Faculty: Ted Rosen, MD
Dr. Ted Rosen gave another enlightening lecture illuminating the key findings from the medical literature of 2019. One study he reviewed evaluated aversion caused by skin disease through crowd sourcing. It revealed more men than women were disgusted or disturbed by skin disease. Additionally, non-parents found skin disease more disgusting and disturbing than parents. The key take-away from this data is that in addition to a patient’s negative perception of their skin condition, patients’ abnormal skin may evoke strong negative reactions from the people around them.
An interesting study analyzed prescribing practices of dermatologists and the resultant dispensing of these medications by pharmacists. It was found pharmacists would often limit topical steroid to two weeks regardless of potency and up to 1/3 of pharmacists dispensed less medication than prescribed by providers. Dr. Rosen expressed that you “can’t assume your prescription is filled as written”.
In regards to skin cancer data, it is important to be aware of increased rates of squamous cell cancers (SCC) in patients with long standing hidradenitis suppurativa (HS). HS patients who present with SCC have a very poor prognosis. Dr. Rosen also reviewed the presentation of leukemia cutis (LC) and data that reveals patients who present with LC and acute myeloid leukemia have a 2x greater likelihood of leukemia specific death. Furthermore, a small case study in a treatment resistant cutaneous T-cell Lymphoma (CTCL) population exposed to an aggressive anti-staph regimen resulted in clinical improvement to complete clearance of disease.
Another interesting study Dr. Rosen presented included analysis of the use of topical steroids in patients who are at risk for Type-2 Diabetes. It has been found topical steroid use may induce type 2 diabetes in patients with prediabetes or who have a family history of diabetes. Dr. Rosen also reviewed some key findings in the psoriasis literature. Of note, there is an increased risk of dental disease in patients who have psoriasis. These patients require regular dental checkups due to their risk for inflammation of the oral mucosa and periodontitis. Additional topics Dr. Rosen covered included acne and obesity, the use of platelet rich plasma for diabetic foot ulcers, pruritus and chronic kidney disease and delusions of Parisitosis.