0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
In This Issue of JAMA Dermatology |

Highlights FREE

JAMA Dermatol. 2015;151(6):577. doi:10.1001/jamadermatol.2014.2921.
Text Size: A A A
Published online

RESEARCH

Atopic dermatitis (AD) is a common chronic inflammatory dermatitis of the skin. The topical calcineurin inhibitors tacrolimus and pimecrolimus are some of the few topical agents that have been approved by the US Food and Drug Administration for the treatment of AD in children. An unfortunate risk associated with oral use of these agents is an increased risk of cancer. In this longitudinal cohort postmarketing surveillance study using the Pediatric Eczema Elective Registry (PEER), Margolis et al demonstrate that pimecrolimus use did not appear to be associated with an increased risk of cancer.

Androgenic alopecia (AGA) involves scalp vertex balding and temporal hairline recession due to 5α-dihydrotestosterone–dependent miniaturization of hair follicles. Although sexual dysfunction remains an adverse event of concern, meta-analyses to date have concluded that finasteride treatment of AGA is safe. However, of the 34 studies in this systematic review by Belknap et al, none had adequate safety reporting, providing no description of the duration or severity of sexual dysfunction, and they failed to distinguish between mild, reversible vs severe, permanent sexual dysfunction.

The number of multiple primary cancers is increasing, and 3.5% of patients with an initial melanoma developed multiple primary melanomas (MPMs). Family and personal history of melanoma are known risk factors for MPM. The probability of CDKN2A mutations is elevated for patients with 3 or more melanomas. In this prospective population-based cohort study, Chen et al demonstrate a stable 2- to 3-times elevated risk by number of previous melanomas for patients with either familial or sporadic melanoma. This was especially true for young patients with familial melanoma, indicating that clinical genetic testing may be important in this population.

Adalimumab is a large-protein tumor necrosis factor–inhibiting molecule that has proven effective in suppressing psoriasis disease activity. Despite extensive interindividual variations in pharmacokinetics, adalimumab is administered in a standard fixed dose. Serum levels and antidrug antibodies to adalimumab are not generally measured. In this multicenter prospective trial, Menting et al describe a therapeutic range of adalimumab trough levels that correspond with optimal clinical effect. In one-third of patients, trough levels exceeded the therapeutic range. Validation of this range may allow a therapeutic algorithm to guide treatment in a rational manner.

Nonadherence to a treatment regimen is pervasive in all fields of medicine, especially in chronic conditions. Acne has a low secondary adherence rate because patients miss doses and discontinue treatment. There is less information on how often patients do not begin treatment. In this patient survey, Anderson et al demonstrate that 27% of patients did not fill all of their prescriptions. Primary adherence was lowest among patients prescribed more than 1 treatment. Reasons for primary nonadherence included cost, forgetfulness, disagreement with treatment regimen, and improvement before filling the prescription.

Figures

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

1,098 Views
0 Citations
×

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs