Distinct Approaches to Perioperative Management of Anticoagulation and Antiplatelet Therapy among Providers Performing Cutaneous Surgery.

BACKGROUND: Despite increasing cross-collaboration between providers who perform cutaneous surgery, a disparity still exists in the current practices regarding perioperative management. This could lead to treatment delays, patient confusion, and increased morbidity, such as clotting, infection, and discomfort of patients. OBJECTIVE: To characterize the management practices of different providers in regards to perioperative anticoagulation and antiplatelet therapy for cutaneous surgery. METHODS AND MATERIALS: This study used an electronic survey to assess current perioperative management practices of dermatologic surgeons and plastic and reconstructive surgeons. RESULTS: 177 physicians (115 dermatologic surgeons and 62 plastic and reconstructive surgeons) responded to the survey. For all therapeutic agents, dermatologic surgeons were significantly more likely than their plastic and reconstructive surgery colleagues to continue all anticoagulant and antiplatelet agents perioperatively for cutaneous surgery (vitamin K antagonists, antiplatelets, LMWH, direct Xa inhibitors, direct thrombin inhibitors, NSAIDS: P<0.001; fish oil, vitamin E: P<0.01). CONCLUSION: Our data highlight the significant practice gaps that exist between dermatologic surgeons and plastic and reconstructive surgeons. Reducing this disparity will facilitate improved continuity of care, especially when patients are referred from dermatologic surgeons to plastic and reconstructive surgeons for more complex repairs, and potentially reduce morbidity and mortality associated with medication discontinuation. J Drugs Dermatol. 2022;21(7):766-772. doi:10.36849/JDD.6726.

Intralesional Steroids for the Management of Periorificial Granulomatous Dermatitis

A 42-year-old male with skin type I and a history of rosacea and eczema presented with crusting, erythema, and pustules distributed on the left oral commissure. Angular cheilitis was diagnosed and regular petrolatum use recommended until resolution of the lesion. Eight days later, with no improvement in symptoms, fungal and bacterial cultures were performed which resulted in the growth of cutibacterium acnes, a variant of p. acnes.

What's New in Psoriasis.

Psoriasis is a common, chronic inflammatory skin disease that is characterized by the formation of sharply demarcated, scaly, erythematous plaques. It affects about 2.2% of the population in the United States and has a large impact on patient quality of life. Many advances have been made in the last few years in the management of psoriasis. Proinflammatory cytokines play major roles in the pathogenesis of disease. Biologic medications targeting the aforementioned cytokines have been developed and studied for the management of psoriatic disease. This article summarizes the newest findings in the management of psoriasis and the various treatment options available.