Pustular and Erythrodermic Psoriasis in Patients Treated With Oral Glucocorticoids: A Survey of United States Dermatologists.

Dermatology dogma has cautioned against the use of orally administered glucocorticoids (OAG) in the treatment of psoriasis, largely due to concerns of life-threatening generalized pustular psoriasis (GPP) and erythrodermic psoriasis (EP). However, studies show that OAG are frequently used for psoriasis, often by dermatologists. Given the widespread use of OAG, we see an urgency in examining the relationship between OAG usage and the development of GPP and EP. This anonymous electronic survey of 50 US dermatologists examines OAG use in the management of psoriasis and the frequency at which dermatologists report seeing associated adverse outcomes of GPP and EP. Overall, 9 out of 50 (18%) respondents occasionally prescribe OAG to patients with psoriasis. Dermatologists who prescribe OAG tended to be younger than those who did not, with two-thirds in clinical practice for 0-10 years. Among all respondents, 16% (8/50) had experienced one or more patients developing GPP/EP in the context of OAG treatment for psoriasis. Our study suggests that OAG for the management of psoriasis is not uncommon among U.S. dermatologists, despite nearly universal awareness of its risks. Our observed low prevalence of GPP and EP emphasizes the need for prospective studies to better characterize OAG’s risk/benefit profile in psoriasis. J Drugs Dermatol. 2022;21(4):427-429. doi:10.36849/JDD.6242.

Skewed Distribution of Medical Spas and Aesthetic Physician Practices: A Cross-Sectional Market Analysis.

BACKGROUND: Medical spas have experienced a recent rise in popularity by consumers. Their regulations vary from state to state, especially concerning oversight and credentialing. A majority of aesthetic physicians were shown to have a medical spa within 5 minutes of their workplace. OBJECTIVE: Our study investigated the current market distribution of medical spas and physician practices in the aesthetic field. MATERIALS AND METHODS: For the 30 most populous cities, data were collected for medical spas and aesthetic physicians. Descriptive ratios were calculated, and various local factors were examined. RESULTS: The cities with the greatest number of medical spas were New York (374), Houston (297), and Los Angeles (227). The cities with the greatest number of aesthetic physicians were New York (365), Houston (135), and Chicago (122). Population size had significant relationships with number of medical spas (p < .000001) and aesthetic physicians (p < .000001). For ratio of medical spas to aesthetic physicians, the top cities were Las Vegas (9.17), Denver (3.86), and San Jose (3.65). In total, 73.3% of cities had more medical spas than aesthetic physicians. CONCLUSION: Certain cities have experienced an unequal distribution of medical spas. Further research should examine how this affects consumer decision-making for the selection of practice settings.

Experiences With Medical Spas and Associated Complications: A Survey of Aesthetic Practitioners.

BACKGROUND: Medical spas have experienced a recent rise in popularity. However, rules and regulations vary nationwide. Given the number of complications attributable to medical spas, questions remain about currently regulatory practices and whether they are sufficient to protect patients from harm. OBJECTIVE: Our study investigated the current state of medical spas and their associated patient complications in the aesthetic field as well as the experiences and attitudes of practitioners. MATERIALS AND METHODS: A survey was distributed to current members of the American Society for Dermatologic Surgery. RESULTS: Of all cosmetic complications encountered in the past 2 years, the majority reported that the percentage of complications seen in their practice attributable to medical spas ranged from 61% to 100%. The most commonly cited complications from medical spas were burn, discoloration, and misplacement of product, whereas the most commonly cited treatments resulting in complications were fillers, intense pulsed light, and laser hair removal. For safety and outcomes, medical spas were rated as inferior to physician-based practices. CONCLUSION: Patient complications associated with medical spas are not uncommon. Overall, practitioners believe medical spas are endangering to patient safety, think that stricter rules and regulations are necessary, and request more support from the specialty medical societies.

Topical Moringa Formulations: An Emerging Skincare Ingredient.

Recently, the addition of moringa to skincare products has become a popular trend, especially in the natural beauty industry. It is being marketed for its intended moisturizing, antioxidant, and anti-aging properties; however, data are scarce demonstrating its clinical effects as well as standardized concentration, formula, source, and extraction methods. Skin specialists must be aware of this trendy ingredient, including its recent claims in marketing material and current evidence in the literature.

Google Glass in the Dermatology Clinic: Changing How We See the World.

Over the years, health disparities in medicine have continued to grow, and dermatology has been especially impacted, given the relative shortage of dermatologists in comparison to patient needs. Novel and disruptive solutions may be required to help improve patient care. In 2013, Google Glass was introduced, which is a wearable head-mounted display. The device is analogous to having a computer connected to your eyeglasses with one of the lenses serving as the screen. The technology has already been introduced for various applications within the medical field. We reviewed the pros and cons of this technology, with specific focus on dermatologic care, and discussed how Google Glass could potentially address current dermatologic health disparities. (SKINmed. 2022;20:187-189).

Optimizing skin tightening in aesthetics in men.

The field of cosmetic dermatology has recently witnessed unbridled growth in the past several years. Part of this has been due to the increasing popularity of aesthetic treatments in men, who represent a growing patient population. Men tend to have higher levels of collagen density and greater skin thickness, but these begin to decrease earlier on. They can also more frequently have severe photodamage. Their clinical presentations can affect the selection of treatments. Physicians should be familiar with the subtle differences between treating men and women. Early studies and literature are beginning to shed more light on these important distinctions. We review the notable differences in facial aging, pathophysiology, and patient selection and discuss available treatment options with these factors in mind.

Medical spa facilities and nonphysician operators in aesthetics.

Consumer interest in aesthetic procedures continues to grow. Through savvy marketing, affordable pricing, and minimal wait times, medical spas have grown in number to where they now outnumber physician-based cosmetic practices in 73% of major U.S. cities. To staff these facilities, owners frequently turn to nonphysician operators who have variable levels of training in dermatology and cosmetics. There has been a lack of uniform standardization of training and oversight, which may contribute to adverse events, such as burns, pigmentary alterations, and scarring. As the market for noninvasive and minimally invasive cosmetic procedures continues to grow, physicians should be informed about the current cosmetic landscape in which they practice to improve patient awareness, education, and safety.

Head and facial dimensions of Chilean workers for design purposes and the differences with other populations.

BACKGROUND: An appropriate match between a product and its end-users requires anthropometric data, which show variations among different countries. Proper Personal Protection Equipment (PPE) fit is key for safety and comfort. Chile had no head and facial anthropometric data available in order to design face/head PPE. OBJECTIVE: To describe face/head anthropometric characteristics of Chilean workers. Additionally, this study compared those dimensions against other populations (United States (US), South Korea and China). METHODS: An anthropometric survey involving 21 measures was conducted between September 2013 to May 2016 using stratified sampling. The measurements were based on ISO/TS 16976-2 and ISO 15535 to ensure the highest standards possible, and a total of 474 workers, aged from 18 to 66 years old, participated in the survey. RESULTS: The biggest differences were in Neck circumference, Weight, Nose breadth, Nose protrusion, Bitragion chin arc, Face length, Subnasale-sellion length, Face width, Bigonial breadth and Bitragion subnasal arc. Head length of Chileans were longer than Chinese and South Korean ones, but shorter than US Head length. Chilean Head breadth is smaller than Chinese and South Korean ones. Chileans Face length was the largest observed. Face width of Chileans was smaller than US and Chinese ones. Gender specific differences were also observed in the inter-country comparisons. Chilean males had larger anthropometric dimensions than females. CONCLUSION: Chilean Head and face dimensions differed significantly when compared against US, South Korean and Chines Head and Face dimensions. Chileans have longer and narrower faces with wider mouths, with a head size in between the US and Asian heads. Face and head PPE for Chileans should use dimensions in the current paper in order to ensure proper fit.

Rise in male cosmetic procedures in dermatology: A 4.5-year clinical evaluation.

This commentary examines the growing popularity of cosmetic procedures in men. With the recent increase in aesthetic procedures across the nation, it is important for physicians to understand trends as they evolve, which can help to optimize clinical training, business operations, and practice management. Although the popularity of cosmetic procedures in men has increased, available data on consumer behavior is limited. Our data fills this gap by examining the patterns of cosmetic procedures in men. Due to hormonal and anatomic differences, the pathophysiology of cutaneous aging differs between sexes, which can have significant implications for treatment. Our data demonstrates a positive trend in recent years and also breaks it down by individual procedures.

Comparison of injectable filler locations in men and women: An age-matched case analysis.

In recent years, the popularity of fillers has risen significantly. Traditionally, women have undergone the vast majority of cosmetic procedures, but men have steadily shown increasing interest. Recently, significant research has been dedicated to understanding the anatomic differences between male and female facial structures and their clinical aesthetic implications, especially for filler placement. In order to compare actual treatment data to evidence these discussions, we randomly selected 100 cases each of men and women, who were matched for age, and documented their filler placement locations. Facial heat maps were constructed to provide readers with visual evidence. Injections for male cheeks were more inferiomedial, while female cheeks were more superolateral. Men had more jawline fillers, while women had more lip and perioral fillers. Our study builds upon gender-specific considerations. It is important for physicians to be knowledgeable regarding the unique approaches to fillers in men and women in order to deliver more effective, tailored, and high-quality care.

Consumer interest in topical cannabidiol: An examination of online search trends from 2015 to 2019.

Cannabinoids represent a diverse group of pharmacologic compounds that have recently grown in popularity for its use in medicine. One of the cannabinoids of the Cannabis plant is cannabidiol (CBD), which is a compound known to regulate physiologic processes. Despite limited high-quality clinical evidence, topical CBD-containing products are frequently marketed to consumers as possessing antiinflammatory, hydrating, moisturizing, and wrinkle-reducing properties. Here, we explored the trends in consumer interest for topical CBD products by querying a popular online search engine database from 2015 to 2019 to offer valuable insights.

Safety of combining cosmetic injectables with radiofrequency microneedling: A 4.5-year review.

Pairing energy-based treatments, including radiofrequency microneedling, with either injectable neuromodulators or soft-tissue fillers can be an effective therapy for facial rejuvenation. However, there remains concerns by some physicians that this combination may add new risks for adverse events. Theoretical risks of combining energy-based treatment with neuromodulator injections include unintentional spread, which may result in eyelid ptosis and asymmetry. Potential risks with soft-tissue fillers include unexpected loss of filler volume, necrosis, burn, and product migration. In order to shed more light on this topic, we performed a retrospective chart review of single-session facial treatments with radiofrequency microneedling and cosmetic injectables over a 4.5 year period. We found no documented adverse events recorded related to combination treatment. This is important information that adds to the patient safety literature.