Dermatology Times September 2024 Print Recap

The September issue of Dermatology Times includes a collection of thought-provoking articles and topics ranging from addressing myths related to botulinum toxins to case reviews of pseudo acne fulminans. Be sure to read the highlights from the issue below. Also, don’t miss a moment of Dermatology Times by signing up for our eNewsletters and subscribing to receive the free print issue and supplement each month.

Unmasking Botulinum Toxin Myths

Botulinum toxin treatments are among the most common approaches to address aesthetic concerns worldwide. Starting as a potent neurotoxin produced by the bacteria Clostridium botulinum, botulinum toxin is now used globally in clinical practice, providing a highly accessible and minimally invasive solution to undesirable conditions such as facial wrinkles. Currently, there are many different botulinum toxin products globally available, with more coming at an accelerated pace.

Nearly all aspects of botulinum toxins have changed dramatically since the first product was approved for therapeutic use in 1989, due to factors such as new manufacturing technologies, advances in toxin science, increases in the number of conditions treated and amount of toxin injected, and a shift in the patient demographics receiving these products. As these changes have occurred, so have inaccurate marketing messages, misuse of toxin-related scientific testing data, incomplete analyses of published data, and a general unawareness among health care professionals administering the toxins of the scope and scale of toxin usage.

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Comparing Devices to Assess Facial Pigmentary and Inflammatory Conditions

Many dermatological conditions are assessed with the naked eye, including dermatoses that prominently feature erythema or pigmentary alteration. Disturbances of pigmentation include skin diseases such as melasma and dermatoheliosis as well as postinflammatory hyperpigmentation from inflammatory skin diseases such as atopic dermatitis and acne. Hypopigmented conditions of the skin include pityriasis alba, vitiligo, and postinflammatory hypopigmentation from conditions such as seborrheic dermatitis.

When assessing these conditions, dermatologists may be unable to appreciate subtle changes in color or have difficulty assessing severity in patients with skin of color. Adjunctive tools such as polarized light, photography, Wood lamp, reflectance spectroscopy, and dermoscopy can help clinicians evaluate subtle pigmentary changes, but these techniques have some disadvantages.

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Insights Into the Approval of Denileukin Diftitox-cxdl for Cutaneous T-Cell Lymphoma

The US Food and Drug Administration (FDA) recently approved Citius Pharmaceuticals’ denileukin diftitox-cxdl (Lymphir) for adults with relapsed or refractory cutaneous T-cell lymphoma (CTCL).

The approval is based on positive phase 3 trial results showing effectiveness in CTCL stages I to III. The trial involved administering the drug intravenously over 5 consecutive days every 21 days, with primary outcomes focused on dose-limiting toxicities and overall response rate, and secondary outcomes including response duration and adverse events.

Following the approval, Dermatology Times spoke with Myron Czuczman, MD, chief medical officer and EVP of Citius, to discuss the implications of the approval for dermatology clinicians and the role of a multidisciplinary care team in treating patients with CTCL.

Lymphir is an innovative agent classified as an immunotoxin, a fusion protein combining IL-2 with a potent toxin. Unlike other FDA-approved systemic targeted therapies for CTCL, Lymphir operates through a distinctive mechanism.

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Understanding and Treating Pseudo Acne Fulminans

Pseudo acne fulminans is a rare but significant dermatological condition that can arise during isotretinoin (Accutane) treatment, particularly in patients with severe inflammatory acne. Shanna Miranti, MPAS, PA-C, advanced practitioner at Riverchase Dermatology in Naples, Florida, and Dermatology Times summer editor in chief, recently presented 2 cases that shed light on this condition, its management, and the importance of careful monitoring and patient counseling during isotretinoin treatment.

Pseudo acne fulminans is characterized by a sudden eruption of nodules and ulcerative, crusted acne lesions. It is considered a rare condition because there have been fewer than 200 case reports documented, but its incidence appears to be increasing with the rising use of isotretinoin. The condition typically occurs in teenaged boys and men, particularly those with severe inflammatory acne including truncal involvement. This often starts within the first month of isotretinoin treatment or after clinicians increase the patient’s dosage to 1 mg/kg daily.

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