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Hidradenitis Suppurativa FOUR CORNERS of CARE THE www.thedermdigest.com Vol. 2, No. 3 | March 2021 Hidradenitis Suppurativa FOUR CORNERS OF CARE Topical CBD: Hope or Hype? The Dermatologist as PCP Ask the Experts Permit No. 129 No. Permit Your Most High-Impact Columbus, WI Columbus, PAID Cosmetic Innovations US Postage US Prsrt Mkt Prsrt EDUCATIONAL • INTERACTIVE • AUTHORITATIVE Say Hello again to Not Actual Size Most eligible commercially $ per prescription insured patients pay as little as 20at any pharmacy* * Certain restrictions apply. The LEO Pharma CONNECT program may reduce out-of-pocket expenses. Must be 12 years of age or older to be eligible, and a legal guardian over 18 years of age must redeem the card for patients aged 12 to 17. You are not eligible if you are enrolled or you participate in any state or federally funded health care program (eg, Medicare, Medicaid, etc). Full details of the LEO Pharma CONNECT program are available at www.FinaceaFoam.com/hcp or may be obtained by calling 1-877-678-7494 between 8:30 AM and 8:30 PM (Eastern), Monday through Friday. The LEO Pharma logo, LEO Pharma, and Finacea are registered trademarks of LEO Pharma A/S. www.FinaceaFoam.com ©2020 LEO Pharma Inc. All rights reserved. March 2020 MAT-32481 THE Contents www.thedermdigest.com Volume 2, Number 3 | March 2021 14 Cover Article You can help hidradenitis suppurativa patients achieve long-term control and avoid flares 2 20 Ted Talks Pediatrics Do you talk politics in your office? Combination therapy can produce good clearance of pediatric warts 6 Literature Lessons Research updates in rheumatologic diseases, psoriasis, hair and nails, contact dermatitis, acne, rosacea, and more continued on page 3 March 2021 | 1 Ted Talks “ In politics, stupidity is not a handicap.” —Attributed to Napoleon Bonaparte he year was 1960, in the middle of a highly conten- T tious presidential contest between John F. Kennedy and Richard Nixon. I was only 11 years old as I sat at the kitchen table while my parents discussed the upcoming election. My father was a dedicated Democrat and my mother a devout Republican, Ted Rosen, MD, FAAD following steadfastly in the foot- Editor-in-Chief steps of their own parents. I was This is Ted's take. pretty amazed at how quietly, What's yours? calmly, and openly they expressed [email protected] their differing opinions about the candidates and their various surrogates often candidates and the two major political parties. used hyperbole about the “fate of the human While they were clearly destined to cast differ- race” hanging in the balance of this particular ing votes, they were at least trying to under- election cycle. Dueling media outlets were stand where the other one stood on critical busy casting aspersions on the other’s com- issues, and why. They even arrived at consensus mentators, while claiming that they had an on a few items, and concluded that the world actual monopoly on the truth. I saw, and I would go on regardless of who got elected. This suspect you did too, a country so hyperpolar- was democracy in action, and in fact, democra- ized that civilized, rational discussion was cy at its very best. I will never forget that night; nearly impossible. it left a lasting impression on me. All this brings me to the point of this edito- Fast-forward to the election of 2020 and rial: Does politics belong in the medical office? compare this childhood experience to today's My employer, a medical school, of course political scene, one dominated by name-call- forbids wearing campaign buttons or posting ing and mudslinging, demonization of can- campaign posters. So, there are no overt visual didates, and attempts to drown out speakers cues to suggest that the topic is welcome. with whom a crowd doesn’t agree. Violence, Nonetheless, during the recent election, many or the threat of violence, often pervaded the patients attempted to engage me in political discourse. A political situation in which both discussion. “Isn’t it disgusting that ... ” or “Can I cherish those individuals who have entrusted me with their care for so many decades, and it would be painful to potentially “ lose them over an issue like marginal tax rates.” continued on page 4 2 | The Dermatology Digest Contents continued from page 1 Cosmetic Corner New Drugs 36 45 Rejuvenation Melasma Will regeneration replace A new agent is safe, well rejuvenation? The second tolerated, and effective of 2 articles covering regenerative aesthetic 23 medicine Pediatrics 30 It may take some Crystal Ball sleuthing to determine what's causing a child's Topical cannabinoids 49 contact dermatitis are gaining ground in Actinic Keratosis dermatology, despite 25 lingering stigma and A newly available Literature Update spotty FDA approval ointment shows promise for actinic keratosis Like it or not, you may be the only doctor many of your patients see regularly 39 High-impact innovations Two cosmetic 55 dermatologists share Diagnose this Zebra the innovations they feel The puzzling case have the most impact of the purple penis March 2021 | 3 www.thedermdigest.com/TED_TALKS continued from page 2 THE you believe this ... ” were heard many a time political discussion belongs inside the doctor- in the examination room. I also had scores patient relationship, so let’s get back to your of patients exclaim that they were “sure” they medical problem.” This was not always easy. knew my political leaning, and that’s why they I readily admit that, on some occasions, I had www.thedermdigest.com felt comfortable sharing their opinions with to suppress an overwhelming urge to throttle me. Of course, half of them were dead wrong a patient, while at other times I felt like giving CORPORATE in their supposition! In an environment of a “high-five.” However, I consciously chose AMY AMMON extreme partisan positioning and almost total the path of strict neutrality and attempted to Executive Director, Publisher refusal to find any common ground, I felt that completely separate the election and associ- [email protected] DON BERMAN these situations put me in an uncomfortable ated political dogma from my professional Executive Director, Digital Strategy and difficult position. No matter what I would life. Similarly, when staff—be they trusted [email protected] say, there could be negative consequences. If nurses, medical assistants, schedulers, or bill- GEORGE MARTIN, MD Executive Director the patient espoused a political preference with ing personnel—would bring up the election which I did not particularly agree, it could lead or matters surrounding it, I would stop and EDITORIAL to an unpleasant verbal altercation and even say something along these lines: “I’m not go- TERESA MCNULTY Print Editor lead to loss of the patient. Being in practice ing to tell you what you can and can’t say, but ELIZA CABANA Digital Editor NANCY BITTEKER Creative Director I chose to basically banish political discourse from the office.” MICHAEL WESTFALL Product Manager for 42 years, I cherish those individuals who political disagreements can cause permanent “have entrusted me with their care for so many negative feelings which could interfere with decades, and it would be painful to potentially our functioning as a harmonious team. Also, Print Circulation: 13,500 dermatologists USA lose them over an issue like marginal tax rates. I really would prefer if you avoiding discussing 2,800 dermatological NP/PA’s Conversely, should the patient champion a po- politics with any patients, as you notice I do The Dermatology Digest ® is published monthly by The Dermatology Digest, sition with which I did identify, and I verbally myself.” For the most part, a single admon- LLC, 88 N Main Street, Pearl River, confirmed that, I could imagine that person ishment along these lines led to peace in the NY 10965. quoting my stance to anyone and everyone as office, both before and after the election. © 2020 The Dermatology Digest, LLC. All rights reserved. No part of this pub- a sort of validation. I could just hear the pa- lication may be reproduced or trans- Was I being a coward? Should I have put my mitted in any form or by any means, tient declaring to a neighbor, friend, relative, electronic or mechanical including by vision of the “best” America front and center, photocopy, recording, or information or co-worker, “Well, my physician, Dr. Ted on full display? Should I have vociferously storage and retrieval without permis- Rosen, told me that he thinks ... ” Wouldn’t it sion in writing from the publisher. stated and then defended what I personally Authorization to photocopy items for just be my luck if the audience for that declara- internal/educational or personal use, believe in? Should I have used my special posi- or the internal/educational or personal tion might be another of my patients who use of specific clients is granted by The tion of authority as a purveyor of health care Dermatology Digest, LLC. For uses disagreed with my take on some issue? Bingo: to try to secure a few votes for one candidate beyond those listed above, please another potentially lost patient. Moreover, who direct your written request to Amy or another in local, state, or national elections? Ammon, Executive Director, Publisher knows how accurately I might be quoted? at: [email protected]. Was I shirking my moral or civic duty? What POSTMASTER: Please send address So, although I am interested in, and relatively do you think? Drop me a note and tell me changes to The Dermatology Digest LLC, 88 N Main Street, Pearl River, NY well informed about, political issues, and how you handle this issue in your professional 10965.
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