INDIVIDUAL ARTICLE: Real-World Patient Cases Using Botanical Serum-Containing Corrective Gel as an Adjunct to Aesthetic Facial Laser or Microneedling Radiofrequency (MRF) Treatment.

Integrated skin care is defined as the complementary use of topical treatments to nonsurgical facial rejuvenation procedures, such as lasers and radiofrequency microneedling devices, to produce pleasing aesthetic results. Real-world experience from expert dermatologists is invaluable in guiding patient treatment plans, as there are limited clinical trials on the efficacy of integrated skincare regimens. The SkinCeuticals (New York, NY) Phyto Corrective gel (botanical serum-containing corrective gel) contains a lightweight botanical serum that hydrates, calms, and soothes skin. It contains antioxidant and anti-inflammatory ingredients derived from plant and fruit extracts, making it an appealing option for adjunctive treatment of post-procedure erythema and swelling.  J Drugs Dermatol. 2024;23:3(Suppl 2):s3-s14.

Dermatology: how to manage rosacea in skin of colour.

Rosacea is a common inflammatory skin disorder affecting the face. Common cutaneous symptoms include papules, pustules, persistent centrofacial erythema, telangiectasias, recurrent flushing, phymatous changes and a variety of ocular manifestations. Previous epidemiological studies have demonstrated that the incidence of rosacea is much lower in people with darker Fitzpatrick phototypes compared to fair-skinned individuals. In patients with darker skin, the centrofacial erythema can be masked and difficult to appreciate, impacting the ability for providers to make diagnoses and leading to misdiagnoses. Thus, it is difficult to say with certainty that the disparities in prevalence in rosacea amongst fair-skinned and darker individuals are true. The primary aim of this article is to raise awareness that rosacea is a global disease and to provide healthcare professionals with strategies to identify and manage rosacea amongst individuals with skin of colour.

Transition of Topical Therapy Formulation in Psoriasis: Insights from a Canadian Practice Reflective.

Patient preferences for psoriasis treatment may affect treatment adherence and disease control; changing topical formulation may improve adherence and patient acceptance of treatment. This study explored dermatologists' reasons for transitioning psoriasis patients from an ointment or gel (Dovobet®) formulation to an aerosol foam (Enstilar®) formulation of calcipotriol and betamethasone dipropionate (Cal/BD), and to assess the success of this transition. Medical records of 81 Canadian patients from 9 dermatologists were retrospectively reviewed for symptoms affecting quality of life, reasons for transitioning treatment, and whether transition was successful. Reasons for transition included efficacy, quality of life, and patient adherence. At follow-up, median psoriasis severity and body surface area affected had decreased from baseline, and patients experienced improved quality of life. Itch and itch-related sleep loss, which were identified as burdensome in 63% of patients at baseline, had resolved in 33% and improved in 54% of patients at follow-up. Dermatologists deemed the transition successful in 85% of patients, with the most common reasons being patient-reported success, clearance of signs/symptoms, and continued prescription refills. Transition from Cal/BD ointment or gel to aerosol foam was generally deemed successful by patients and dermatologists, and was associated with improved quality of life and improved itch control.

Vichy mineralizing water with hyaluronic acid is effective and well tolerated as an adjunct to the management of various dermatoses and after esthetic procedures.

INTRODUCTION: M89, containing 89% of Vichy mineralizing water and hyaluronic acid, has been developed to reinforce the skin barrier and to improve skin quality. AIM: To assess efficacy and tolerability of M89. METHOD: Observational survey of subjects with facial dermatoses or after esthetic procedures. M89 served as adjunct to conventional therapy. Clinician assessments of erythema, desquamation, irritation and patient-reported dryness, burning, itching, and stinging/tingling were conducted at baseline and 4 weeks. At 1 week and 4 weeks, patient assessed tolerance and satisfaction with M89. RESULTS: A total of 1630 subjects participated; 92.5% were females. Mean age was 41.1 ± 11.3 years. Dermatological indications accounted for 32.5%, procedures for 67.5%. At 4 weeks, in subjects with dermatoses, erythema had resolved or improved in 68.0%, desquamation in 83.4%, and irritation in 93.3%. Dryness, burning, itching, and stinging/tingling scores had decreased by 63.8%, 81.8%, 70.9%, and 85.2%, respectively (all P ≤ .0001); 75.7% considered that their skin was sufficiently hydrated. In the procedure group, erythema had resolved or improved in 72.5%, desquamation in 75.2%, and irritation in 88.1%. Dryness, burning, itching, and stinging/tingling scores had decreased by 62.1%, 78.8%, 70.0%, and 84.2%, respectively (all P ≤ .0001); 74.1% considered that their skin was sufficiently hydrated. Almost all subjects reported soothed skin and satisfaction with product texture. Subject and investigator satisfaction was very high. CONCLUSION: M89 significantly improves skin signs and symptoms after 4 weeks of continued use with no tolerance issues in subjects with dermatological indications. Moreover, subjects who have had recently undergone esthetic procedures M89 allowed a satisfying skin recovery.

A review of protection against exposome factors impacting facial skin barrier function with 89% mineralizing thermal water.

BACKGROUND: The skin exposome refers to the constellation of external exposures that contribute to cutaneous aging, including solar radiation, air pollution, tobacco smoke, unbalanced nutrition, and cosmetic products. This review explores the skin exposome and the role of a combination hyaluronic acid and mineralized thermal water product used to restore and maintain optimal skin barrier function. METHOD: An expert panel of 7 dermatologists who treat clinical signs of facial aging convened for a one-day meeting to discuss the results of a literature review on the skin exposome and the role of M89, a mineralized thermal water and hyaluronic acid-based gel, to improve the quality of facial skin. Evidence coupled with expert opinion and experience of the panel was used to address clinical challenges in the treatment of photo-aging, and the use of M89. RESULTS: Solar radiation (ultraviolet radiation, visible light, and infrared radiation), air pollution, tobacco smoke, nutrition, and miscellaneous factors, including stress, sleep deprivation, and temperature, may potentiate skin aging by triggering molecular processes that damage skin structure. M89 was developed to maintain and restore skin and contains ingredients to aid physical, hydric, antioxidant, and antimicrobial skin barrier function. CONCLUSIONS: Increasing knowledge of the exposome and microenvironment contributing to skin aging may support a better understanding of measures to support the skin. The initial results of in vitro and clinical studies of M89 show its potential to improve skin barrier function.

Increasing tuition fees in a country with two different models of medical education.

CONTEXT Since the early 1990s, medical school tuition fees have increased substantially in all regions of Canada except Quebec. This provides a natural opportunity to examine the effect of tuition fee increases on medical student demographics, indebtedness and financial stress. METHODS We conducted a national survey of medical students in 2007. We compared results for Quebec students with results for students studying in other parts of the country. We also compared results for 2007 medical students with results for medical students who had completed a similar survey in 2001 and with data for the general population. For the 2007 cohort, we also identified predictors of anticipated debt at the time of medical school graduation. RESULTS A total of 7795 students responded to either the 2001 (n = 3871) or 2007 (n = 3924) survey. Median anticipated debt increased from $40 000 in 2001 to $71 000 in 2007 (Canadian dollars). Medical students in Quebec were more likely to have grown up in a lower-income neighbourhood (odds ratio [OR] = 1.22, 95% confidence interval [CI] 1.03-1.44), were less likely to report significant financial stress (OR = 0.43, 95% CI 0.37-0.50) and reported a lower median anticipated debt than medical students in the rest of Canada ($30 000 versus $90 000; p < 0.001). Across Canada, factors associated with increased debt at the time of graduation were higher tuition fees, lower parental income, non-Chinese ethnicity, higher debt at entry to medical school, smaller non-repayable financial grants, longer pre-medical education and higher non-tuition expenses. CONCLUSIONS Quebec medical students differ from their counterparts in the rest of Canada in several notable ways. In particular, medical student debt has increased more and is greater in the rest of Canada than in Quebec. Our findings have implications for doctor human resources planning in Canada.

Treatment of vitiligo with narrow-band ultraviolet B: advantages and disadvantages.

BACKGROUND: Narrow-band ultraviolet B (NB-UVB) therapy for vitiligo is increasingly used in patients who are unresponsive to other forms of therapy. OBJECTIVE: This study measures levels of patient and physician satisfaction and the associated advantages and disadvantages of NB-UVB. METHODS: A retrospective chart review was conducted of the first 50 patients with vitiligo treated at the Photoderm Clinic in Ottawa, Ontario. Data were obtained from digital photographs and patient charts (n = 50). RESULTS: Percent repigmentation of the face and body was very good compared with the hands and feet (poor = 0-or< 33%; good = 33-or< 66%; very good = >or= 66%). The physician and patients were satisfied with results achieved with NB-UVB therapy (very good [VG]: medical doctor [MD] 49% [95% CI 35-63], patient [Pt] 51% [95% CI 37-65]; good [G]: MD 24% [95% CI 12-36], Pt 22% [95% CI 10-34]). CONCLUSION: NB-UVB therapy is an effective treatment for vitiligo (ie, VG, repigmentation >or= 66%) that leads to high levels of patient and physician treatment-related satisfaction. Although there are disadvantages to NB-UVB therapy, the advantages outweigh the drawbacks. An objective evaluation such as the Vitiligo Area Scoring Index (VASI) is necessary to validate these findings. Additional limitations include those inherent in retrospective study design.