Ustekinumab: differential use in psoriasis

Chronic plaque psoriasis is a systemic disease affecting over 3% of the population, and many patients are unsatisfied with their current treatment regimen. With advances in understanding of the pathophysiology of psoriasis, new therapeutic options are being developed. The newest of these agents, ustekinumab, offers patients rapid results and the convenience of four annual subcutaneous doses, with efficacy and safety profiles comparable with those of other biologics. However, ustekinumab has been on the market in the US for less than 2 years and will require years of extensive use before the full adverse event profile is fully understood. The purpose of this paper is to summarize the treatment options currently available for psoriasis, with an emphasis on ustekinumab in order to give prescribers an overview of the available data and allow them to make educated and informed prescribing decisions

Time needed to schedule dermatological consultations in Brazil

BACKGROUND: It is not clear what the population's demand for dermatologists is, nor how many professionals are needed in order to provide adequate care in this area of expertise. Knowledge of the flow of patients at dermatological clinics throughout the country allows for the formation of expansion and distribution policies regarding professionals, and provides backing for the decision to increase medical residency places. OBJECTIVES: To evaluate the time it takes to schedule a private dermatological consultation in Brazil, and other factors concerning consultations. METHODS: Survey with a random sample of 14% of Brazilian dermatologists, simulating the scheduling of emergency clinical and cosmetic consultations, and botulinum toxin procedures. Also, details relating to cost and professionals, were studied. Data were adjusted for each region of the country. RESULTS: A total of 873 dermatologists were evaluated. Full SBD members represented 85%, and 66% were women. The median time to schedule a consultation ranged from 6 (out-of-pocket payment) to 7 (medical insurance) consecutive working days. Times varied depending on the region. A multivariate analysis showed that out-of-pocket consultations and procedures were scheduled sooner than with medical insurance, regardless of whether they were clinical or cosmetic. CONCLUSION: The characteristics of dermatologists are varied throughout regions of the country. Private consultations and procedures are scheduled sooner than with insurance companies

Psoriasis Patient–Physician Interactions

Background Psoriasis patients are too frequently dissatisfied with the doctor–patient relationship. Purpose To explore how psoriasis patients and dermatologists view the doctor–patient relationship. Methods Separate discussion groups were held in which physicians and patients discussing their thoughts on interactions between psoriasis patients and their physicians. Four groups of six to eight dermatologists discussed patient expectations, observed psoriasis patients as they discussed their views on office visits, and finally discussed the patient encounter after observing the patient dialogues. Results Patients desired more information, quick treatments, clear therapeutic expectations, and recognition of emotional burden. After viewing patient discussions, dermatologists noted that patients often do not receive or internalize adequate information and therefore need further explanation of treatment regimens to increase compliance and patient satisfaction. Conclusions Dermatologists and patients had different impressions of key issues in the psoriasis patient–physician encounter. Patients' needs may be better met by providing more information on psoriasis treatments, even when the information may not change the treatment plan, and by providing information in writing. </jats:sec

Sorafenib Induced Eruptive Melanocytic Lesions

Sorafenib is a multikinase inhibitor FDA-approved for the treatment of advanced renal cell and hepatocellular carcinoma. Dermatologic side effects include hand-foot skin reaction, facial and scalp erythema and desquamation, splinter subungual hemorrhages, alopecia, pruritus, xerosis, keratoacanthomas, and squamous cell carcinomas. We report sudden eruption of melanocytic nevi diffusely in a patient receiving sorafenib

Sorafenib Induced Eruptive Melanocytic Lesions

Sorafenib is a multikinase inhibitor FDA-approved for the treatment of advanced renal cell and hepatocellular carcinoma. Dermatologic side effects include hand-foot skin reaction, facial and scalp erythema and desquamation, splinter subungual hemorrhages, alopecia, pruritus, xerosis, keratoacanthomas, and squamous cell carcinomas. We report sudden eruption of melanocytic nevi diffusely in a patient receiving sorafenib