Welcome to the September 2017 issue of the Journal of Clinical and Aesthetic Dermatology (JCAD). We begin this issue with an excellent review article titled, “Acne Scarring—Pathogenesis, Evaluation, and Treatment Options,” by Connolly et al. The authors focus on atrophic scars, the most common type of acne scar, and, while they only briefly describe the cellular sequelae that lead to scar formation and the suggested approach to patient evaluation, they provide a very thorough review of the various treatment methods for acne scars by using an algorithmic approach that classifies the scars as erythematous, general atrophic, or individual atrophic types.
Next, we present a study by Farberg et al titled, “The Impact of Quantitative Data Provided by a Multi-spectral Digital Skin Lesion Analysis Device on Dermatologists’ Decisions to Biopsy Pigmented Lesions.” Here, the investigators examined how often dermatologists decided to biopsy pigmented lesions when provided with either clinical images alone or clinical images plus multi-spectral digital skin lesion analysis data that included the probability graphs and classifier score. The authors found that incorporating the classifier score and probability data into the physician evaluation of pigmented lesions led to both increased sensitivity and speciIcity, thereby resulting in more accurate biopsy decisions.
Following this, Muti and Basso compared the efficacy of two different dilutions of incobotulinumtoxinA (50U reconstituted with 1.60mL or 0.55mL of 0.9% NaCl) in treating moderate-to-severe lateral periorbital lines in female subjects age 40 to 50 years. The authors found no signiIcant differences in efficacy or tolerability between the two dilutions at any time point following injections. The authors concluded these results allows physicians more treatment options for crow’s feet (i.e., less diluted incobotulinumtoxinA enables physicians to target certain muscles more precisely, while a higher dilution might lead to more homogeneous results due to the larger area of effect).
Next, Fite and Cohen describe a case of polycystic ovarian syndrome (PCOS)-associated confluent and reticulated papillomatosis (CARP) in a 19-year-old African American woman who was successfully treated with azithromycin. The authors provide a detailed discussion on the proposed etiologies and various treatment options for CARP.
Following this, Sun et al describe two cases of pyoderma gangrenosum (PG) and hidradenitis suppurativa (HS). These female patients (Case 1: 45 years of age; Case 2: 37 years of age) both failed to improve using targeted therapy with canakinumab, despite reports in the literature of successful use of canakinumab in patients with PG and HS. The authors report that their patients demonstrated relatively greater improvement on TNF blockade with infliximab rather than canakinumab.
And finally, in this month’s In Focus, Del Rosso reviews short-term (12 week) and long-term studies (up to 52 weeks) as well as case report series evaluating topical ivermectin (IVM) for the treatment of rosacea. In his article, “Topical Ivermectin: Data Supporting Dual Modes of Action in Rosacea Treatment,” the author discusses outcomes from studies and case series that support IVM’s dual modes of action, including anti-inflammatory and anti-parasitic effect. We hope you enjoy this issue of JCAD. As always, we welcome your comments, feedback, and submissions.
James Q. Del Rosso, DO, FAOCD
Editor-in-Chief, Clinical Dermatology
Wm. Philip Werschler, MD, FAAD, FAACS
Editor-in-Chief, Aesthetic Dermatology
Seemal R. Desai, MD, FAAD