Recent Developments

ModMed Survey: Patients Embrace Digital Tools for Health Care Interactions

Today’s patients increasingly take into account the overall health care experience, and issues such as timeliness, friendliness of the staff, and use of modern technology all contribute to their impression of a practice. In fact, results of a new survey from practice technology leader ModMed (modmed.com) conducted by independent research firm OnePoll, many patients are willing to change providers based on these factors.

The ModMed 2022 Patient Experience Report: What Patients Really Think surveyed 2,000 patients about their experience with a doctor’s office. Of these, 73% say they are likely to keep a “mental scorecard” of all the things they like and dislike about a new doctor’s office. But while they are keeping track, patients seem willing to give practices a chance. Patients say they give an office four chances, on average, before deciding to find a new doctor.

For many patients, the ability to book appointments online is a key convenience. According to the survey, 60% of patients are likely to select one doctor over another if able to make appointments online. A similar percentage of respondents (61%) will consider ease of making payments in their decision to stick with a doctor.

More than half of patients surveyed are more likely to pay a bill faster than usual if they receive a text message reminder and are more likely to pay faster if given an online option.

“These days practices make an impression on patients from before they walk in the door until long after they’ve left. There are countless touchpoints providers have with patients where they can influence a positive experience,” says Daniel Cane, chief executive officer at ModMed.”We wanted to provide these insights so providers can stop guessing what’s important to patients and instead be in a position to enhance or create a health care delivery model that is more in line with today’s connected consumer.”

Digital tools are increasingly important to patients. But the data suggest that patient interest isn’t just about convenience. More than half (54%) strongly agree that their doctor seems more attentive when using technology in the exam room. Nearly half (47%) of respondents strongly agree, and an additional 42% somewhat agree, that office staff seem more engaged since introducing new technology at the office. A significant proportion (46%) of respondents prefer their doctor use a tablet to review patient history.

When it comes to scheduling appointments, results of the survey reveal a majority of patients agree that it’s frustrating when they call for an appointment and have to leave a voicemail and wait to be called back. In fact, 48% prefer to email, text or use an online portal over a phone call to make appointments. About two-thirds (67%) are more likely to use chat over calling to make an appointment or request lab results.

“Taking a digital-first approach with patients could free up staff to focus more on non-administrative tasks, giving them more time to focus on patients and potentially boosting their own job satisfaction,” Mr. Cane observes.

Of course, a digital-first approach is intended to complement human interaction. Survey participants stress that want to be treated well. Because they value their time, they may choose to leave or never return to a doctor’s office if they don’t have a good experience. One out of three patients have switched doctors due to unfriendly staff. And when deciding to see the same doctor, 67% of patients polled believe it is important to consider how personable and engaged a doctor is.

Every Scar Tells a Story: Actress Vanessa Morgan Shares Hers

Scars are a fact of life for many people. Roughly half (48.5%) of all adults report having at least one scar, according to recently published findings from an international epidemiological study. (J Eur Acad Dermatol Venereol; May 2022) In 22% of respondents, the most recent scar was less than one year old. Half of all recent scars are linked to accidents or disease.

Recent scars in women were most common on the abdomen (20.4%) and face (15.9%), whereas in men, recent scars were more common on the face (18.7%) and abdomen (13.2%). Significantly more men (13.3%) than women (8.4%) reported scars on their hands.

Practical Dermatology® magazine sat down with “Riverdale” actress Vanessa Morgan to discuss her very personal “scar story.” Ms. Morgan helped Gold Bond launch the “My Scar My Story” campaign by sharing this story on IG Live while receiving a meaningful tattoo from tattoo artist Noah Lee to commemorate her scar. The new campaign aims to empower people everywhere to embrace their scars and celebrate the stories they tell.

What is your scar story?

Vanessa Morgan: I gave birth to my son, River, in 2021 via an emergency c-section. There was a full moon when my water broke and, apparently, hospitals are packed during full moons. So, I was still waiting 4 hours after my water had broken and by that time River’s heart rate was really increasing. The doctors let me know that it was really risky to wait any longer and that I should have the c-section. I was so scared, but all I could think was, “I didn’t carry a baby for 10 months for him not to make it, and I need to do whatever I have to, to keep him safe.” My mom instincts kicked in immediately and I just knew that I had to do it for my son.

Why did you decide to get this tattoo?

Ms. Morgan: Giving birth to my son was the most meaningful moment in my life, and I was left with a scar that is a beautiful reminder of what my body was able to achieve. So I wanted to add more meaning with a tattoo next to my scar that honors that journey. I have so much gratitude for my body and what I’ve been able to do, and I really wanted to honor that with a new tattoo.

What does it mean to you?

Ms. Morgan: To build on my birth story, I wanted to get a tattoo next to my c-section scar of the word “kintsugi,” which is a metaphor for embracing your flaws. To me, that expresses what I truly believe—that you are more beautiful for having been broken. I’ve always admired the idea of embracing imperfections, and I’ve chosen a tattoo that symbolizes that my body is more beautiful now, with this scar, than it ever was before.

Tell us about your partnership with Gold Bond.

Ms. Morgan: I’ve partnered with Gold Bond, a brand that champions real, healthy skin, to launch My Scar My Story, a campaign encouraging people to celebrate the stories told on their skin. Together with Gold Bond, I’m hoping to help inspire others to see their skin as an intricate canvas that tells the stories of our lives. Additionally, through this partnership, I want to help others find their own routine for skin that looks and feels healthy, allowing them to feel confident in their skin so they can focus on what really matters: living their authentic lives. My most important skin story is that of the c-section scar I received from the birth of my son, but my story is just one of many. So, in sharing my scar story, my goal is to empower everyone to honor their real skin and share their own scar stories via #MyScarStory, tagging @goldbond to join the conversation.

What do you do every day to keep your skin healthy? Is this challenging when you are on the set?

Ms. Morgan: For my face routine, I really love Tata Harper’s products, like the Water-Lock Moisturizer. I also really enjoy using pure rose water throughout the day to freshen my face and keep it moisturized. While most people focus on taking care of the skin on their face, I’m also careful to make sure I keep the skin on my body healthy, which is why I love Gold Bond’s products. In particular, the Advanced Healing Ointment is my favorite for quickly soothing and relieving my skin when it’s dry or cracked. It absorbs quickly to hydrate, restore, and protect dry skin with shea butter and ceramides that have been clinically tested to restore healthy skin.

Additionally, I love the Gold Bond Healing lotion for immediate hydration. I use it daily and see noticeably healthier skin. It contains 7 essential moisturizers, as well as vitamin A to help improve the appearance of skin, vitamin C to help protect against environmental stressors, and vitamin E to help prevent moisture loss. Plus, it’s dermatologist-tested and hypoallergenic so I feel good about using it. I love that Gold Bond products are paraben free which is something that has always been important to me when it comes to products that I put on my body.

It’s not challenging to keep my skin healthy while on set. I focus on keeping my face and body moisturized, which is key, and like to keep my routine simple. I actually discovered rose water on the set, from my makeup artist, and that has turned into a staple product for me.

FDA Approves Spevigo as First Treatment Option for Generalized Pustular Psoriasis Flares

With FDA approval last month, Spevigo (spesolimab) from Boehringer Ingelheim has become the first and only treatment option for generalized pustular psoriasis (GPP) flares in adults in the US. Spevigo is a novel, selective antibody that blocks the activation of the interleukin-36 receptor (IL-36R), a key part of a signaling pathway within the immune system shown to be involved in the cause of GPP.

In the 12-week pivotal Effisayil 1 clinical trial, patients experiencing a GPP flare (N=53) were treated with Spevigo or placebo. After one week, patients treated with Spevigo showed no visible pustules (54%) compared to placebo (6%).

In Effisayil 1, the most common adverse reactions (≥5%) in patients that received Spevigo were asthenia and fatigue, nausea and vomiting, headache, pruritus and prurigo, infusion site hematoma and bruising, and urinary tract infection.

“GPP flares can greatly impact a patient’s life and lead to serious, life-threatening complications,” says Mark Lebwohl, MD, lead investigator and publication author, and Dean for Clinical Therapeutics, Icahn School of Medicine at Mount Sinai, Kimberly and Eric J. Waldman Department of Dermatology, New York. “The approval of Spevigo is a turning point for dermatologists and clinicians. We now have an FDA-approved treatment that may help make a difference for our patients who, until now, have not had any approved options to help manage GPP flares.”

An estimated 1 out of every 10,000 people in the US has GPP.

Revelle Aesthetics Wins Extended FDA Clearance for Avéli for Long-Term Reduction in Cellulite

Revelle Aesthetics, Inc.’s Avéli is now indicated for long-term reduction in the appearance of cellulite in the buttocks and thigh areas of adult females, demonstrating benefits through one year.

Avéli allows a provider to identify which of the fibrous septa bands are causing a cellulite dimple, and then confirm in real-time they are releasing those targeted septa to deliver visibly smoother skin. Results are visible quickly after a single in-office procedure with little-to-no downtime.

Revelle’s approach to successful integration into practices consists of clinical proctoring along with dedicated marketing and educational support.

“There is a real need out there with women; we as physicians just need to start having the cellulite conversation with them,” says Dr. Nazanin Saedi, a board-certified dermatologist at Dermatology Associates of Plymouth Meeting in Philadelphia, PA, and member of the Board of Directors for the American Society for Dermatologic Surgery. “Before Avéli, I didn’t feel I had much to offer them that was impressive and reliable. Avéli is a very straightforward and lasting solution to something we have struggled to treat for so long. When I tell my patients how Avéli works, it is an easy conversation – it just makes sense to them. Results in a one-time treatment and the lack of capital equipment make Avéli an economically attractive, easy-to-integrate option for us and our patients.”

Psoriasis, Other Autoimmune Diseases Increase Risk for Cardiovascular Disease

Earlier research has suggested associations between some autoimmune disorders and a higher risk of cardiovascular disease, and now, a new study shows that 19 of the most common autoimmune disorders seem to increase risk for developing heart disease.

Patients with autoimmune disease have a substantially higher risk (between 1.4 and 3.6 times depending on which autoimmune condition) of developing cardiovascular disease than people without an autoimmune disorder. This excess risk is comparable to that of type 2 diabetes.

The group of 19 autoimmune disorders accounts for about 6% of cardiovascular events. Importantly, excess cardiovascular risk was visible across the whole cardiovascular disease spectrum, beyond classical coronary heart disease, including infection-related heart disorders, heart inflammation, as well as thromboembolic and degenerative heart disorders, suggesting the implications of autoimmunity on cardiovascular health are likely to be much broader than originally thought.

Furthermore, the excess risk was not explained by traditional cardiovascular risk factors such as age, sex, socioeconomic status, blood pressure, BMI, smoking, cholesterol and type 2 diabetes. The excess risk is particularly high among patients with autoimmune disorders under 45 years.

The findings were presented at the annual congress of the European Society of Cardiology in Barcelona and published in the Lancet.

The study was based on electronic health records from the United Kingdom’s Clinical Practice Research Datalink (CPRD), a very large database of anonymized patient data from about one-fifth of the current UK population. Among 22 million patient records, the researchers assembled a cohort of patients newly diagnosed with any of the nineteen autoimmune disorders. They then looked at the incidence of 12 cardiovascular outcomes—an unprecedented granularity that was made possible by the very large size of the dataset—in the following years, and they compared it to a matched control group. The risk of developing cardiovascular disease for patients with one or more autoimmune disorders was on average 1.56 times higher than in those without autoimmune disease. They also found that the excess risk rose with the number of different autoimmune disorders in individual patients. Among the disorders with the highest excess risk were systemic sclerosis, Addison’s disease, lupus and type I diabetes, the study showed.

“We see that the excess risk is comparable to that of type 2 diabetes. But although we have specific measures targeted at diabetes patients to lower their risk of developing cardiovascular disease (in terms of prevention and follow-up), we don’t have any similar measures for patients with autoimmune disorders,” says study co-author Nathalie Conrad, PhD an epidemiologist in cardiovascular science at the University of Leuven in Belgium.

“We need to develop targeted prevention measures for these patients. And we need to do further research that helps us understand why patients with an autoimmune disorder develop more cardiovascular diseases than others, and how we can prevent this from happening.”

The underlying mechanisms linking autoimmunity and heart disease are still poorly understood, she said. “The general hypothesis is that chronic and systemic inflammation, which is a common denominator in autoimmune disorders, can trigger all sorts of cardiovascular disease,” she said. “Effects of autoimmune disease on connective tissues, small vessels, and cardiomyocytes, and possibly some of the treatments commonly used to treat autoimmunity are also likely to contribute to patients’ cardiovascular risk. This really needs to be investigated thoroughly.”

New Arcutis Campaign Raises Pso Awareness

Arcutis Biotherapeutics, Inc. is launching an educational campaign designed to raise awareness about the physical and emotional impact of plaque psoriasis and empower those living with the disease to have open, honest conversations with their health care providers, family, and friends.

The campaign, Expose Psoriasis, features expert advice from a leading dermatologist and the personal story and tips from an award-winning writer and psoriasis patient advocate.

Expose Psoriasis illuminates how plaque psoriasis may significantly impact many aspects of daily life, including day-to-day decisions such as what to wear, participation in social activities, and interpersonal relationships. The campaign also aims to raise awareness that symptoms may occur anywhere on the body, including knees, elbows, torso, and sensitive places like the face, genitals, and areas of skin-to-skin contact (intertriginous areas), such as armpits, under the breasts, stomach folds, between the buttocks, and in the groin area.

A recent survey conducted by The Harris Poll found that two in five survey respondents with psoriasis in intertriginous areas did not recognize they had intertriginous psoriasis until they saw pictures of intertriginous plaques.

“People who experience psoriasis in more private parts of the body, such as on the genitals or intertriginous areas, may feel reluctant or embarrassed to show their dermatology specialist these areas. Additionally, since most people typically think a dermatology visit is only for discussing the physical aspects of their skin, those with psoriasis may not realize that they should be sharing how the disease is impacting their emotional and mental wellbeing,” explains Tina Bhutani, MD, dermatologist and co-director of the UCSF Psoriasis and Skin Treatment Center. “It’s so important for people to tell their health care providers about all the ways psoriasis impacts them because there are many treatment options and resources available that can help. Understanding the full impact of the disease allows dermatology specialists to determine the best course of action to care for our patients.”

Expose Psoriasis also addresses the value of having a support network and provides talking points that people can use to discuss their disease with their loved ones.

“Psoriasis can have an impact on your relationships with others and talking about your symptoms with loved ones can be difficult, but it’s so important to do so,” explains Sabrina Skiles, award-winning writer and psoriasis patient advocate. “Remember, your family and friends are there to support you, not judge you. By sharing your story with them and educating them about the disease, you are normalizing the topic and strengthening your support network.”

People interested in testing their knowledge about psoriasis can take this interactive quiz here. For more information about this initiative, visit www.ExposePsoriasis.com.

CLOSE UP with Emma Guttman, MD, PhD

Rocatinlimab, an investigational drug that inhibits activated OX40-expressing T cells, demonstrated improvements in head and neck atopic dermatitis among patients with moderate to severe disease in a Phase 2 trial presented at the European Academy of Dermatology and Venerology’s 2022 meeting. Here, study author Emma Guttman, MD, PhD, Waldman Professor and System Chair of The Kimberly and Eric J. Waldman Department of Dermatology and the Director of Center of Excellence in Eczema, and the Director of Laboratory of Inflammatory Skin Diseases at Icahn School of Medicine in New York City, discusses the significance of these findings and what they may mean for eczema patients in the future.

Why is this topic important to study?

Emma Guttman, MD, PhD: Many available medications for atopic dermatitis don’t target the full spectrum of T-cell mediated inflammation that is involved in facial rashes. Facial rashes are more resistant to treatment, and even new facial rashes were reported with some agents. Rocatinlimab may also be beneficial for head and neck atopic dermatitis because it blocks Th2, Th1, and Th17 cells.

Describe the research and your findings

Dr. Guttman: In the post-hoc analysis, 219 patients with head and neck atopic dermatitis received subcutaneous rocatinlimab 150mg or 600mg every 4 weeks (Q4W), 300 or 600 mg every 2 weeks (Q2W) for 36 weeks, or placebo (Weeks 0–18, followed by rocatinlimab 600mg Q2W Weeks 18–36), and a 20-week off-drug follow-up period (Week 56). An additional analysis assessed the effect of rocatinlimab at weeks 16–56. Among patients with head and neck atopic dermatitis that was inadequately controlled with topical therapy, all rocatinlimab doses led to greater improvements in Eczema Area and Severity Index (EASI) score than placebo. This is consistent with findings from the primary endpoint in moderate to severe atopic dermatitis patients. After treatment discontinuation at Week 36, most patients maintained responses for up to 20 weeks until Week 56. The durability of response with rocatinlimab is unique among current atopic dermatitis therapies, potentially reflecting the unique mechanism of action and may be suggestive of disease modification. There were no new safety signals observed.

What is the next step?

Dr. Guttman: The results are really good, and response is maintained after the drug is stopped. The findings should be published in a peer-reviewed journal soon. A Phase 3 trial of rocatinlimab is currently being designed. We are hoping that study will start by the end of 2022. If further studies yield positive results and the drug is approved, we can move to this drug if someone develops a facial rash on another drug or their facial rash isn’t adequately treated, as well as when they have moderate to severe AD. If you see a patient with significant involvement on their face, in addition to other body parts, this drug can hopefully be used as a first line if the Phase 3 will be successful. It will be good to have choices for our patients, much like we do in psoriasis today.

Revision Skincare, RVL Pharmaceuticals Partner to Meet Consumer Needs

With a goal to collaborate on a variety of marketing efforts within the medical aesthetics industry, Revision Skincare and RVL Pharmaceuticals, Inc. the owner of UPNEEQ, are partnering to address what they see as significant unmet consumer needs.

Revisions says that, with shared values and visions for business growth and an expanding footprint, the collaboration aligns two game-changing brands to offer more accessible solutions to aesthetic patients and providers nationwide.

For more than two decades, Revision Skincare has been at the forefront of physician-dispensed brands. RVL Pharmaceuticals offers appropriate patients a nonsurgical solution for acquired ptosis and provides results in as little as 5 minutes with UPNEEQ, the first and only FDA-approved prescription eye drop for the treatment of acquired ptosis in adults.

“We know that RVL Pharmaceuticals has a lot of choices when it comes to commercial partnerships. We are excited to join this mission with RVL to offer breakthrough patient solutions,” says Maria Carell, CEO, and President, Revision Skincare.

Through the partnership, Revision Skincare and RVL Pharmaceuticals will bring broader access to products like D·E·J Eye Cream, Revox Line Relaxer, and UPNEEQ.

“We are thrilled to partner with Revision Skincare! Their strong history of innovation and passion for skin health aligns with our core directive around ocular medical aesthetics,” says Brian Markison, CEO, RVL Pharmaceuticals.

50/50 Women on Boards Recognizes Cutera for Gender-Balanced Board of Directors

The 50/50 Women on Boards recognized Cutera for having a gender-balanced board. With four women directors, holding 50% of its corporate board seats, Cutera, Inc. is one of 8% of Russell 3000 companies with a gender-balanced board.

“We are honored to be recognized by 50/50 Women on Boards for our commitment to ensuring gender balance and diversity at every level of our company,” says David Mowry, CEO of Cutera. “Cutera is dedicated to ensuring opportunities that are equal, regardless of gender, race, or identity.”

“Over the last decade, our 50/50 Women on Boards Gender Diversity Index reveals the gradual acceleration of women to corporate boards. However, there is still a significant gap to achieve gender balance,” says Betsy Berkhemer-Credaire, CEO of 50/50 Women on Boards. “It’s critical that we recognize these milestones and acknowledge corporations, such as Cutera, for leading by example with a gender-balanced corporate board.”

50/50 Women on Boards (50/50WOB) is a nonprofit 501(c)3 that is a leading education and advocacy campaign driving the movement toward gender balance and diversity on corporate boards. The campaign publishes its 50/50 Women on Boards Gender Diversity Index directory and research reports to track the gender composition of corporate boards on the Russell 3000 by board size, state, sector, and rating.

CDC Reports Acne, AD, PsO, and Other Active Exfoliative Skin Conditions Increase Risk for Severe Monkeypox

People with active exfoliative skin conditions are at higher risk for severe monkeypox, according to interim clinical guidance from the Centers for Disease Control and Prevention.

Many people infected with monkeypox virus have a mild, self-limiting disease course in the absence of specific therapy. Individuals with eczema, burns, impetigo, varicella zoster virus infection, herpes simplex virus infection, severe acne, severe diaper dermatitis with extensive areas of denuded skin, psoriasis, or Darier disease [keratosis follicularis] should be considered for treatment following consultation.

Antivirals developed for use in patients with smallpox may prove beneficial against monkeypox.

Also on the list of high-risk patients who may require treatment are:

• People with severe disease (e.g., hemorrhagic disease, confluent lesions, sepsis, encephalitis, or other conditions requiring hospitalization)
• People who are immunocompromised
• Pediatric populations, particularly patients younger than 8 years of age
• Pregnant or breastfeeding women
• People with one or more complications (e.g., secondary bacterial skin infection; gastroenteritis with severe nausea/vomiting, diarrhea, or dehydration; bronchopneumonia; concurrent disease or other comorbidities)

FDA Cracks Down on Companies Selling Unapproved Drugs for Mole and Skin Tag Removal

The FDA issued three warning letters to three companies, including Amazon, for selling unapproved products for removing moles and skin tags, in violation of the Federal Food, Drug, and Cosmetic Act (FD&C Act).

There are no FDA-approved over-the-counter drug products for the removal of moles and skin tags.

The FDA has issued a consumer warning noting that products marketed for removing moles and other skin lesions can cause injuries and scarring. The sale of these products risks public health and may jeopardize consumers’ health when used without consulting a health care professional.

The FDA issued the warning letters to Amazon.com, Ariella Naturals, and Justified Laboratories. The mole and skin tag removal products sold by these firms have not been evaluated by the FDA for safety, effectiveness, or quality and require FDA approval. The introduction or delivery for introduction of these products into interstate commerce without an approved application is an additional violation of the FD&C Act.

The warning letters alert the companies that failure to adequately address the violations cited by the FDA may result in legal action including seizure and/or injunction. The FDA will continue to use all tools available to protect public health and remove fraudulent or unproven drug products from the U.S. marketplace. Warning letters are not meant to be final agency action.

The FDA encourages consumers and health care professionals to report adverse events to the MedWatch Adverse Event Reporting program so the agency can protect the public from any unsafe products. The FDA works to protect consumers by informing about the risks and how to buy online safely.