascades. Oral tetracyclines-especially doxycycline and minocycline-are frequently prescribed for the treatment of moderate-to-severe acne, given their anti-inflammatory properties and their effect on P. acnes reduction. Notwithstanding their established efficacy in the management of acne vulgaris, there is a desire to limit systemic exposure to antibiotics given growing concerns regarding bacterial resistance as well as the potential for serious side effects. This report describes outcomes of two randomized, vehicle-controlled trials (Phases IIa and IIb) of BPX-01, a topical minocycline gel, in the treatment of moderate-to-severe acne. Methods: In Study 1 (NCT02709096), at a single center, 33 subjects with highly fluorescing facial skin were randomized 2:1 to BPX-01 1% or vehicle control once-daily treatment for four weeks. Changes in P. acnes quantitative bacteriological cultures were assessed, as well as cutaneous tolerance to the study drug by both subjects and the investigator. In Study 2 (NCT02815332), subjects with moderate-to-severe inflammatory nonnodular acne (n=226) at 15 centers were randomized 1:1:1 to treatment with BPX-01 1%, BPX-01 2%, or vehicle control once-daily for 12 weeks. The primary endpoint was reduction in the number of inflammatory lesions; other endpoints included the number of noninflammatory lesions, Investigator's Global Assessment (IGA) of severity, and subjective ratings (investigator and subject) of acne. In both studies, cutaneous tolerability and safety were assessed, and plasma minocycline levels were tracked with a highly sensitive assay. Results: In Study 1, BPX-01 treatment reduced P. acnes colonization by 90.9 percent, which exceeded the reduction in the vehicle control group (65.53%; p=0.020). In Study 2, treatment with BPX-01 2% reduced the number of inflammatory lesions by 58.5 percent, exceeding the reduction in the vehicle control group (43.8%; p=0.0256). Trends toward an improvement preferential to BPX-01 2% were observed in the other endpoints. Across both studies, BPX-01 treatment was well-tolerated, with no photosensitivity, postinflammatory hyperpigmentation, or skin discoloration reported. A single subject (out of 259 study participants ) was identified to have detectable levels of plasma minocycline at low levels (42ng/mL) after 12 weeks of treatment but had no signs or symptoms associated with systemic administration of minocycline. Conclusion: BPX-01 appears to exhibit an effectiveness profile for reduction of inflammatory (nonnodular) acne lesions similar to that of oral minocycline formulations. However, because BPX-01 is topical and exhibits negligible systemic exposure, the likelihood of adverse events associated with oral minocycline use is much lower. These results demonstrate effectiveness of BPX-01 topical minocycline gel in reducing P. acnes colonization, suggesting that the BPX-01 2% formulation is a promising treatment for moderate-to-severe nonnodular, inflammatory acne vulgaris in both reduction of inflammatory lesions and also overall improvement in facial acne according to IGA.
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Affiliation(s)
- Andrew Alexis
- Dr. Alexis is with Mount Sinai St. Luke's in New York, New York
- Dr. Del Rosso is with JDR Dermatology Research in Las Vegas, Nevada
- Dr. Desai is with ACRC Trials/Innovative Dermatology in Plano, Texas
- Dr. Downie is with Image Dermatology in Montclair, New Jersey
- Dr. Draelos is with Dermatology Consulting Services in High Point, North Carolina. Drs. Feser and Forconi are with International Clinical Research in Sanford, Florida
- Dr. Fowler is with DS Research in Louisville, Kentucky
- Dr. Gold is with the Tennessee Clinical Research Center in Nashville, Tennessee
- Dr. Kaufman-Janette is with the Skin Research Institute in Coral Gables, Florida
- Dr. Lain is with the Austin Institute for Clinical Research in Heatherwilde, Texas
- Dr. Lee is with Progressive Clinical Research in San Antonio, Texas
- Dr. Ling is with MedaPhase in Newnan, Georgia
- Dr. Shamban is with Medical and Cosmetic Dermatology in Santa Monica, California
- Dr. Werschler is with Premier Clinical Research in Spokane, Washington. Ms. Daniels is with BioPharmX in Menlo Park, California
| | - James Q Del Rosso
- Dr. Alexis is with Mount Sinai St. Luke's in New York, New York
- Dr. Del Rosso is with JDR Dermatology Research in Las Vegas, Nevada
- Dr. Desai is with ACRC Trials/Innovative Dermatology in Plano, Texas
- Dr. Downie is with Image Dermatology in Montclair, New Jersey
- Dr. Draelos is with Dermatology Consulting Services in High Point, North Carolina. Drs. Feser and Forconi are with International Clinical Research in Sanford, Florida
- Dr. Fowler is with DS Research in Louisville, Kentucky
- Dr. Gold is with the Tennessee Clinical Research Center in Nashville, Tennessee
- Dr. Kaufman-Janette is with the Skin Research Institute in Coral Gables, Florida
- Dr. Lain is with the Austin Institute for Clinical Research in Heatherwilde, Texas
- Dr. Lee is with Progressive Clinical Research in San Antonio, Texas
- Dr. Ling is with MedaPhase in Newnan, Georgia
- Dr. Shamban is with Medical and Cosmetic Dermatology in Santa Monica, California
- Dr. Werschler is with Premier Clinical Research in Spokane, Washington. Ms. Daniels is with BioPharmX in Menlo Park, California
| | - Seemal R Desai
- Dr. Alexis is with Mount Sinai St. Luke's in New York, New York
- Dr. Del Rosso is with JDR Dermatology Research in Las Vegas, Nevada
- Dr. Desai is with ACRC Trials/Innovative Dermatology in Plano, Texas
- Dr. Downie is with Image Dermatology in Montclair, New Jersey
- Dr. Draelos is with Dermatology Consulting Services in High Point, North Carolina. Drs. Feser and Forconi are with International Clinical Research in Sanford, Florida
- Dr. Fowler is with DS Research in Louisville, Kentucky
- Dr. Gold is with the Tennessee Clinical Research Center in Nashville, Tennessee
- Dr. Kaufman-Janette is with the Skin Research Institute in Coral Gables, Florida
- Dr. Lain is with the Austin Institute for Clinical Research in Heatherwilde, Texas
- Dr. Lee is with Progressive Clinical Research in San Antonio, Texas
- Dr. Ling is with MedaPhase in Newnan, Georgia
- Dr. Shamban is with Medical and Cosmetic Dermatology in Santa Monica, California
- Dr. Werschler is with Premier Clinical Research in Spokane, Washington. Ms. Daniels is with BioPharmX in Menlo Park, California
| | - Jeanine B Downie
- Dr. Alexis is with Mount Sinai St. Luke's in New York, New York
- Dr. Del Rosso is with JDR Dermatology Research in Las Vegas, Nevada
- Dr. Desai is with ACRC Trials/Innovative Dermatology in Plano, Texas
- Dr. Downie is with Image Dermatology in Montclair, New Jersey
- Dr. Draelos is with Dermatology Consulting Services in High Point, North Carolina. Drs. Feser and Forconi are with International Clinical Research in Sanford, Florida
- Dr. Fowler is with DS Research in Louisville, Kentucky
- Dr. Gold is with the Tennessee Clinical Research Center in Nashville, Tennessee
- Dr. Kaufman-Janette is with the Skin Research Institute in Coral Gables, Florida
- Dr. Lain is with the Austin Institute for Clinical Research in Heatherwilde, Texas
- Dr. Lee is with Progressive Clinical Research in San Antonio, Texas
- Dr. Ling is with MedaPhase in Newnan, Georgia
- Dr. Shamban is with Medical and Cosmetic Dermatology in Santa Monica, California
- Dr. Werschler is with Premier Clinical Research in Spokane, Washington. Ms. Daniels is with BioPharmX in Menlo Park, California
| | - Zoe Diana Draelos
- Dr. Alexis is with Mount Sinai St. Luke's in New York, New York
- Dr. Del Rosso is with JDR Dermatology Research in Las Vegas, Nevada
- Dr. Desai is with ACRC Trials/Innovative Dermatology in Plano, Texas
- Dr. Downie is with Image Dermatology in Montclair, New Jersey
- Dr. Draelos is with Dermatology Consulting Services in High Point, North Carolina. Drs. Feser and Forconi are with International Clinical Research in Sanford, Florida
- Dr. Fowler is with DS Research in Louisville, Kentucky
- Dr. Gold is with the Tennessee Clinical Research Center in Nashville, Tennessee
- Dr. Kaufman-Janette is with the Skin Research Institute in Coral Gables, Florida
- Dr. Lain is with the Austin Institute for Clinical Research in Heatherwilde, Texas
- Dr. Lee is with Progressive Clinical Research in San Antonio, Texas
- Dr. Ling is with MedaPhase in Newnan, Georgia
- Dr. Shamban is with Medical and Cosmetic Dermatology in Santa Monica, California
- Dr. Werschler is with Premier Clinical Research in Spokane, Washington. Ms. Daniels is with BioPharmX in Menlo Park, California
| | - Christina Feser
- Dr. Alexis is with Mount Sinai St. Luke's in New York, New York
- Dr. Del Rosso is with JDR Dermatology Research in Las Vegas, Nevada
- Dr. Desai is with ACRC Trials/Innovative Dermatology in Plano, Texas
- Dr. Downie is with Image Dermatology in Montclair, New Jersey
- Dr. Draelos is with Dermatology Consulting Services in High Point, North Carolina. Drs. Feser and Forconi are with International Clinical Research in Sanford, Florida
- Dr. Fowler is with DS Research in Louisville, Kentucky
- Dr. Gold is with the Tennessee Clinical Research Center in Nashville, Tennessee
- Dr. Kaufman-Janette is with the Skin Research Institute in Coral Gables, Florida
- Dr. Lain is with the Austin Institute for Clinical Research in Heatherwilde, Texas
- Dr. Lee is with Progressive Clinical Research in San Antonio, Texas
- Dr. Ling is with MedaPhase in Newnan, Georgia
- Dr. Shamban is with Medical and Cosmetic Dermatology in Santa Monica, California
- Dr. Werschler is with Premier Clinical Research in Spokane, Washington. Ms. Daniels is with BioPharmX in Menlo Park, California
| | - Rion Forconi
- Dr. Alexis is with Mount Sinai St. Luke's in New York, New York
- Dr. Del Rosso is with JDR Dermatology Research in Las Vegas, Nevada
- Dr. Desai is with ACRC Trials/Innovative Dermatology in Plano, Texas
- Dr. Downie is with Image Dermatology in Montclair, New Jersey
- Dr. Draelos is with Dermatology Consulting Services in High Point, North Carolina. Drs. Feser and Forconi are with International Clinical Research in Sanford, Florida
- Dr. Fowler is with DS Research in Louisville, Kentucky
- Dr. Gold is with the Tennessee Clinical Research Center in Nashville, Tennessee
- Dr. Kaufman-Janette is with the Skin Research Institute in Coral Gables, Florida
- Dr. Lain is with the Austin Institute for Clinical Research in Heatherwilde, Texas
- Dr. Lee is with Progressive Clinical Research in San Antonio, Texas
- Dr. Ling is with MedaPhase in Newnan, Georgia
- Dr. Shamban is with Medical and Cosmetic Dermatology in Santa Monica, California
- Dr. Werschler is with Premier Clinical Research in Spokane, Washington. Ms. Daniels is with BioPharmX in Menlo Park, California
| | - Joseph F Fowler
- Dr. Alexis is with Mount Sinai St. Luke's in New York, New York
- Dr. Del Rosso is with JDR Dermatology Research in Las Vegas, Nevada
- Dr. Desai is with ACRC Trials/Innovative Dermatology in Plano, Texas
- Dr. Downie is with Image Dermatology in Montclair, New Jersey
- Dr. Draelos is with Dermatology Consulting Services in High Point, North Carolina. Drs. Feser and Forconi are with International Clinical Research in Sanford, Florida
- Dr. Fowler is with DS Research in Louisville, Kentucky
- Dr. Gold is with the Tennessee Clinical Research Center in Nashville, Tennessee
- Dr. Kaufman-Janette is with the Skin Research Institute in Coral Gables, Florida
- Dr. Lain is with the Austin Institute for Clinical Research in Heatherwilde, Texas
- Dr. Lee is with Progressive Clinical Research in San Antonio, Texas
- Dr. Ling is with MedaPhase in Newnan, Georgia
- Dr. Shamban is with Medical and Cosmetic Dermatology in Santa Monica, California
- Dr. Werschler is with Premier Clinical Research in Spokane, Washington. Ms. Daniels is with BioPharmX in Menlo Park, California
| | - Michael Gold
- Dr. Alexis is with Mount Sinai St. Luke's in New York, New York
- Dr. Del Rosso is with JDR Dermatology Research in Las Vegas, Nevada
- Dr. Desai is with ACRC Trials/Innovative Dermatology in Plano, Texas
- Dr. Downie is with Image Dermatology in Montclair, New Jersey
- Dr. Draelos is with Dermatology Consulting Services in High Point, North Carolina. Drs. Feser and Forconi are with International Clinical Research in Sanford, Florida
- Dr. Fowler is with DS Research in Louisville, Kentucky
- Dr. Gold is with the Tennessee Clinical Research Center in Nashville, Tennessee
- Dr. Kaufman-Janette is with the Skin Research Institute in Coral Gables, Florida
- Dr. Lain is with the Austin Institute for Clinical Research in Heatherwilde, Texas
- Dr. Lee is with Progressive Clinical Research in San Antonio, Texas
- Dr. Ling is with MedaPhase in Newnan, Georgia
- Dr. Shamban is with Medical and Cosmetic Dermatology in Santa Monica, California
- Dr. Werschler is with Premier Clinical Research in Spokane, Washington. Ms. Daniels is with BioPharmX in Menlo Park, California
| | - Joely Kaufman-Janette
- Dr. Alexis is with Mount Sinai St. Luke's in New York, New York
- Dr. Del Rosso is with JDR Dermatology Research in Las Vegas, Nevada
- Dr. Desai is with ACRC Trials/Innovative Dermatology in Plano, Texas
- Dr. Downie is with Image Dermatology in Montclair, New Jersey
- Dr. Draelos is with Dermatology Consulting Services in High Point, North Carolina. Drs. Feser and Forconi are with International Clinical Research in Sanford, Florida
- Dr. Fowler is with DS Research in Louisville, Kentucky
- Dr. Gold is with the Tennessee Clinical Research Center in Nashville, Tennessee
- Dr. Kaufman-Janette is with the Skin Research Institute in Coral Gables, Florida
- Dr. Lain is with the Austin Institute for Clinical Research in Heatherwilde, Texas
- Dr. Lee is with Progressive Clinical Research in San Antonio, Texas
- Dr. Ling is with MedaPhase in Newnan, Georgia
- Dr. Shamban is with Medical and Cosmetic Dermatology in Santa Monica, California
- Dr. Werschler is with Premier Clinical Research in Spokane, Washington. Ms. Daniels is with BioPharmX in Menlo Park, California
| | - Edward Lain
- Dr. Alexis is with Mount Sinai St. Luke's in New York, New York
- Dr. Del Rosso is with JDR Dermatology Research in Las Vegas, Nevada
- Dr. Desai is with ACRC Trials/Innovative Dermatology in Plano, Texas
- Dr. Downie is with Image Dermatology in Montclair, New Jersey
- Dr. Draelos is with Dermatology Consulting Services in High Point, North Carolina. Drs. Feser and Forconi are with International Clinical Research in Sanford, Florida
- Dr. Fowler is with DS Research in Louisville, Kentucky
- Dr. Gold is with the Tennessee Clinical Research Center in Nashville, Tennessee
- Dr. Kaufman-Janette is with the Skin Research Institute in Coral Gables, Florida
- Dr. Lain is with the Austin Institute for Clinical Research in Heatherwilde, Texas
- Dr. Lee is with Progressive Clinical Research in San Antonio, Texas
- Dr. Ling is with MedaPhase in Newnan, Georgia
- Dr. Shamban is with Medical and Cosmetic Dermatology in Santa Monica, California
- Dr. Werschler is with Premier Clinical Research in Spokane, Washington. Ms. Daniels is with BioPharmX in Menlo Park, California
| | - Mark Lee
- Dr. Alexis is with Mount Sinai St. Luke's in New York, New York
- Dr. Del Rosso is with JDR Dermatology Research in Las Vegas, Nevada
- Dr. Desai is with ACRC Trials/Innovative Dermatology in Plano, Texas
- Dr. Downie is with Image Dermatology in Montclair, New Jersey
- Dr. Draelos is with Dermatology Consulting Services in High Point, North Carolina. Drs. Feser and Forconi are with International Clinical Research in Sanford, Florida
- Dr. Fowler is with DS Research in Louisville, Kentucky
- Dr. Gold is with the Tennessee Clinical Research Center in Nashville, Tennessee
- Dr. Kaufman-Janette is with the Skin Research Institute in Coral Gables, Florida
- Dr. Lain is with the Austin Institute for Clinical Research in Heatherwilde, Texas
- Dr. Lee is with Progressive Clinical Research in San Antonio, Texas
- Dr. Ling is with MedaPhase in Newnan, Georgia
- Dr. Shamban is with Medical and Cosmetic Dermatology in Santa Monica, California
- Dr. Werschler is with Premier Clinical Research in Spokane, Washington. Ms. Daniels is with BioPharmX in Menlo Park, California
| | - Mark Ling
- Dr. Alexis is with Mount Sinai St. Luke's in New York, New York
- Dr. Del Rosso is with JDR Dermatology Research in Las Vegas, Nevada
- Dr. Desai is with ACRC Trials/Innovative Dermatology in Plano, Texas
- Dr. Downie is with Image Dermatology in Montclair, New Jersey
- Dr. Draelos is with Dermatology Consulting Services in High Point, North Carolina. Drs. Feser and Forconi are with International Clinical Research in Sanford, Florida
- Dr. Fowler is with DS Research in Louisville, Kentucky
- Dr. Gold is with the Tennessee Clinical Research Center in Nashville, Tennessee
- Dr. Kaufman-Janette is with the Skin Research Institute in Coral Gables, Florida
- Dr. Lain is with the Austin Institute for Clinical Research in Heatherwilde, Texas
- Dr. Lee is with Progressive Clinical Research in San Antonio, Texas
- Dr. Ling is with MedaPhase in Newnan, Georgia
- Dr. Shamban is with Medical and Cosmetic Dermatology in Santa Monica, California
- Dr. Werschler is with Premier Clinical Research in Spokane, Washington. Ms. Daniels is with BioPharmX in Menlo Park, California
| | - Ava T Shamban
- Dr. Alexis is with Mount Sinai St. Luke's in New York, New York
- Dr. Del Rosso is with JDR Dermatology Research in Las Vegas, Nevada
- Dr. Desai is with ACRC Trials/Innovative Dermatology in Plano, Texas
- Dr. Downie is with Image Dermatology in Montclair, New Jersey
- Dr. Draelos is with Dermatology Consulting Services in High Point, North Carolina. Drs. Feser and Forconi are with International Clinical Research in Sanford, Florida
- Dr. Fowler is with DS Research in Louisville, Kentucky
- Dr. Gold is with the Tennessee Clinical Research Center in Nashville, Tennessee
- Dr. Kaufman-Janette is with the Skin Research Institute in Coral Gables, Florida
- Dr. Lain is with the Austin Institute for Clinical Research in Heatherwilde, Texas
- Dr. Lee is with Progressive Clinical Research in San Antonio, Texas
- Dr. Ling is with MedaPhase in Newnan, Georgia
- Dr. Shamban is with Medical and Cosmetic Dermatology in Santa Monica, California
- Dr. Werschler is with Premier Clinical Research in Spokane, Washington. Ms. Daniels is with BioPharmX in Menlo Park, California
| | - Wm Philip Werschler
- Dr. Alexis is with Mount Sinai St. Luke's in New York, New York
- Dr. Del Rosso is with JDR Dermatology Research in Las Vegas, Nevada
- Dr. Desai is with ACRC Trials/Innovative Dermatology in Plano, Texas
- Dr. Downie is with Image Dermatology in Montclair, New Jersey
- Dr. Draelos is with Dermatology Consulting Services in High Point, North Carolina. Drs. Feser and Forconi are with International Clinical Research in Sanford, Florida
- Dr. Fowler is with DS Research in Louisville, Kentucky
- Dr. Gold is with the Tennessee Clinical Research Center in Nashville, Tennessee
- Dr. Kaufman-Janette is with the Skin Research Institute in Coral Gables, Florida
- Dr. Lain is with the Austin Institute for Clinical Research in Heatherwilde, Texas
- Dr. Lee is with Progressive Clinical Research in San Antonio, Texas
- Dr. Ling is with MedaPhase in Newnan, Georgia
- Dr. Shamban is with Medical and Cosmetic Dermatology in Santa Monica, California
- Dr. Werschler is with Premier Clinical Research in Spokane, Washington. Ms. Daniels is with BioPharmX in Menlo Park, California
| | - Annamarie Daniels
- Dr. Alexis is with Mount Sinai St. Luke's in New York, New York
- Dr. Del Rosso is with JDR Dermatology Research in Las Vegas, Nevada
- Dr. Desai is with ACRC Trials/Innovative Dermatology in Plano, Texas
- Dr. Downie is with Image Dermatology in Montclair, New Jersey
- Dr. Draelos is with Dermatology Consulting Services in High Point, North Carolina. Drs. Feser and Forconi are with International Clinical Research in Sanford, Florida
- Dr. Fowler is with DS Research in Louisville, Kentucky
- Dr. Gold is with the Tennessee Clinical Research Center in Nashville, Tennessee
- Dr. Kaufman-Janette is with the Skin Research Institute in Coral Gables, Florida
- Dr. Lain is with the Austin Institute for Clinical Research in Heatherwilde, Texas
- Dr. Lee is with Progressive Clinical Research in San Antonio, Texas
- Dr. Ling is with MedaPhase in Newnan, Georgia
- Dr. Shamban is with Medical and Cosmetic Dermatology in Santa Monica, California
- Dr. Werschler is with Premier Clinical Research in Spokane, Washington. Ms. Daniels is with BioPharmX in Menlo Park, California
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Reuzé S, Alexis A, Chargari C, Bockel S, Berthelot K, Escande A, Dumas I, Orlhac F, Haie-Meder C, Deutsch E, Robert C. OC-0075: A MRI radiomic signature for predicting brachytherapy outcomes in locally advanced cervical cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30385-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Limkin E, Reuzé S, Sun R, Schernberg A, Alexis A, Dirand A, Deutsch E, Ferté C, Robert C. EP-1993: Evaluation of the pertinence of CT-based radiomics shape features with 3D printed phantoms. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32302-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Reuzé S, Chargari C, Schernberg A, Seban R, Alexis A, Bockel S, Berthelot K, Escande A, Dercle L, Haie-Meder C, Deutsch E, Robert C. PO-0807: Diversity of PET imaging biomarkers predicting cervical cancer treatment outcome: where do we stand? Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31117-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Alexis A, Del Rosso J, Desai SR, Downie J, Draelos ZD, Feser C, Forconi R, Fowler J, Gold M, Kaufman-Janette J, Lain E, Lee M, Ling M, Shamban A, Werschler W, Daniels A. Rapid Improvement with BPX-01 Minocycline Topical Gel in the Treatment of Moderate-to-Severe Inflammatory Acne Vulgaris: a Randomized, Double-Blind, Vehicle-Controlled Study. ACTA ACUST UNITED AC 2017. [DOI: 10.25251/skin.1.supp.52] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Abstract Not Available Study supported by BioPharmX.
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