Candida Infections in Clinical Trials of Ixekizumab (Taltz), an Interleukin-17A Monoclonal Antibody, in Patients With Psoriasis or Psoriatic Arthritis Interleukin-17 mediates immunity against pathogens such as Candida. Ixekizumab, an anti-interleukin-17A antibody, showed efficacy treating psoriasis (PsO) and psoriatic arthritis (PsA). Detailed here are Candida infections from 11 PsO and three PsA ixekizumab studies. Overall, patients received 80-mg ixekizumab every 2 or 4 weeks for 12 weeks (PsO) or 24 weeks (PsA) and then every 4 weeks. Candida (high-level term), six Candida subcategories (oral, vulvovaginal, skin, esophageal, nail, and unspecific), and four fungal infections (esophagitis, oral, oropharyngitis, and vulvovaginal mycotic) were included. Patients were counted once per category for multiple events. Analysis included 5,689 patients with PsO (12,061.5 patient-years of exposure, median exposure = 883 days) and 1,118 patients with PsA (1,373.4 patient-years of exposure, median exposure = 309 days). Overall, Candida infections were low and occurred in 4.4% (PsO incidence rate = 2.1) and 3.1% (PsA incidence rate = 2.5); most were mild or moderate in severity. The average duration of moderate and mild Candida ranged from 33 to 105 days. Most Candida infections were single events, 74% and 91%, with median onset of 328 and 146 days for PsO and PsA, respectively. Five patients (four with PsO and one with PsA) were reported to have a severe infection. Oral, skin, and vulvovaginal Candida were the most frequently reported Candida infections.

Leveraging Teledermatology for Patient Triage Nurses in outpatient settings face challenges balancing heavy patient caseloads while accommodating unplanned acute visits. Nurses also spend significant time triaging patients' symptoms on the telephone. Patients often find it difficult to accurately describe symptoms, and without accompanying images, unnecessary office visits are scheduled. Teledermatology, involving the exchange of digital images remotely between patient and provider, has shown promise in accurately triaging patients and decreasing unnecessary visits. At one outpatient dermatology site at a multisite comprehensive cancer center, a 6-month performance improvement initiative was conducted to evaluate the effectiveness of teledermatology using an electronic patient portal. Nurses instructed prescreened patients to send digital images via the portal. On the basis of image appearance and patients' symptoms, nurses provided assessment and education over the phone, and patients either kept their future appointments or came in for an earlier evaluation. More complex cases were escalated to the physician. This initiative reduced the number of unnecessary patient visits, which opened more visit slots for those with acute issues. Teledermatology improved overall efficiency of care, and patients and clinicians have reported satisfaction with the process.

Safe and Effective Laser Hair Removal Treatments: A Literature Review for New Providers Objective The aim of this study was to review the current literature regarding safe and effective laser hair removal (LHR) treatments. Methods Significant and current studies (2008–2017) were retrieved through a series of searches conducted in CINAHL, Cochrane, and MEDLINE databases using Boolean terms/phrases. Pertinent results are explained in narrative form with supporting tables and figures. Results Today, there is a vast amount of current literature on the need for LHR treatments and on its side effects and comparative studies using various lasers on the market. There is an ongoing concern associated with the lack of standards and guidelines. Conclusion Practitioners interested in offering LHR within the primary care setting must verify that operating a Class 4 medical device is within their scope of practice. Despite the increased popularity of LHR treatments and the advancement of technology, there are limited up-to-date information on safe and effective treatment parameters and minimal information regarding the importance of patient education. More research is necessary to determine the efficacy of LHR treatments in both men and women of all ages and skin types. With no LHR guidelines in place, the best practice for LHR treatments is contained within this literature review using the most recent research available to date.

Kava-Induced Ichthyosis Acquired ichthyosis is an uncommon finding in the outpatient dermatology clinic. This case portrays a presentation of ichthyosis induced by the medicinal drink, kava, which is becoming a more mainstream beverage in American culture. This case provides an overview of the clinical presentation of ichthyosis and a historical background on kava as well as recent studies on kava-induced ichthyosis or kava dermopathy. It also highlights the need to consider the use of herbal and alternative therapies when considering the underlying causes of skin disorders.

White Plaques of the Posterior Buccal Mucosa Teledermatology is a term to describe the provision of dermatologic medical services through telecommunication technology. This is a teledermatology case of oral lichen planus.

Scaled Papules in an HIV-Positive Patient Teledermatology is the term used to describe the provision of dermatologic medical services through telecommunication technology. The following is a teledermatology case of scaled papules in an HIV-positive patient.

Diffuse Nonresolving Violaceous Plaques This is a case of a patient presenting with nonresolving violaceous plaques for over 12 years of duration. In addition to the skin findings, the patient notes progressive arthropathy and nail changes. A multiple-choice question is presented, and readers will be challenged to diagnose this patient based on the case presentation, symptoms, and patient history. An answer is given followed by a discussion of the diagnosis, clinical features, and therapeutic management.

Use of 5-Fluorouracil “Chemowraps” as a Method of Field Therapy for Actinic Keratosis and Adjunctive Therapy for Squamous Cell Carcinoma Drugs are medications or substances that are used to modify physiologic responses and alleviate associated symptoms. In dermatology, medications and substances are utilized on a daily basis and include topical treatments to anesthetics in micrographic surgery to biologic-acting immunologic agents. The purposes of this section are to focus on drug, specifically how it works and how it is utilized, and to discuss routine alternatives (if available). In this column, we will focus on the uses, mechanism of action, adverse effects, and alternatives of 5-fluorouracil used in chemowraps for actinic keratoses and squamous cell carcinoma.

Skin Test No abstract available