June 2019

Immunotherapy Combo Fails to Slow Progression of Melanoma
Final results from an international trial demonstrated that adding a second immunotherapeutis agent to a PD-1 inhibitor failed to slow disease progression or improve survival in patients with unresectable or metastic melanoma. In the study patients who received pembrolizumab (Keytruda) in addition to the IDO1 inhibitor epacadostat had a median progression-free survival of 4.7 months versus 4.9 months among patients randomized to pembrolizumab and placebo. While the median overall survival rate was not achieved in either group, the hazard ratio demonstrated a small numerical advantage with placebo patients. In a summary overview, researcher Georgina V. Long, MD, PhD explained: "Our results showed no clinical benefit of epacadostat plus pembrolizumab compared with placebo plus pembrolizumab. The usefulness of IDO1 inhibition as a strategy to enhance anti-PD-1 therapy activity in cancer remains uncertain." The research supports results presented at the American Society of Clinical Oncology.

Researchers Identify Relationship Between Adult Depression and Hidratenitis Suppurativa
A recent meta-analysis of 10 separate studies including 40,307 patients with Hidratenitis Suppurativa (HS) sought to evaluate trends between Adult Depression and Anxiety, and Hidratenitis Suppurativa. The pooled odds ratio for depression in HS patients was 1.84. The analysis found that the prevalence of depression in patients with HS varied based on the diagnostic criteria with studies using a screen tool reporting a prevalence of depression of 26.8%, and studies using clinical criteria for diagnosis with a prevalence of 11.9%. Various studies have suggested that anxiety and depression are more common in patients with HS than patients of other dermatological conditions. While the researchers explained that further study is necessary, they related that in the meantime clinicians would do well to acknowledge the link: "Results suggest that the development of strategies to recognize and treat those psychiatric comorbidities in patients with HS is warranted.

New Drug Demonstrates Potential for First Topical Anti-Androgen for Acne
A recent in vitro study published in the Journal of Drugs in Dermatology analyzed Cortexolone 17 a-propionate (clascoterone)--a novel topical androgen antagonist--on it's ability to treat acne. While various studies have demonstrated that clascoterone is is a potent anti-androgen that is well tolerated with selective topical activity, the recent study provides in-depth analysis on the mechanism of action of clascoterone for the first time. The researchers found the clascoterone was able to bind the androgen receptor with high affinity in vitro, inhibit AR-regulated transcription in a reporter cell line, and antagonize androgen-regulated lipid and inflammaroty cytokine production in a dose-dependent manner in human primary sebocytes. When compared to spironolactone--another AR antagonist--clascoterone proved significantly more effective at inhibiting inflammatory cytokine synthesis from sebocytes. This finding led the researchers and additional clinical observers to conclude the clascoterone may likely serve as the first topical anti-androgen to treat acne.
Among patients with locally advanced cutaneous squamous cell carcinoma who are ineligible for surgical treatment, lesions in the same area after 2 or more surgical procedures are associated with a lower rate of response to cemiplimab.
To find the answer, see an activity published in Medpage Today on risk stratification for cutaneous squamous cell carcinoma.
As a highly esteemed, board-certified aesthetic plastic surgeon, Dr. Leon H. Kircik, MD has pioneered the development of the latest generation of dermal fillers and neurotoxins. Upon completion of his dermatology residenecy at State University of New York, Dr. Kircik completed a Mohs Micrographic Surgery and Cutaneous Oncology Fellowship under Dr. Frederik Mohs at the University of Wisconsin. Dr. Kircik currently teaches as an Associate Clinical Professor of Dermatology at Indiana University Medical Center as well as Icahn School of Medicine at Mount Sinai Medical center in New York City, while also serving as the Medical Director of DermResearch, and Physicians Skin Care in Louisville, Kentucky. Among his extensive portfolio of influential roles, Dr. Kircik is regularly called upon by the FDA to present data to advisory panels and provide counsel involving the regulatory process for new medical devices.
Within most industries in the United States, women hold just 25% of senior leadership positions. In the healthcare industry, the ratio is more proportionate with women holding 49% of top tier positions however, increasing numbers of female graduating medical students may lead to a change. There is a growing trend of increased female healthcare practitioners and a rising number of women in the field of aesthetic medicine. Today, women constitute more than one-third of practicing physicians and half of physicians in training, resulting in the rise of female dermatologists and aesthetic doctors. 
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