Recent Developments

Low-Acne Diet?

There is much conjecture among dermatologists regarding the relationship of diet and acne, but one recent study draws a clearer connection between the two. The study, which was presented at the AAD Annual Meeting in San Francisco (P706 Rouhani, et al. Acne improves with a popular, low glycemic diet from South Beach), found that most patients with acne reported an improvement in their condition when they followed the low-glycemic diet known as the South Beach diet. Patients with acne lesions were asked if any changes in their skin occurred and whether these changes were improvements in their acne. Overall, 86.7 percent of dieters noted skin changes to be improvements. Specifically, 90.7 percent of patients already on acne treatment saw improvements, while 81.7 percent of those untreated also saw improvements. Most noted these improvements within three months of beginning the diet. Among those already on acne therapy, 91 percent decreased the dose or frequency of treatment in light of improvements noted on the diet.

A Good Comb-Over
Combing through a child's wet hair may be a more accurate means of identifying active head lice infestation than visual inspection (Arch Dermatol. 2009; 145: 309-313). To compare diagnostic accuracy of visual inspection vs. wet combing, researchers evaluated 304 students aged six to 12 in five primary schools where head lice was epidemic. They found that wet combing had a significantly higher sensitivity in diagnosing active infestation (90.5 percent vs. 28.6 percent). Accuracy was 99.3 percent for wet combing and 95 percent for visual inspection. Among those with history of infestations, visual inspection was more sensitive, however.

Stem Cells for Ulcers
For ulcers and other skin manifestations associated with scleroderma, stem-cell therapy may prove successful. The process uses autologous bone marrow-derived stem cells, which were cultured ex vivo where their numbers expanded greatly. A solution of the stem cells and fibrinogen was placed in one chamber of a double-chambered syringe, and the second chamber is filled with a solution of dilute thrombin. The two solutions combine when ejected from the syringe as a spray over the wound. The mix then polymerizes, which helps to hold the stem cells in place in the wound. The wound is then covered with two-layer bioengineered skin containing a layer of keratinocytes and a layer of fibroblasts.

Preliminary results from three patients were presented at the AAD Annual Meeting in San Francisco. According to Vincent Falanga, MD, results were rapid, with substantial healing at four and eight weeks.

Educate the Masses
New consumer education disease sites represent an addition to the dermatology services offered by VivaCare, allowing physicians to publish original content with information for patients about specific diseases. Among these consumer-driven sites are www.acne-doctors.com, www.eczema-doctors.com, www.rosacea-doctors.com, www.beauty-doctors.com, www.skincancer-doctors.com, and www.psoriasis-doctors.com. Beyond the opportunity for individual dermatologists to contribute patient-focused content, each site will also include directories of dermatologists specializing in each condition. Physician enrollment is free at Vivacare.com.

Smoothing It Over
Patients with acne scars may be interested in Isolagen Therapy. The company recently announced its positive efficacy results from a Phase II/III clinical study evaluating Isolagen Therapy in the treatment of moderate to severe acne scars. Researchers evaluated 109 patients with acne, and both patient and evaluator assessments met primary endpoints and were statistically significant. Regarding patient assessment, 43 percent of patients reported a response to the therapy-treated side of the face, while 18 percent of patients reported a response on the placebo-treated side. Evaluators reported that 59 percent of patients responded on the Isolagen-treated side of the face, and 42 percent of patients responded on the placebo-treated side. Safety data is currently under review.

Isolagen, Inc. says it submitted a Biologics License Application to the FDA last month for Isolagen Therapy for the treatment of wrinkles/nasolabial folds.

T-cell Lymphoma Risks in Women
Younger African American and Hispanic women may be at higher risk for T-cell lymphoma progression, according to a report presented at the AAD meeting (P607 Sun G, et al.). Researchers identified 1074 patients with mycosis fungoides who were diagnosed by or referred to the center between 1989 and 2007. Surprisingly, early-onset MF occurred more frequently in African American (32.6 percent) and Hispanics (35.6 percent) than in whites (12.7 percent). Importantly, researchers noted that women drove the differences in early age of onset, with statistically significant differences between African American and Hispanic women and white women. Moreover, researchers found that while Hispanics and whites were similarly likely to initially present with MF at stage 1, African Americans appeared to present at stage 4.

Age of Exploration
A new website permits your patients to learn about skin diseases and their treatment. "Explore Your Skin" (exploreyourskin.com) from Promius Pharma uses three dimensional videos, animated shorts, and text, to describe how diseases manifest, the company says. It also explains how some therapies can help, including how cosmetic procedures are performed.

Psoriasis and Psychiatric Disorders
Patients with psoriasis have higher rates of psychiatric disorders and higher healthcare expenditures than individuals without the skin disease, new research presented at the AAD Annual Meeting shows (P3346 Han C, et al.). A study involved a review of charts for 7,971 patients with moderate to severe psoriasis and 31,884 matched controls for the year 2004. ICD-9 codes or therapeutic class indicators were used to determine rates of psychiatric disorders in each group. Individuals with psoriasis had statistically significantly higher prevalences of anxiety (6.94 vs. 4.37 percent), depression (9.17 vs. 5.32 percent), bipolar disorder (1.10 vs. 0.51 percent), and delirium (0.25 vs. 0.14 percent). A greater proportion of patients with moderate to severe psoriasis had been treated with antidepressants, anxiolytics, anti-psychotics, and anti-manics.

Hold the Line
Replacing a pre-operative visit after a biopsy with a phone call may slash the waiting time for Mohs surgery by about 25 percent, according to new report from the AAD meeting. Researchers compared waiting times and satisfaction levels in patients who had an office consultation per standard practice and patients who had a phone consultation before Mohs surgery for non-melanoma skin cancer. Phone consult patients said that their waiting time from biopsy to surgery was 75 days, as compared to 104 days for patients who had an office consult. Additionally, 98 percent of phone consult patients reported being "very satisfied" with their overall surgical experience versus 87 percent of office consult patients. While 90 percent of phone consult patients said they preferred a phone consult, only 70 percent of office consultation patients reported that they preferred an office consultation.

Fungi on the Net
Dermatologists and their patients can access specialized information about fungal infections and treatment through a new online educational program launched by OrthoDermatologics at ertaczo.com. For physicians, there's information about diagnosis and treatment of tinea pedis and comorbidities. There's also a linked website with video presentations: TheFungalLink.com. For patients, the Ertaczo site provides information on prevention, hygiene, and treatment, as well as money-saving offers for prescriptions.

Upcoming Events

• The American Society for Laser Medicine and Surgery (ASLMS) annual meeting will be held April 3 - 5, 2009 at National Harbor, MD. www.eshow2000.com/aslms/2009/
• International Society of Hair Restoration Surgery (ISHRS), will hold its 17th Annual Scientific Meeting July 22-26, 2009 in Amsterdam, The Netherlands. www.ishrs.org
• The Five Continent Congress on Lasers and Aesthetic Medicine will be held September 10-12, 2009 in Nice, France. www.5continent-congress.com