May 2019

New Research Identifies Optimal Uses for 18 Popular HA Fillers
In response to growing demands for injectable hyaluronic acid (HA) filler, clinical researchers sought to provide data on the performance of 18 of the most popular fillers on the market. The research --published by the Journal of the American Society of Plastic Surgeons--collected rheologic and physicochemical measurements on 18 HA filler products including Juvéderm (Allergan); Belotero Balance (Anteis, S.A. for Merz Pharma); Restylane (Q-Med AB/Galderma); and Teosyal (Teoxane) among others. The researcher examined the impact of rheologic parameter elastic modulus (G') and HA concentration on swelling and cohesion to distinguish between the fillers, as higher G' fillers tend to be firmer with more elastic compression response and lower G's tend to be softer and less elastic. The research found that Restylane Fynesse was the filler with the lowest G,' while Restylane Lyft had the highest. Researchers further detailed recommended uses for optimal patient outcomes.  

Researchers Find Brodalumab Effective for Psoriasis Patients with Skin of Color
Recent research published in the American Journal of Clinical Dermatology examined the efficacy, safety, and health outcomes in patients with skin of color--self-categorized as Black, Asian, Hispanic/Latino-- receiving brodalumab over 52 weeks. Tested against a group of caucasian patients, the findings suggest that brodalumab may be superior to ustekinumab in Black, Asian, and Hispanic/Latino subgroups. The study’s authors noted that a larger sample size of non-caucasian patient would be needed to make a definitive statement. While there is no clear biologic basis for the advantage of bradalumab among, the authors suggest genetic polymorphisms may play a role in difference in psoriasis manifestations and pathogenesis.

Study Finds Active Sunscreen Ingredients Exceed Plasma Concentration Thresholds

A pilot study published in JAMA demonstrated that active ingredients found in four on-the-market sunscreens exceeded FDA-established plasma-concentration threshold. The maximum avobenzone plasma concentrations were 1.8 ng/mL for cream, 4.3 ng/mL for lotion, 3.4 ng/mL for spray 2, and 4.0 ng/mL for spray 1. The study’s lead author, David Strauss, MD, PhD, of the FDA in Silver Spring, Maryland explained: “Systemic concentrations greater than 0.5 ng/mL were reached for all four products after four applications on day 1,” but made clear that “ "these results do not indicate that individuals should refrain from the use of sunscreen." The study protocol was approved by the FDA Research in Human Subjects Committee.
While Skin Cancer Awareness Month may be coming to an end, the unforgiving sun-filled summer months have only just begun. Remind your patients to regularly perform self-exams in order to detect skin cancer at it's earliest stages. Following the ABCDEs developed by the American Academy of Dermatology, you and your patients can regularly determine if any moles of symptomatic of melanoma:

One half of the mole is unlike the other half.
There is an irregular or poorly defined border.
Check for varying colors, such as shades of tan, brown, black or sometimes white, red, or blue.
Melanomas are usually larger than 6mm when diagnosed.
The mole is different from others or changes in size, shape or color.
Recognized internationally for his innovative work in laser therapy, and non-invasive facial and body rejuvenation techniques, Dr. Goldberg leads as an authoritative pioneer in cosmetic dermatology. Among his many roles, Dr. Goldberg currently serves as a Clinical Professor of Dermatology and Director of Laser Research of New York's Mount Sinai School of Medicine, and a Clinical Professor of Dermatology and Chief of Dermatologic Surgery at UMDNJ-New Jersey Medical School. Alongside his 125 peer-reviewed published manuscripts, Dr. Goldberg has authored numerous educational dermatological books, and currently serves as the Senior Chief Editor of of the Journal of Cosmetic and Laser Therapy. Additionally, as an attorney, Dr. Goldberg currently serves as an Adjunct Professor of Law at the New York's Fordham University School of Law where he combines his extensive expertise in healthcare and his experience in law to to teach a course entitled "Advanced in Health Care Law."
With the use of artificial intelligence technology in medical specialties on the rise, there is an increased concern among clinicians about the potential practice and patient-related repercussions. As most dermatological data is image-based, artificial intelligence can be used to recognize specified features of data set images and deduce a diagnosis. Rather than being a “man versus the machine” dilemma, the trends towards advanced technology can instead prove to be an opportunity to transform clinical practice by augmenting it with artificial intelligence.
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