April 2019 Editorial Message

VOL. 12, NO. 3 • APRIL 2019

Dear Colleagues: 

Welcome to the April 2019 issue of The Journal of Clinical and Aesthetic Dermatology. We start this issue with a review article by Martin, Young, and Aldredge titled, “Recommendations for Initiating Systemic Therapy in Patients with Psoriasis.” Here, the authors present a rationale for the utilization of systemic therapy among select patients with moderate-to-severe psoriasis. The authors discuss the barriers to use of systemic agents, as well as provide strategies for the ideal selection and safe initiation of systemic agents based on the individual needs of each patient in order to achieve optimal outcomes. Additionally, the authors describe the various systemic agents that are currently approved for use, including their mechanisms of action, contraindications, recommended dosage and administration, and potential reported adverse effects.  

Next, in case report by Lam et al titled, “Collision Tumor of Basal and Squamous Cell Carcinoma of the Palm,” the authors describe a case of a basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) collision tumor on the palm of a 71-year-old woman. The authors provide a brief review of literature regarding basal cell carcinoma of the palm and hand, including etiology, diagnosis, and treatment recommendations. 

Following this, Benedetto et al present a case report titled, “Development of Periungual Pyogenic Granuloma with Associated Paronychia Following Isotretinoin Therapy: A Case Report and a Review of the Literature.” In addition to the case description, the authors review the pathogenesis and available treatment modalities for periungal pyogenic granuloma triggered by isotretinoin therapy.

Next, in the case report titled, “Lithium-induced Linear Psoriasis: A Rare Presentation,” Garg et al  report a case of an adult woman who presented with lithium-induced unilateral psoriasis arranged in Blaschko lines on the left leg. The authors provide a brief discussion on the etiology, differential diagnoses, and treatment methods.

Following this, in an original research article titled, “Randomized, Placebo-controlled Study of a Nutraceutical Based on Hyaluronic Acid, L-carnosine and Methylsulfonylmethane in Facial Skin Aesthetics and Well-being,” Guaitolini et al evaluated the efficacy and safety of a multicomponent nutraceutical (MCN) on facial skin. Two groups of female subjects affected by facial skin photoaging took a daily dose of MCN (hyaluronic acid, L-carnosine, and methylsulfonylmethane) or a placebo for 60 days. Investigator and patient assessments of glabella, periocular, and oral commissural areas were measured using an instrumental skin tester and digital images (investigators) or satisfaction/quality of life survey (patients). The investigators reported significant improvements in the glabella, periocular, and commissural areas with respect to facial skin hydration, elasticity, and sebaceous secretion, compared to placebo, at Day 60 post-treatment. Statistically significant improvement in skin wrinkles were only observed in the periocular area. Additionally, the authors reported subject satisfaction regarding skin appearance, well-being, and quality of life to be significantly higher in MCN subjects, compared with placebo. No significant adverse effects were reported in either group. 

 We close the issue with in an original research article titled, “Evaluation of the Antioxidant Capacity and Protective Effects of a Comprehensive Topical Antioxidant Containing Water-soluble, Enzymatic, and Lipid-soluble Antioxidants,” McDaniel et al evaluated the antioxidant capacity and UVA/UVB radiation protective capabilities of WEL-DS as well as the clinical effectiveness and tolerability of WEL-DS for visible improvements in facial photodamage. The study had 3 parts: 1) In-vitro testing that utilized a hydrogen peroxide assay to detect antioxidant activity in human skin explants following application with WEL-DS, a leading antioxidant serum (L-AOX), or a saline control; 2) a minimal erythema dose (MED) clinical study to measure WEL-DS’s ability to protect the skin against UV radiation; and 3) a clinical study that evaluated the efficacy and tolerability of twice-daily application of WEL-DS. Clinical studies included adult females (ranging in age from 25 to 65) with mild-to-moderate photodamage. Investigators reported that in the in-vitro study, skin treated with WEL-DS neutralized up to 53 percent more oxidative stress relative to L-AOX, demonstrated significantly less UV-induced erythema, and demonstrated cellular protective effects, compared with the skin treated with the leading antioxidant serum and the untreated irradiated skin (control). In the clinical studies, the authors reported  improvements in fine lines/wrinkles; skin tone; dyschromia; erythema and pores among patients in the WEL-DS group, compared with placebo, at Weeks 4, 8, 12, and 16 of active treatment.  

Make sure to check out our Online-only Exclusives this month where we feature a study by Sakhiya et al titled, “Retrospective Analysis of the Efficacy of 10,600nm Carbon Dioxide Laser Ablation for Small Congenital Melanocytic Nevi (CMN) in Adults.” Here, investigators retrospectively evaluated the efficacy (Investigator’s Global Assessment [IGA] score) and patient satisfaction for CO2 laser ablation for the treatment of small CMN in 17 adults. The authors reported that the average IGA and patient satisfaction scores were 6.41 and 3.76, respectively, for patients treated using CO2 laser ablation, and conclude this treatment modality is an effective and safe alternative in certain patients with small CMN who wish to avoid more invasive surgical options. Visit jcadonline.com/online-only-exclusives/ or jcad.mydigitalpublication.com/publication/?m=54680&l=1 to access this article, as well as our past Online-only Exclusives features.

We hope you enjoy this issue of JCAD. As always, we welcome your feedback and submissions.

With regards,

James Q. Del Rosso, DO, FAOCDEditor-in-Chief, Clinical Dermatology

Wm. Philip Werschler, MD, FAAD, FAACSEditor-in-Chief, Aesthetic Dermatology

Seemal R. Desai, MD, FAAD— Associate Editor