Optimizing Topical Therapy in Psoriasis
Updates on managing some of the most common dermatologic conditions for which patients seek care illuminated presentations at the Skin Disease Education Foundation’s 42nd Annual Hawaii Dermatology Seminar®. This educational supplement summarizes the highlights of clinical sessions presented during this CME/CE conference.
Treatment of psoriasis has continued to advance, with three interleukin (IL)-17 antagonists approved by the US Food and Drug Administration (FDA) and a fourth in phase 3 trials. An authority on the use of biologics in psoriasis presents current data on the safety and efficacy of these therapies. Tumor necrosis factor (TNF) inhibitors also retain a place in the management of psoriasis, with records of long-term safety. A fourth TNF inhibitor awaits FDA approval for use in psoriasis, offering data on transmission during pregnancy and lactation. An expert on the use of this drug class presents the evidence.
Topical therapies remain the cornerstone of care for many patients with psoriasis as well as those with rosacea. Our faculty update readers about new and investigational topical therapies for moderate or severe psoriasis, as well as for acne and rosacea. The current literature on monitoring patients receiving isotretinoin also is summarized.
Aesthetic and cosmetic dermatology services form a sizable portion of some practices. Our faculty review data on safety of topical and procedural therapies for cellulite as well as safe injection of facial fillers.
Acne; adalimumab; adapalene; bimekizumab; brimonidine; brodalumab; cellulite; certolizumab pegol; cosmetic dermatology; doxycycline; etanercept; facial filler injection; halobetasol propionate; IL-17 inhibitors; infliximab; isotretinoin; ivermectin; ixekizumab; minocycline; oxymetazoline hydrochloride; psoriasis; tumor necrosis factor inhibitors; secukinumab; tapinarof; tazarotene; vascular occlusion
Participants should read the activity information, review the activity in its entirety, and complete the online post-test and evaluation. Upon completing this activity as designed and achieving a passing score on the post-test, you will be directed to a Web page that will allow you to receive your certificate of credit via e-mail or you may print it out at that time.
The online post-test and evaluation can be accessed at https://tinyurl.com/HDS18Supp.
Inquiries about CME accreditation may be directed to the University of Louisville Office of Continuing Medical Education & Professional Development (CME & PD) at [email protected] or 502-852-5329.
Hilary E. Baldwin, MD
Linda F. Stein Gold, MD
Kenneth B. Gordon, MD
Jeremy B. Green, MD
Craig L. Leonardi, MD
Roberta D. Sengelmann, MD
Physicians: This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME)
through the joint providership of the University of Louisville School of Medicine and Global Academy for Medical Education, LLC. The University of Louisville School of Medicine is accredited by the ACCME to provide continuing education for physicians.
The University of Louisville Office of Continuing Medical Education & Professional Development designates this enduring activity for a maximum of 2.0 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Joint Accreditation Statement: In support of improving patient care, this activity has been planned and implemented by Postgraduate Institute for Medicine and Global Academy for Medical Education. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.
Continuing Nursing Education: The maximum number of hours awarded for this Continuing Nursing Education activity is 2.0 contact hours. Designated for 1.0 of pharmacotherapy credit for Advanced Practice Nurses.
Increasing knowledge of the pathophysiology of acne, rosacea, and psoriasis has led to new and investigational treatment options with which clinicians need to be familiar. Evidence for the role of interleukin (IL)-17 in psoriasis has led to the introduction of therapies that have revolutionized management of this condition in individuals with moderate or severe disease. Yet tumor necrosis factors, the first class of biologics intro- duced for use in psoriasis, remain valuable alternatives for many patients. A growing body of data has underlined the central role of inflammation in rosacea; new thera- pies and treatment combinations are improving care for patients with papulopustular and erythematotelangiectatic disease. Isotretinoin is a cornerstone of treatment for moderate to severe acne, but guidance for monitoring those on therapy is sparse, as are pharmacologic alternatives. New topical therapies are expanding options for patients with all severity levels of acne. Many patients seek dermatologic care to treat cellulite and to improve their facial appearance. Knowledge about topical and proce- dural alternatives for addressing cellulite and safe injection of facial fillers is critical to serving these needs.
By reading and studying this supplement, participants should be better able to:
- Assess the safety of tumor necrosis factor inhibitors in the treatment of psoriasis
- Compare and contrast the interleukin (IL)-17 antagonists used to treat psoriasis
- Discuss the role and use of topical therapies in the management of psoriasis, including newer therapies
- Detect adverse events during isotretino in therapy for acne
- Evaluate current and emerging therapies for acne and rosacea
- Describetopical, procedural,and investigational treatments for cellulite
- Demonstrate familiarity with procedures for safe injection of facial fillers, and preventing and managing vascular occlusion
Individuals in a position to control the content of this educational activity are required to disclose: 1) the existence of any relevant financial relationship with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients with the exemption of non-profit or government organizations and non-health care related companies, within the past 12 months; and 2) the identification of a commercial product/device that is unlabeled for use or an investigational use of a product/device not yet approved.
Hilary E. Baldwin, MD, Speakers Bureau: Allergan; Galderma; Valeant. Contracted Research: Dermira; Galderma; Novan; Valeant.
Linda F. Stein Gold, MD, Speakers Bureau: Allergan; Celgene; Galderma; Leo; Novartis; Pfizer; Valeant. Consultant: AbbVie; Allergan; Celgene; Galderma; Leo; Medimetriks; Novartis; Pfizer; Promius; Valeant. Fees for Non-CME Services Received Directly from a Commercial Interest or Its Agent: AbbVie; Allergan; Celgene; Dermira; Galderma; La Roche-Posay; Leo; Medimetriks; Novan; Novartis; Pfizer; Promius; Sebela; Valeant. Contracted Research: Allergan; Aqua; Dermira; Galderma; Leo; Pfizer; Valeant.
Kenneth B. Gordon, MD, Consultant: AbbVie; Amgen; Boehringer Ingelheim; Celgene; Dermira; Eli Lilly; Janssen; Novartis; Pfizer. Contracted Research: AbbVie; Boehringer Ingelheim; Celgene; Janssen; Novartis.
Jeremy B. Green, MD, Speakers Bureau: Allergan; Cutera; Galderma; Merz. Consultant: Allergan; Endo; Galderma; Merz. Contracted Research: Allergan; BioPharmX; Brickell Biotech; Cutera; Galderma; Merz; Revance; Sienna. Stocks/Stock Options/Ownership Interest: Candesant; Illustris.
Craig L. Leonardi, MD, Speakers Bureau: AbbVie; Celgene; Eli Lilly; Novartis. Consultant: AbbVie; Amgen; Boehringer Ingelheim; Dermira; Eli Lilly; Janssen; Leo; Pfizer; Sandoz; UCB. Contracted Research: Actavis; AbbVie; Amgen; Boehringer Ingelheim; Celgene; Cellceutix; Coherus; Corrona; Dermira; Eli Lilly; Galderma; Glenmark; Janssen; Leo; Merck; Novartis; Novella; Pfizer; Sandoz; Stiefel; Wyeth.
Roberta D. Sengelmann, MD, Speakers Bureau: Merz. Consultant: Allergan; Castle; Merz.
University of Louisville CME & PD Advisory Board and Staff Disclosures: The CME & PD Advisory Board and Staff have nothing to disclose.
CME/CE Reviewer: Courtney R. Schadt, MD, Assistant Professor of Medicine, Chief of Dermatology, Robley Rex Veterans Affairs Medical Center, and Director, Dermatology Residency Program, University of Louisville School of Medicine, Louisville, Kentucky, has nothing to disclose.
The Postgraduate Institute of Medicine planners and managers have nothing to disclose.
Global Academy for Medical Education Staff: Eileen A. McCaffrey, MA; Shirley V. Jones, MBA; Sylvia H. Reitman, MBA, DipEd; and Ron Schaumburg have nothing to disclose.
Off-Label/Investigational Use Disclosure
This CME/CE activity discusses the off-label use of certain approved medications as well as data from clinical trials on investigational agents. Such material is identified within the text of the articles.
Contact Information for Technical Questions
Please technical questions or concerns to Global Academy for Medical Education at 973-290-8225 or email [email protected].
Copyright © 2018 by Global Academy for Medical Education, LLC, Frontline Medical Communications Inc., and its Licensors. All rights reserved. No part of this publication may be reproduced or transmitted in any form, by any means, without prior written permission of the Publisher. Global Academy for Medical Education, LLC, Global Education Group, and Frontline Medical Communications will not assume responsibility for damages, loss, or claims of any kind arising from or related to the information contained in this publication, including any claims related to the products, drugs, or services mentioned herein.
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