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WAILEA, HAWAII – Using larger doses and avoiding overarching of the brows are among the considerations to keep in mind when using neuromodulators in men, advised Canadian dermatologist Katie Beleznay, MD.

In general, men have a very different anatomy with a different brow position, and have needs different from those of women, said Dr. Beleznay of the University of British Columbia, Vancouver.

One secret for successful injections of toxins in male patients: Dose matters. Men have stronger muscles in the face and need larger doses to overcome their muscular strength, Dr. Beleznay said in a video interview at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.

On average, “if you use 20-30 units in a female glabella, maybe you’d use 40-50, maybe even 60 units in a male patient,” she said. However, the volume depends on the strength of the muscles in the area, and some men may need less to avoid a frozen look. “You can always treat less and bring them back in a couple of weeks and add more,” especially with patients who are new to treatment, Dr. Beleznay noted.

She disclosed financial relationships with Allergan, Revance, Evolus, Galderma, and Zeltiq.

SDEF and this news organization are owned by the same parent company.

WAILEA, HAWAII – Using larger doses and avoiding overarching of the brows are among the considerations to keep in mind when using neuromodulators in men, advised Canadian dermatologist Katie Beleznay, MD.

In general, men have a very different anatomy with a different brow position, and have needs different from those of women, said Dr. Beleznay of the University of British Columbia, Vancouver.

One secret for successful injections of toxins in male patients: Dose matters. Men have stronger muscles in the face and need larger doses to overcome their muscular strength, Dr. Beleznay said in a video interview at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.

On average, “if you use 20-30 units in a female glabella, maybe you’d use 40-50, maybe even 60 units in a male patient,” she said. However, the volume depends on the strength of the muscles in the area, and some men may need less to avoid a frozen look. “You can always treat less and bring them back in a couple of weeks and add more,” especially with patients who are new to treatment, Dr. Beleznay noted.

She disclosed financial relationships with Allergan, Revance, Evolus, Galderma, and Zeltiq.

SDEF and this news organization are owned by the same parent company.

WAILEA, HAWAII – Using larger doses and avoiding overarching of the brows are among the considerations to keep in mind when using neuromodulators in men, advised Canadian dermatologist Katie Beleznay, MD.

In general, men have a very different anatomy with a different brow position, and have needs different from those of women, said Dr. Beleznay of the University of British Columbia, Vancouver.

One secret for successful injections of toxins in male patients: Dose matters. Men have stronger muscles in the face and need larger doses to overcome their muscular strength, Dr. Beleznay said in a video interview at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.

On average, “if you use 20-30 units in a female glabella, maybe you’d use 40-50, maybe even 60 units in a male patient,” she said. However, the volume depends on the strength of the muscles in the area, and some men may need less to avoid a frozen look. “You can always treat less and bring them back in a couple of weeks and add more,” especially with patients who are new to treatment, Dr. Beleznay noted.

She disclosed financial relationships with Allergan, Revance, Evolus, Galderma, and Zeltiq.

SDEF and this news organization are owned by the same parent company.

WAILEA, HAWAII – A study that used patient-reported outcomes to assess the impact of different contraceptive methods on acne provided “fascinating results,” Lawrence F. Eichenfield, MD, said at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.

“Progestins are present in birth control for the birth control, but they’re not usually good for the acne,” Dr. Eichenfield said in a video interview at the meeting.

Dr. Eichenfield, professor of dermatology and pediatrics at the University of California, San Diego, and his colleagues reviewed patient reports from an Internet-based survey of more than 2,000 adolescent and young adult acne patients asking whether they were on any contraceptive, and if so, how they thought the contraceptive method affected their acne.

Overall, hormonal progestin-only IUDs and some progestin-only implants correlated with worse acne. Of the combined oral contraceptives, those on the OCs containing drospirenone performed best, he said. Also of interest, the triphasic OCs, with the progestin in three phases, had a better impact on the acne than did the dual ones, he added.

The review of patient-reported outcomes can not only inform clinicians on how they should prescribe hormonal therapy, but also raises awareness of the impact of contraceptives on acne in general, Dr. Eichenfield said.

The results were published last year (J Drugs Dermatol. 2016 Jun 1;15[6]:670-4).

Dr. Eichenfield disclosed relationships with Anacor/Pfizer, Genentech, Lilly, Regeneron/Sanofi, Medimetriks, and Otsuka.

SDEF and this news organization are owned by the same parent company.

WAILEA, HAWAII – A study that used patient-reported outcomes to assess the impact of different contraceptive methods on acne provided “fascinating results,” Lawrence F. Eichenfield, MD, said at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.

“Progestins are present in birth control for the birth control, but they’re not usually good for the acne,” Dr. Eichenfield said in a video interview at the meeting.

Dr. Eichenfield, professor of dermatology and pediatrics at the University of California, San Diego, and his colleagues reviewed patient reports from an Internet-based survey of more than 2,000 adolescent and young adult acne patients asking whether they were on any contraceptive, and if so, how they thought the contraceptive method affected their acne.

Overall, hormonal progestin-only IUDs and some progestin-only implants correlated with worse acne. Of the combined oral contraceptives, those on the OCs containing drospirenone performed best, he said. Also of interest, the triphasic OCs, with the progestin in three phases, had a better impact on the acne than did the dual ones, he added.

The review of patient-reported outcomes can not only inform clinicians on how they should prescribe hormonal therapy, but also raises awareness of the impact of contraceptives on acne in general, Dr. Eichenfield said.

The results were published last year (J Drugs Dermatol. 2016 Jun 1;15[6]:670-4).

Dr. Eichenfield disclosed relationships with Anacor/Pfizer, Genentech, Lilly, Regeneron/Sanofi, Medimetriks, and Otsuka.

SDEF and this news organization are owned by the same parent company.

WAILEA, HAWAII – A study that used patient-reported outcomes to assess the impact of different contraceptive methods on acne provided “fascinating results,” Lawrence F. Eichenfield, MD, said at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.

“Progestins are present in birth control for the birth control, but they’re not usually good for the acne,” Dr. Eichenfield said in a video interview at the meeting.

Dr. Eichenfield, professor of dermatology and pediatrics at the University of California, San Diego, and his colleagues reviewed patient reports from an Internet-based survey of more than 2,000 adolescent and young adult acne patients asking whether they were on any contraceptive, and if so, how they thought the contraceptive method affected their acne.

Overall, hormonal progestin-only IUDs and some progestin-only implants correlated with worse acne. Of the combined oral contraceptives, those on the OCs containing drospirenone performed best, he said. Also of interest, the triphasic OCs, with the progestin in three phases, had a better impact on the acne than did the dual ones, he added.

The review of patient-reported outcomes can not only inform clinicians on how they should prescribe hormonal therapy, but also raises awareness of the impact of contraceptives on acne in general, Dr. Eichenfield said.

The results were published last year (J Drugs Dermatol. 2016 Jun 1;15[6]:670-4).

Dr. Eichenfield disclosed relationships with Anacor/Pfizer, Genentech, Lilly, Regeneron/Sanofi, Medimetriks, and Otsuka.

SDEF and this news organization are owned by the same parent company.

WAILEA, HAWAII – Two hyaluronic acid products now available in the United States are “much more stretchable and flexible” than other fillers, according to Nowell Solish, MD, of the University of Toronto.

The dermal fillers, Restylane Defyne and Restylane Refyne, have been available in Canada, and Dr. Solish was involved in a Canadian study of the fillers in patients in motion. With the new fillers, “animation looks more natural after than before the fillers,” he said at the Hawaii Dermatology Seminar, provided by Global Academy for Medical Education/Skin Disease Education Foundation. In addition to providing a more natural look, the new fillers may also help prevent the development of lines in certain areas, such as around the mouth, he noted.

In a video interview at the meeting, Dr. Solish explained that when he treats a patient, he looks for where there is “too much activity,” such as frequent pursing of the lips, and puts filler in to balance the activity.

He disclosed relationships with Allergan, Galderma (the manufacturer of Restylane products), and Revance.

SDEF and this news organization are owned by the same parent company.

WAILEA, HAWAII – Two hyaluronic acid products now available in the United States are “much more stretchable and flexible” than other fillers, according to Nowell Solish, MD, of the University of Toronto.

The dermal fillers, Restylane Defyne and Restylane Refyne, have been available in Canada, and Dr. Solish was involved in a Canadian study of the fillers in patients in motion. With the new fillers, “animation looks more natural after than before the fillers,” he said at the Hawaii Dermatology Seminar, provided by Global Academy for Medical Education/Skin Disease Education Foundation. In addition to providing a more natural look, the new fillers may also help prevent the development of lines in certain areas, such as around the mouth, he noted.

In a video interview at the meeting, Dr. Solish explained that when he treats a patient, he looks for where there is “too much activity,” such as frequent pursing of the lips, and puts filler in to balance the activity.

He disclosed relationships with Allergan, Galderma (the manufacturer of Restylane products), and Revance.

SDEF and this news organization are owned by the same parent company.

WAILEA, HAWAII – Two hyaluronic acid products now available in the United States are “much more stretchable and flexible” than other fillers, according to Nowell Solish, MD, of the University of Toronto.

The dermal fillers, Restylane Defyne and Restylane Refyne, have been available in Canada, and Dr. Solish was involved in a Canadian study of the fillers in patients in motion. With the new fillers, “animation looks more natural after than before the fillers,” he said at the Hawaii Dermatology Seminar, provided by Global Academy for Medical Education/Skin Disease Education Foundation. In addition to providing a more natural look, the new fillers may also help prevent the development of lines in certain areas, such as around the mouth, he noted.

In a video interview at the meeting, Dr. Solish explained that when he treats a patient, he looks for where there is “too much activity,” such as frequent pursing of the lips, and puts filler in to balance the activity.

He disclosed relationships with Allergan, Galderma (the manufacturer of Restylane products), and Revance.

SDEF and this news organization are owned by the same parent company.

WAILEA, HAWAII – Patients attribute every nail problem to nail fungus, but part of the problem with nails is concomitant tinea pedis, tinea corporis, and other reservoirs of infection, according to Neal Bhatia, MD, director of clinical dermatology at Therapeutics Clinical Research in San Diego.

Failure to locate and treat these other reservoirs can lead to recurrence of the nail infection, Dr. Bhatia said at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.

“If we aren’t treating the skin as well as the nails, it is creating a reservoir effect that reaccumulates in the nail itself,” he said. Similarly, the nails can serve as a reservoir of infection for the skin.

“That makes it all the more important” to treat both skin and nails and “treat through the disease state,” he commented in a video interview. Cost can influence treatment decisions, and there is a role for both topical and systemic therapy, he said. However, “if there’s not adequate testing or if there’s not a good proof of the diagnosis, we are just losing out no matter what we use,” he cautioned.

Dr. Bhatia disclosed relationships with companies including Actavis, Aqua, Allergan, Anacor, Bayer, Biofrontera, Biopharmx, Dermira, Dusa, Exceltis, Ferndale, Foamix, Galderma, Intraderm, ISDIN, LaRoche-Posay, Leo, Novartis, Sanofi, and Valeant.

SDEF and this news organization are owned by the same parent company.

WAILEA, HAWAII – Patients attribute every nail problem to nail fungus, but part of the problem with nails is concomitant tinea pedis, tinea corporis, and other reservoirs of infection, according to Neal Bhatia, MD, director of clinical dermatology at Therapeutics Clinical Research in San Diego.

Failure to locate and treat these other reservoirs can lead to recurrence of the nail infection, Dr. Bhatia said at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.

“If we aren’t treating the skin as well as the nails, it is creating a reservoir effect that reaccumulates in the nail itself,” he said. Similarly, the nails can serve as a reservoir of infection for the skin.

“That makes it all the more important” to treat both skin and nails and “treat through the disease state,” he commented in a video interview. Cost can influence treatment decisions, and there is a role for both topical and systemic therapy, he said. However, “if there’s not adequate testing or if there’s not a good proof of the diagnosis, we are just losing out no matter what we use,” he cautioned.

Dr. Bhatia disclosed relationships with companies including Actavis, Aqua, Allergan, Anacor, Bayer, Biofrontera, Biopharmx, Dermira, Dusa, Exceltis, Ferndale, Foamix, Galderma, Intraderm, ISDIN, LaRoche-Posay, Leo, Novartis, Sanofi, and Valeant.

SDEF and this news organization are owned by the same parent company.

WAILEA, HAWAII – Patients attribute every nail problem to nail fungus, but part of the problem with nails is concomitant tinea pedis, tinea corporis, and other reservoirs of infection, according to Neal Bhatia, MD, director of clinical dermatology at Therapeutics Clinical Research in San Diego.

Failure to locate and treat these other reservoirs can lead to recurrence of the nail infection, Dr. Bhatia said at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.

“If we aren’t treating the skin as well as the nails, it is creating a reservoir effect that reaccumulates in the nail itself,” he said. Similarly, the nails can serve as a reservoir of infection for the skin.

“That makes it all the more important” to treat both skin and nails and “treat through the disease state,” he commented in a video interview. Cost can influence treatment decisions, and there is a role for both topical and systemic therapy, he said. However, “if there’s not adequate testing or if there’s not a good proof of the diagnosis, we are just losing out no matter what we use,” he cautioned.

Dr. Bhatia disclosed relationships with companies including Actavis, Aqua, Allergan, Anacor, Bayer, Biofrontera, Biopharmx, Dermira, Dusa, Exceltis, Ferndale, Foamix, Galderma, Intraderm, ISDIN, LaRoche-Posay, Leo, Novartis, Sanofi, and Valeant.

SDEF and this news organization are owned by the same parent company.

WAILEA, HAWAII – Any proton pump inhibitor (PPI) has the potential to cause skin reactions, so it is important to ask patients about their use, according to J. Mark Jackson, MD, of the University of Louisville (Ky.).

If patients are going to react to a PPI, they usually will do so within 3 or 4 months of starting treatment, rather than in the first week or so of treatment, Dr. Jackson said in a video interview at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.

Skin reactions to PPIs are often maculopapular, with a flat and a raised component that can be nonspecific, Dr. Jackson noted.

Interestingly, he added, many times patients can switch to a different PPI and not get a skin reaction. However, there are some patients who develop a lupuslike reaction on the skin, and in these cases, there tends to be cross reactivity, “so they couldn’t switch to a different PPI and be risk-free” of the same reaction, he noted.

Dr. Jackson disclosed financial relationships with companies including AbbVie, Amgen, Celgene, Dermira, Galderma, Genentech, Janssen, Lilly, Medimetriks, Merck, Novartis, Pfizer, Promius, and Top MD.

SDEF and this news organization are owned by the same parent company.

WAILEA, HAWAII – Any proton pump inhibitor (PPI) has the potential to cause skin reactions, so it is important to ask patients about their use, according to J. Mark Jackson, MD, of the University of Louisville (Ky.).

If patients are going to react to a PPI, they usually will do so within 3 or 4 months of starting treatment, rather than in the first week or so of treatment, Dr. Jackson said in a video interview at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.

Skin reactions to PPIs are often maculopapular, with a flat and a raised component that can be nonspecific, Dr. Jackson noted.

Interestingly, he added, many times patients can switch to a different PPI and not get a skin reaction. However, there are some patients who develop a lupuslike reaction on the skin, and in these cases, there tends to be cross reactivity, “so they couldn’t switch to a different PPI and be risk-free” of the same reaction, he noted.

Dr. Jackson disclosed financial relationships with companies including AbbVie, Amgen, Celgene, Dermira, Galderma, Genentech, Janssen, Lilly, Medimetriks, Merck, Novartis, Pfizer, Promius, and Top MD.

SDEF and this news organization are owned by the same parent company.

WAILEA, HAWAII – Any proton pump inhibitor (PPI) has the potential to cause skin reactions, so it is important to ask patients about their use, according to J. Mark Jackson, MD, of the University of Louisville (Ky.).

If patients are going to react to a PPI, they usually will do so within 3 or 4 months of starting treatment, rather than in the first week or so of treatment, Dr. Jackson said in a video interview at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.

Skin reactions to PPIs are often maculopapular, with a flat and a raised component that can be nonspecific, Dr. Jackson noted.

Interestingly, he added, many times patients can switch to a different PPI and not get a skin reaction. However, there are some patients who develop a lupuslike reaction on the skin, and in these cases, there tends to be cross reactivity, “so they couldn’t switch to a different PPI and be risk-free” of the same reaction, he noted.

Dr. Jackson disclosed financial relationships with companies including AbbVie, Amgen, Celgene, Dermira, Galderma, Genentech, Janssen, Lilly, Medimetriks, Merck, Novartis, Pfizer, Promius, and Top MD.

SDEF and this news organization are owned by the same parent company.

WAILEA, HAWAII – Many atopic dermatitis patients with refractory disease may have also developed allergic contact dermatitis, according to Jonathan Silverberg, MD, of Northwestern University in Chicago.

Clinically, there is often overlap between AD and allergic contact dermatitis, said Dr. Silverberg, who was involved in the development of recent consensus guidelines on when to do patch testing in the setting of AD.

For many patients with severe disease, “sometimes when we patch test, we can find a relevant allergen for the patient to avoid, [and] within a few months, their disease just goes down a notch, gets much better, and really starts to respond to topical and more conservative approaches,” Dr. Silverberg said in a video interview at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation. Or patients may respond well to AD treatment on certain parts of the body, but there may be other areas that don’t respond as well, suggesting a possible component of allergic contact dermatitis, he added

The guidelines sought to sort out scenarios “where it makes sense to patch test” and to provide direction on best practices, noted Dr. Silverberg, who is director of the Northwestern Medicine Multidisciplinary Eczema Center, and director of the patch testing clinic, Northwestern Memorial Hospital, Chicago.

He disclosed relationships with companies including AbbVie, Anacor, Celgene, Chugai, GlaxoSmithKline, Lilly, MedImmune-AstraZeneca, Pfizer, Procter & Gamble, Puricore, and Regeneron-Sanofi.SDEF and this news organization are owned by the same parent company.

WAILEA, HAWAII – Many atopic dermatitis patients with refractory disease may have also developed allergic contact dermatitis, according to Jonathan Silverberg, MD, of Northwestern University in Chicago.

Clinically, there is often overlap between AD and allergic contact dermatitis, said Dr. Silverberg, who was involved in the development of recent consensus guidelines on when to do patch testing in the setting of AD.

For many patients with severe disease, “sometimes when we patch test, we can find a relevant allergen for the patient to avoid, [and] within a few months, their disease just goes down a notch, gets much better, and really starts to respond to topical and more conservative approaches,” Dr. Silverberg said in a video interview at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation. Or patients may respond well to AD treatment on certain parts of the body, but there may be other areas that don’t respond as well, suggesting a possible component of allergic contact dermatitis, he added

The guidelines sought to sort out scenarios “where it makes sense to patch test” and to provide direction on best practices, noted Dr. Silverberg, who is director of the Northwestern Medicine Multidisciplinary Eczema Center, and director of the patch testing clinic, Northwestern Memorial Hospital, Chicago.

He disclosed relationships with companies including AbbVie, Anacor, Celgene, Chugai, GlaxoSmithKline, Lilly, MedImmune-AstraZeneca, Pfizer, Procter & Gamble, Puricore, and Regeneron-Sanofi.SDEF and this news organization are owned by the same parent company.

WAILEA, HAWAII – Many atopic dermatitis patients with refractory disease may have also developed allergic contact dermatitis, according to Jonathan Silverberg, MD, of Northwestern University in Chicago.

Clinically, there is often overlap between AD and allergic contact dermatitis, said Dr. Silverberg, who was involved in the development of recent consensus guidelines on when to do patch testing in the setting of AD.

For many patients with severe disease, “sometimes when we patch test, we can find a relevant allergen for the patient to avoid, [and] within a few months, their disease just goes down a notch, gets much better, and really starts to respond to topical and more conservative approaches,” Dr. Silverberg said in a video interview at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation. Or patients may respond well to AD treatment on certain parts of the body, but there may be other areas that don’t respond as well, suggesting a possible component of allergic contact dermatitis, he added

The guidelines sought to sort out scenarios “where it makes sense to patch test” and to provide direction on best practices, noted Dr. Silverberg, who is director of the Northwestern Medicine Multidisciplinary Eczema Center, and director of the patch testing clinic, Northwestern Memorial Hospital, Chicago.

He disclosed relationships with companies including AbbVie, Anacor, Celgene, Chugai, GlaxoSmithKline, Lilly, MedImmune-AstraZeneca, Pfizer, Procter & Gamble, Puricore, and Regeneron-Sanofi.SDEF and this news organization are owned by the same parent company.

WAILEA, HAWAII – Evidence from several recent studies suggests that the prevalence of adult onset atopic dermatitis in the United States may be as high as 7%-10%, said Jonathan I. Silverberg, MD, of the department of dermatology, preventive medicine, and medical social sciences, Northwestern University, Chicago.

Many features are similar to atopic dermatitis (AD) seen in childhood, but in adults the eczema is more likely to affect the hands and the eyelids. “We often have a hard time telling that apart from contact dermatitis,” Dr. Silverberg said in a video interview at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.

Some adults may have forgotten they had AD as children and don’t recognize it if it reappears in adulthood, but sometimes AD appears with no childhood history, he noted. “There’s a skepticism that if it is adult onset, it must not be atopic dermatitis,” but he has found that is not always the case.

A take-home message for clinicians: “Don’t be surprised when a patient walks in the door as an adult meeting all criteria for atopic dermatitis. It can be, and you can diagnose them comfortably,” said Dr. Silverberg, who is also director of the Northwestern Medicine Multidisciplinary Eczema Center, Northwestern Memorial Hospital, Chicago.

Most of the treatments for adult AD “cover many different arms of the immune system,” and include topical steroids and immunosuppressants, he added.

Dr. Silverberg disclosed relationships with companies including AbbVie, Anacor, Celgene, Chugai, GlaxoSmithKline, Lilly, MedImmune-AstraZeneca, Pfizer, Procter & Gamble, Puricore, and Regeneron-Sanofi. SDEF and this news organization are owned by the same parent company.

WAILEA, HAWAII – Evidence from several recent studies suggests that the prevalence of adult onset atopic dermatitis in the United States may be as high as 7%-10%, said Jonathan I. Silverberg, MD, of the department of dermatology, preventive medicine, and medical social sciences, Northwestern University, Chicago.

Many features are similar to atopic dermatitis (AD) seen in childhood, but in adults the eczema is more likely to affect the hands and the eyelids. “We often have a hard time telling that apart from contact dermatitis,” Dr. Silverberg said in a video interview at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.

Some adults may have forgotten they had AD as children and don’t recognize it if it reappears in adulthood, but sometimes AD appears with no childhood history, he noted. “There’s a skepticism that if it is adult onset, it must not be atopic dermatitis,” but he has found that is not always the case.

A take-home message for clinicians: “Don’t be surprised when a patient walks in the door as an adult meeting all criteria for atopic dermatitis. It can be, and you can diagnose them comfortably,” said Dr. Silverberg, who is also director of the Northwestern Medicine Multidisciplinary Eczema Center, Northwestern Memorial Hospital, Chicago.

Most of the treatments for adult AD “cover many different arms of the immune system,” and include topical steroids and immunosuppressants, he added.

Dr. Silverberg disclosed relationships with companies including AbbVie, Anacor, Celgene, Chugai, GlaxoSmithKline, Lilly, MedImmune-AstraZeneca, Pfizer, Procter & Gamble, Puricore, and Regeneron-Sanofi. SDEF and this news organization are owned by the same parent company.

WAILEA, HAWAII – Evidence from several recent studies suggests that the prevalence of adult onset atopic dermatitis in the United States may be as high as 7%-10%, said Jonathan I. Silverberg, MD, of the department of dermatology, preventive medicine, and medical social sciences, Northwestern University, Chicago.

Many features are similar to atopic dermatitis (AD) seen in childhood, but in adults the eczema is more likely to affect the hands and the eyelids. “We often have a hard time telling that apart from contact dermatitis,” Dr. Silverberg said in a video interview at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.

Some adults may have forgotten they had AD as children and don’t recognize it if it reappears in adulthood, but sometimes AD appears with no childhood history, he noted. “There’s a skepticism that if it is adult onset, it must not be atopic dermatitis,” but he has found that is not always the case.

A take-home message for clinicians: “Don’t be surprised when a patient walks in the door as an adult meeting all criteria for atopic dermatitis. It can be, and you can diagnose them comfortably,” said Dr. Silverberg, who is also director of the Northwestern Medicine Multidisciplinary Eczema Center, Northwestern Memorial Hospital, Chicago.

Most of the treatments for adult AD “cover many different arms of the immune system,” and include topical steroids and immunosuppressants, he added.

Dr. Silverberg disclosed relationships with companies including AbbVie, Anacor, Celgene, Chugai, GlaxoSmithKline, Lilly, MedImmune-AstraZeneca, Pfizer, Procter & Gamble, Puricore, and Regeneron-Sanofi. SDEF and this news organization are owned by the same parent company.

WAILEA, HAWAII – Several patterns can provide clues to diagnoses of rheumatologic diseases, according to Daniel E. Furst, MD, professor of rheumatology, University of Washington, Seattle.

Dermatology and rheumatology share the use of pattern recognition when making a diagnosis, he said in a video interview at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation. An important pattern is the idea of polyarticular versus monoarticular disease. Rheumatoid arthritis, osteoarthritis, autoimmune diseases, and gout and crystalline diseases, he said, encompass “about 80% of the cases with polyarticular arthritis.”

Another pattern to consider is symmetry versus asymmetry. Osteoarthritis and gout will be asymmetric, while autoimmune diseases and RA will be symmetrical, Dr. Furst pointed out. Also consider areas of involvement, such as upper and lower parts of the body. “Lower tends to be more gout and more OA,” while upper-extremity involvement is more likely to be autoimmune diseases and RA, he said.

“You don’t have to be Einstein to be a rheumatologist; just remember some simple stuff,” added Dr. Furst, who also discusses the use of lab tests in the interview.

Dr. Furst is also professor emeritus, University of California, Los Angeles, and is affiliated with the University of Florence (Italy) Medical School.

He disclosed financial relationships with companies including AbbVie, Actelion, Amgen, BMS, Cytori, Genentech/Roche, Novartis, and Pfizer.

SDEF and this news organization are owned by the same parent company.

WAILEA, HAWAII – Several patterns can provide clues to diagnoses of rheumatologic diseases, according to Daniel E. Furst, MD, professor of rheumatology, University of Washington, Seattle.

Dermatology and rheumatology share the use of pattern recognition when making a diagnosis, he said in a video interview at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation. An important pattern is the idea of polyarticular versus monoarticular disease. Rheumatoid arthritis, osteoarthritis, autoimmune diseases, and gout and crystalline diseases, he said, encompass “about 80% of the cases with polyarticular arthritis.”

Another pattern to consider is symmetry versus asymmetry. Osteoarthritis and gout will be asymmetric, while autoimmune diseases and RA will be symmetrical, Dr. Furst pointed out. Also consider areas of involvement, such as upper and lower parts of the body. “Lower tends to be more gout and more OA,” while upper-extremity involvement is more likely to be autoimmune diseases and RA, he said.

“You don’t have to be Einstein to be a rheumatologist; just remember some simple stuff,” added Dr. Furst, who also discusses the use of lab tests in the interview.

Dr. Furst is also professor emeritus, University of California, Los Angeles, and is affiliated with the University of Florence (Italy) Medical School.

He disclosed financial relationships with companies including AbbVie, Actelion, Amgen, BMS, Cytori, Genentech/Roche, Novartis, and Pfizer.

SDEF and this news organization are owned by the same parent company.

WAILEA, HAWAII – Several patterns can provide clues to diagnoses of rheumatologic diseases, according to Daniel E. Furst, MD, professor of rheumatology, University of Washington, Seattle.

Dermatology and rheumatology share the use of pattern recognition when making a diagnosis, he said in a video interview at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation. An important pattern is the idea of polyarticular versus monoarticular disease. Rheumatoid arthritis, osteoarthritis, autoimmune diseases, and gout and crystalline diseases, he said, encompass “about 80% of the cases with polyarticular arthritis.”

Another pattern to consider is symmetry versus asymmetry. Osteoarthritis and gout will be asymmetric, while autoimmune diseases and RA will be symmetrical, Dr. Furst pointed out. Also consider areas of involvement, such as upper and lower parts of the body. “Lower tends to be more gout and more OA,” while upper-extremity involvement is more likely to be autoimmune diseases and RA, he said.

“You don’t have to be Einstein to be a rheumatologist; just remember some simple stuff,” added Dr. Furst, who also discusses the use of lab tests in the interview.

Dr. Furst is also professor emeritus, University of California, Los Angeles, and is affiliated with the University of Florence (Italy) Medical School.

He disclosed financial relationships with companies including AbbVie, Actelion, Amgen, BMS, Cytori, Genentech/Roche, Novartis, and Pfizer.

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