J Drugs Dermatol
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The treatment of disorders of hyperpigmentation including melasma, photoaging-related dyschromia, and postinflammatory hyperpigmentation pose numerous challenges, especially in patients with higher Fitzpatrick skin types (skin of color). Given limitations in efficacy as well as safety and cost considerations of available therapies, a "magic bullet" single treatment modality for hyperpigmentation is currently lacking. Successful treatment typically involves a combination of topical agents with or without in-office procedures, exploiting the different mechanisms of action of each agent or treatment modality. This article will review recently published studies involving newer topical and procedural approaches to this common dermatologic concern.
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In December of 2013 the Food and Drug Administration announced it would look further into the safety and efficacy of the biocide triclosan and requested further safety data as part of a new review with the Environmental Protection Agency. The use of triclosan has increased exponentially since its introduction in in 1972, to the point that 75% of commercial soap brands contain triclosan and 76% of a nationwide sample of adults and children excrete triclosan in the urine. This announcement raised an important dialog about the appropriate use of all over the counter biocides. Particular concerns include whether these biocides are more effective than regular soaps, whether they may create new drug resistant bacteria, and whether they may also act as hormone disruptors in humans or the environment.
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Randomized Controlled Trial Multicenter Study Comparative Study
Efficacy of tofacitinib, an oral janus kinase inhibitor, on clinical signs of moderate-to-severe plaque psoriasis in different body regions.
Tofacitinib is a novel, oral Janus kinase inhibitor currently under investigation for plaque psoriasis. ⋯ Short-term (12-week) treatment with oral tofacitinib produced clinical improvement across all body regions assessed in patients with moderate-to-severe plaque psoriasis, including areas typically non-responsive to treatment.
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There is currently no data detailing the degree to which dermatologists follow CDC/Infectious Diseases Society of America (IDSA) guidelines in the treatment of abscesses, which recommend that incision and drainage (I+D) as primary therapy for skin and soft tissue infections (SSTI). ⋯ Although most dermatologists were prepared to manage uncomplicated abscesses (98%), this survey identifies gaps in clinical standards of care established by the CDC/IDSA. Identification of these practice gaps may impact physician practice and dermatology residency curricula, and may serve to improve abscess management and antibacterial stewardship in the outpatient setting.
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Case Reports
A substitute for skin grafts, flaps, or internal tissue expanders in scalp defects following tumor ablative surgery.
The skin of the scalp is relatively thick, minimally mobile, with distinct hair distribution. TopClosure® is a novel device for skin stretching and secure wound closure. ⋯ The TopClosure system, effectively, aided closure of moderate and large scalp defects by stress-relaxation and mechanical creep and serving as a topical tension-relief platform for tension sutures, allowing mobilization of skin and subcutaneous tissue without undermining or need of drainage, for early, direct wound closure. Local complications were minimal and donor site morbidity was eliminated. Surgical time, hospital stay and costs were reduced, and post-operative wound aesthetics were improved.