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January 25, 2021 Newsletter

Hidradenitis suppurativa (HS) is a little-known disease that causes deep and painful lumps under the skin, usually in the armpits or groin.

Many people mistake the deep lumps for painful pimples or acne cysts. HS can also be misdiagnosed as boils, infected hair follicles (folliculitis), or a sexually transmitted disease.

Because HS is often mistaken for another condition, people can go years without getting the care they need. Some people live with HS for 12 years or longer before getting diagnosed.

Without the right diagnosis and individualized treatment, HS can worsen. What starts out as one or two deep, painful, pimple-like lumps can turn into several lumps. In time, these lumps can break open and leak a foul-smelling liquid. The lumps can continue to return, rupture, and heal.

Patients with hidradenitis suppurativa have a high prevalence of acne vulgaris, research published in Journal of the American Academy of Dermatology shows. Furthermore, the mean age of onset of hidradenitis suppurativa patients is lower when they also have acne vulgaris, the data show.

The prevalence of acne vulgaris was assessed in consecutive new patients with hidradenitis suppurativa referred to the Department of Dermatology at Bispebjerg Hospital in Copenhagen, Denmark.

A total of 302 patients (191 women and 111 men) with a mean age of 39.4 years referred between January 1, 2016 and October 8, 2018 were included in the evaluation.

The overall prevalence of acne vulgaris was 21.2%. Nineteen of the patients with acne vulgaris (29.7%) had hidradenitis suppurativa assessed as Hurley stage I, 39 (60.9%) Hurley stage II and 6 (9.4%) Hurley III. There was no statistical difference in Hurley stage of hidradenitis suppurativa between patients with and without acne.

However, acne vulgaris was associated with a lower age of onset of hidradenitis suppurativa. Those patients with hidradenitis suppurativa and acne vulgaris attending the clinic were significantly younger than those without acne vulgaris (33.8 versus 40.8 years,), and the mean age at onset of hidradenitis suppurativa was significantly lower in patients with acne vulgaris than it was in those without (21.4 versus 27.2 years).

Hidradenitis suppurativa patients with acne vulgaris also had lower levels of plasma inflammatory markers (C-reactive protein [CRP], neutrophils, and neutrophil/lymphocyte ratio [NLR]) than those without acne vulgaris.

Prevalence of acne vulgaris among hidradenitis suppurativa patients was not impacted by the sex of the patient, smoking status, obesity or diagnosis of polycystic ovary syndrome (PCOS). There was also no difference in Dermatology Quality of Life Index (DLQI) and localization of hidradenitis suppurativa between the patients with and without acne vulgaris.

Patients referred for specialized hospital care tended to have a high prevalence of acne vulgaris. Furthermore, hidradenitis suppurativa patients with acne vulgaris tend to have a significantly lower mean age and age at onset of hidradenitis suppurativa compared to hidradenitis suppurativa patients without acne vulgaris. These findings call for greater awareness of this association between acne and HS and for a co-management approach to treatment.

The Danish findings support those of a population-based sample from the United states which found that the prevalence of acne vulgaris was 15.2% among adults with hidradenitis suppurativa, compared to 2.9% in adults without hidradenitis suppurativa.

The US cross-sectional analysis used electronic health records data from a population-based sample of over 55 million patients to identifying adults with acne vulgaris among patients with and without hidradenitis suppurativa.

Prevalence of acne vulgaris in patients with hidradenitis suppurativa was found to be 15.2% (7,315 /48,050), compared to 2.9% (497,360 /16,899,470) for adults without hidradenitis suppurativa. Prevalence of acne vulgaris was greatest among hidradenitis suppurativa patients who were female (16.4%), aged 18-44 years (18.2%), non-white (17.5%), obese (15.5%), and had PCOS (28.7%).

Hidradenitis suppurativa patients had 4.51 times the odds of having acne vulgaris compared to non-HS patients, and the association between hidradenitis suppurativa and acne vulgaris was generally stronger for patients who were male, aged ≥ 65 years, non-whites, and obese.

The association between acne vulgaris and polycystic ovary syndrome (PCOS) is already well established. Recent research has demonstrated that approximately 1 in 11 women with hidradenitis suppurativa also have PCOS. The link among the three conditions is not yet clearly established, as circulating and end organ androgen expression appear to be normal among hidradenitis suppurativa patients.

If you have signs of HS or acne, have your dermatologist examine for both as HS may not be easily recognized by the general public. Dr. Moore’s research team, Arlington Research Center, his screening patients for HS to participate in clinical trials for HS. We also have clinical trials for acne. Contact Arlington Research Center at studies@acderm.com or 817-795-7546 ext. 339 to see if you qualify for an HS clinical trial.

Sources: AAD.org and Dermatology News February 2019


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December 30, 2020 Clinical Trials

If your child has severe eczema, learn how he or she could participate in this research study of an oral study drug for children 6 months to 11 years of age.

The purpose of this study is to examine how the body processes the study drug, evaluate drug safety and assess how the safety and taste hold up (tolerability and palatability) in children (6 months to 11 years old) with severe atopic dermatitis, also known as eczema. The study medication comes in a tablet form or a solution that will be taken by mouth.

WHO MAY PARTICIPATE IN THIS STUDY?
Your child may qualify for this research study, if the following applies to your child:

  • Your child is between 6 months to 11 years old
  • Your child has severe Atopic Dermatitis
  • Your child is experiencing active Atopic Dermatitis symptoms, such as: itchiness, irritated dry skin, redness, etc.

You may receive reimbursement for your time and travel expenses related to study participation.
Please visit http://www.clinicaltrialsandme.com/M16-049 for locations participating in the study.


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December 30, 2020 Clinical Trials

While severe psoriasis affects the skin, causing it to itch and burn, it can also have an emotional impact on adolescents, as well as their parents.

Because of the raised, red, scaly patches on their skin, many adolescents feel ashamed or embarrassed by their condition. These emotions can cause them to not want to hang out with friends, attend school functions, or participate in extracurricular activities.

For parents watching these physical and emotional effects, it’s difficult when other treatments have not been successful in managing their child’s psoriasis.

Because many adolescents and their families struggle with psoriasis, this research study is being conducted to evaluate an investigational drug for severe psoriasis. In this study, researchers want to learn more about the safety and effectiveness of the investigational drug.

The investigational drug has not been approved by any regulatory agency for the treatment of children and adolescents with this condition. It is only available to children and adolescents in research studies like this one.

The results of this study will provide more information about the investigational drug and whether it could one day be approved for children and adolescents with severe plaque psoriasis.

What will happen during this study?

To participate in this study, all patients will go through a screening process to determine if they are eligible. If a patient meets the study requirements, agrees to participation, and has their parents’ permission, they will begin the study.

Patients will receive five subcutaneous injections (needle inserted just beneath the skin) of the investigational drug over the course of 40 weeks. All injections will be given at the study clinic.

Total participation in this study will last up to 65 weeks, which includes approximately 9 study clinic visits for injections of the investigational drug, blood tests, and other assessments, as well as 1 follow-up phone call. Patients who complete participation in this study may be able to take part in a 52-week extension study in which all patients will continue receiving the investigational drug.

What are the benefits and risks related to this study?

It’s possible patients could benefit from study participation, but that is not guaranteed. However, participation in this study may benefit children and adolescents with plaque psoriasis in the future.

Patients could also experience one or more side effects. Before beginning the study, the study staff will review all study-related risks and side effects with parents and patients.

Throughout their study participation, patients will be monitored closely. The sponsor of this study was required to design a protocol, which explains all study procedures. An independent review board responsible for patient safety reviewed this protocol, approved it, and requires that
it be followed exactly as written.

Who is eligible to participate in this study?
To be eligible for this study, patients must:

  • Be 12 to 17 years of age
  • Have been diagnosed with chronic plaque psoriasis for at least 6 months

All study-related visits, tests, and drugs will be provided at no cost. In addition, compensation for study-related travel may be provided.


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December 30, 2020 Clinical Trials

We know life with Hidradenitis Suppurativa isn’t always easy.

There are many unanswered questions surrounding the causes of HS and the painful and distressing symptoms it triggers in the body. With limited approved medical treatment options available, it’s important to keep looking for potential answers.

For this reason, the Ivy Clinical Research Study is investigating 3 different possible treatment options to assess the benefits each could offer to people with moderate to severe HS.

The Ivy Study may be an option for you if:*

  • you have a diagnosis of moderate to severe HS
  • you are 18 – 75 years of age
  • you have HS lesions in two different locations on your body

*There are other requirements for participation in the study. The study doctor will be able to explain these to you.


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December 29, 2020 Newsletter
According to the American Academy of Dermatology (AAD), more than 14 million people are living with rosacea. Most people who get rosacea are:
  • Between 30 and 50 years of age
  • Fair-skinned, and often have blonde hair and blue eyes
  • From Celtic or Scandinavian ancestry
  • Likely to have someone in their family tree with rosacea or severe acne
  • Likely to have had lots of acne — or acne cysts and/or nodules
Women are a bit more likely than men to get rosacea. Women, however, are not as likely as men to get severe rosacea. Some people are more likely to get rosacea, but anyone can get this skin disease. People of all colors get rosacea. Children get rosacea. It often begins with a tendency to blush or flush more easily than other people.
The redness can slowly spread beyond the nose and cheeks to the forehead and chin. Even the ears, chest, and back can be red all the time. Rosacea can cause more than redness. There are so many signs and symptoms that rosacea has four subtypes:
  1. Erythematotelangiectatic rosacea – Redness, flushing, visible blood vessels
  2. Papulopustular rosacea – Redness, swelling, and acne-like breakouts
  3. Phymatous rosacea – Skin thickens and has a bumpy texture
  4. Ocular rosacea – Eyes red and irritated, eyelids can be swollen, and the person may have what looks like a sty.
With time, people who have rosacea often see permanent redness in the center of their face. Some patients confuse symptoms of Acne with Rosacea.
Many things can trigger Rosacea outbursts. Things such as sun exposure, emotional stress, hot weather, wind, heavy exercise, alcohol consumption, hot baths, cold weather, spicy foods or a number of other factors can trigger Rosacea. When considering Rosacea triggers, the role of coffee and caffeine have been difficult to determine. Caffeine can vasoconstrict or shrink inflammation, possibly helping rosacea. Heat from a hot cup of coffee may cause vasodilation and make rosacea worse.
A recent study of data from the Nurses’ Health Study II that evaluated intake of coffee, tea, soda, and chocolate every 4 years in over 82,000 women shed some light on the role coffee may play (JAMA Dermatol. 2018 Dec 1;154[12]: 1394-1400). There were almost 5,000 cases of physician-diagnosed rosacea in the Study. When the investigators looked at caffeinated coffee consumption, the more caffeine and the more coffee they drank each day, the more likely it was for them not to have rosacea. Those who consumed four or more servings of caffeinated coffee a day had a significantly lower risk of rosacea, compared with those who consumed one or fewer servings per month.
But there was no significant association with decaffeinated coffee or with edibles that contained caffeine such as tea, soda, and chocolate. Something about caffeinated coffee seems to be protective for the development of rosacea.
One of the most prominent triggers for Rosacea is sun exposure. Even sun exposure coming through windows can cause Rosacea to flare. To prevent Rosacea flare-ups due to outdoor or indoor sun exposure, consider using a Topical sun-block. with zinc oxide over 6%. Topical sunblocks with zinc oxide over 6% can also often treat rosacea. Dr. Moore recommends products like Elta Clear, ISDIN Eryfotona, and Sente Pollution Shield (that also protects against pollution that can be a trigger).
Oral SUNISDIN includes ingredients that protect against sun-exposureVitamin A (as Beta-Carotene), Vitamin C (as Ascorbic Acid), Vitamin D3 (as Cholecalciferol), Vitamin E (as D-alpha Tocopherol), Selenium (as Sodium Selenite), Polypodium leucotomos Leaf Extract (Polypodium leucotomos L), Green Tea Leaf Extract (Camellia Sinensis (L) Kuntze), Grapeseed Extract (Vitis Vinifera), Lycopene, Lutein (Marigold Flower Extract) Other Ingredients: Sunflower Oil, Sunflower Lecithin, Maltodextrin, Dibasic Calcium Phosphate, Triglycerides, Starch, Arabic Gum, Yellow Beeswax, Medium Chain Triglycerides, Sodium Selenite. Inquire about this product in our office.
Dr. Moore provides a number of solutions for patients diagnosed with Rosacea. There are a number of prescription solutions as well as laser treatments that can reduce redness and minimize the appearance redness often accompanying Rosacea. See the December Special on Laser Treatment for Rosacea Below.
You may also qualify to participate in a Clinical Trial for Rosacea. For more information see your Arlington Center for Dermatology provider or call us at 817-795-7546 ext 339 or email us at studies@acderm.com.
Sources: AAD.org and Dermatology News February 2020

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December 29, 2020 Newsletter
Recent studies regarding diet and acne have concluded that a diet higher in fat, sugar, and milk may be a contributing factor to having acne in a cross-sectional study of approximately 24,000 adults in France.
Acne in adults has been associated with social, emotional, and psychological consequences similar to those found with chronic diseases such as asthma, arthritis, epilepsy, and diabetes.
The study, published in JAMA Dermatology (June, 2020), identified 24,452 adults who participated in the NutriNet-Santé study, an ongoing, web-based study in France. Approximately 75% of the participants were women, the average age was 57 years, and 46% reported past or current acne.
Participants responded to an 11-item questionnaire between November 2008 and July 2019. Questions were related to the occurrence and diagnosis of acne, as well as medical history. Based on their acne status, participants were identified as falling into the categories of never acne, past acne, or current acne, and their dietary intake was assessed at baseline and every 6 months using three nonconsecutive 24-hour dietary records for 2 weekdays and 1 weekend day.
In an analysis, current acne was significantly associated with consumption of fatty and sugary foods, as well as with consumption of sugary drinks and milk. In addition, carbohydrate intake and saturated fatty acid intake were significantly associated with current acne.
Three dietary patterns accounted for 42% of the identified acne. A healthy pattern of higher fruit, vegetable, and fish intake accounted for 18%, a fatty and sugary pattern of higher fat and sugar intake (including chocolate) accounted for 13%, and an animal product and cereal pattern of higher intake of meat, milk, and refined cereals accounted for 11% of acne cases.
Results appear to support the hypothesis that a Western diet (rich in animal products and fatty and sugary foods) is associated with the presence of acne in adulthood. Possible explanations for the findings include the effects of a high glycemic-load diet on circulating IGF-1 and insulin, which ultimately increases both oxidative stress and inflammation that promotes the development of acne.
The study findings were limited by several factors including the use of relatively homogenous younger and female patient population and the reliance on self-reported acne, as well as the observational design, which did not allow for identification of direct, causal associations between diet and acne. Larger studies are needed to examine the relationship between diet and adult acne to inform prevention and treatment, they wrote.
Much of the previous literature on the role of diet in acne has focused on the association of milk consumption and high glycemic (sugar)-load diet with acne. Dietary interventions should be implemented with caution because of the potential for other effects such as reduced calcium or vitamin D.
A recent study from Saudi Arabia examined the relationship between Vitamin D deficiencies and people with acne.
It is thought that because of vitamin D’s regulatory effect on the immune system as well as its antioxidant and anti-comedogenic properties, deficiencies could contribute to the pathogenesis of acne. The study was conducted in 2016-2017 examining 68 patients with acne vulgaris (27 male, 41 female) and 50 matched healthy controls (24 male, 26 female). Subjects in the patient and control groups had not taken any vitamin D supplementation and were not suffering from any comorbidity or complication of vitamin D deficiency.
Acne grading was classified as mild in 21 patients (30.88%), moderate in 24 (38.24%), and severe in 21 (30.88%). Inclusion criteria required that male and female patients had been diagnosed with acne vulgaris according to the global acne grading system (GAGS) score.
Our results indicate that serum concentrations of vitamin D in controls were significantly higher than those in acne vulgaris patients. These results were in line with several other studies that found no elevation of serum vitamin D levels in acne patients. The study data showed no relationship between sun exposure and improvement in vitamin D readings in patients with acne.
Patients with acne may suffer from psychological distress contributing to a general avoidance of spending extended periods outdoors. This suggests a possible explanation of low vitamin D levels in patients with acne vulgaris. These results were consistent with other studies that revealed lower levels of serum vitamin D in severe acne vulgaris patients might be due to psychological stress.
The study found no significant relationship between vitamin D deficiency and the severity of acne vulgaris. This study revealed a connection between patients with a statistical significantly low serum vitamin D levels with patients with acne vulgaris. This highlights the importance of screening patients with acne for vitamin D
insufficiency and deficiency. Further clinical trials are needed to determine if acne treatment with both topical vitamin D analogs and vitamin D supplementation is of significant effect.
Eating a healthy diet and monitoring Vitamin D levels may contribute to lower levels of acne in both adults and adolescents.
Dr. Moore and her team treat all levels of acne with a variety of topical and oral medications. Dr. Moore’s Research Center is also enrolling Acne patients in new Clinical Trials for Acne. Call (817-795-7546 x339) or email (studies@acderm.com) to get more information about this recent Acne Clinical Trial.

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November 18, 2020 Newsletter

FDA is alerting consumers of Saniderm Products and UVT Inc.’s voluntary recall of Saniderm Advanced Hand Sanitizer. Following FDA’s recommendation, two distributors – Saniderm Products and UVT – agreed to recall Saniderm Advanced Hand Sanitizer packaged in 1-liter plastic bottles and labeled with “Made in Mexico” and “Produced by: Eskbiochem SA de CV.”

The UVT hand sanitizer is labeled with lot number 0530 and an expiration date of 04/2022. The Saniderm Products hand sanitizer is labeled with lot number 53131626 and “Manufactured on April/1/20.”

FDA advises consumers not to use any hand sanitizer manufactured by Eskbiochem SA de CV in Mexico, due to the potential presence of methanol (wood alcohol), a substance that can be toxic when absorbed through the skin or ingested. FDA has identified the following products manufactured by Eskbiochem:

  • All-Clean Hand Sanitizer (NDC: 74589-002-01) Esk Biochem Hand Sanitizer (NDC: 74589-007-01)
  • CleanCare NoGerm Advanced Hand Sanitizer 75% Alcohol (NDC: 74589-008-04)
  • Lavar 70 Gel Hand Sanitizer (NDC: 74589-006-01)
  • The Good Gel Antibacterial Gel Hand Sanitizer (NDC: 74589-010-10)
  • CleanCare NoGerm Advanced Hand Sanitizer 80% Alcohol (NDC: 74589-005-03)
  • CleanCare NoGerm Advanced Hand Sanitizer 75% Alcohol (NDC: 74589-009-01)
  • CleanCare NoGerm Advanced Hand Sanitizer 80% Alcohol (NDC: 74589-003-01)
  • Saniderm Advanced Hand Sanitizer (NDC: 74589-001-01)

FDA tested samples of Lavar Gel and CleanCare No Germ. Lavar Gel contains 81 percent (v/v) methanol and no ethyl alcohol, and CleanCare No Germ contains 28 percent (v/v) methanol. Methanol is not an acceptable ingredient for hand sanitizers and should not be used due to its toxic effects.

Consumers who have been exposed to hand sanitizer containing methanol should seek immediate treatment, which is critical for potential reversal of toxic effects of methanol poisoning. Substantial methanol exposure can result in nausea, vomiting, headache, blurred vision, permanent blindness, seizures, coma, permanent damage to the nervous system or death. Although all persons using these products on their hands are at risk, young children who accidently ingest these products and adolescents and adults who drink these products as an alcohol (ethanol) substitute, are most at risk for methanol poisoning.

On June 17, 2020, FDA contacted Eskbiochem to recommend the company remove its hand sanitizer products from the market due to the risks associated with methanol poisoning. To date, the company has not taken action to remove these potentially dangerous products from the market. Therefore, FDA recommends consumers stop using these hand sanitizers and dispose of them immediately in appropriate hazardous waste containers. Do not flush or pour these products down the drain.

FDA reminds consumers to wash their hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after coughing, sneezing, or blowing one’s nose. If soap and water are not readily available, the Centers for Disease Control and Prevention (CDC) recommend consumers use an alcohol-based hand sanitizer that contains at least 60 percent ethanol.

FDA remains vigilant and will continue to take action when quality issues arise with hand sanitizers. Additionally, the agency is concerned with false and misleading claims for hand sanitizers, for example that they can provide prolonged protection such as 24-hours against viruses including COVID-19, since there is no evidence to support these claims.

To date, FDA is not aware of any reports of adverse events associated with these hand sanitizer products. FDA encourages health care professionals, consumers and patients to report adverse events or quality problems experienced with the use of hand sanitizers to FDA’s MedWatch Adverse Event Reporting program:

Source: US Food and Drug Administration July 2020


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November 16, 2020 Newsletter

Good skin care involves more than just your face. Many users of washes, moisturizers and skin rejuvenation products apply them only to the visible regions of the face. Have you forgotten to take care of your neck while focusing on your face? Here are a few things which may help…..

Nourish Your Neck
Have you noticed that your skin is starting to look a bit dull? When the harsh summer sun gives way to the dryness of indoor heat, your skin may also turn dry and dull. Smooth your moisturizer and/or hydrator down past the collarbone area to keep both neck and décolleté soft and firm.

Protect It
Apply sunscreen every day! We recommend sunscreens that contain zinc oxide >6% which protects you from burns, skin cancers, and premature aging. Even while indoors or driving, you are exposed to UV (under fluorescent lighting, through windows, etc.) Over the years, sun exposure/burn can lead to dark spots, wrinkles, and skin laxity. Apply to face, neck, and décolleté. Physician-grade sunscreens include the following: Elta MD has several formulations of sunscreen with zinc oxide >9%; Eraclea 4 in 1 has 20.5% zinc oxide; ISDN Eryfotona has 11% zinc oxide and is formulated not only to protect but also to repair sun damage.

Moisturizers
Over the counter moisturizers for the neck include Cerave Moisturizing Cream, Cetaphil Restoraderm, and Neutrogena Hydro Boost. Physician-grade moisturizers (from physicians’ offices and not over-the-counter) include Sorbolene, Avene Xeracalm Balm, Sente Dermal Repair (see below), Skinbetter Face and Neck Cream, and Skin Better Trio.

Sente Dermal Repair Cream is another great moisturizing option. This product contains Heparan Sulfate Analog (in the same family as injectable hyaluronic acid fillers), a revolutionary repairing molecule that helps reduce redness, delivers deep hydration, and support the skin’s ability to repair itself. In a clinical study, 100% of subjects had increased skin hydration starting from week 2 through study completion at week 8. 73% of subjects showed improvements in fine lines and wrinkles at week 8.

Hydrators
How are moisturization and hydration different? Simply put, hydration equals water, and moisture equals oil. If your skin is dehydrated, it is lacking water. To hydrate your skin, drinking plenty of water is key. Reminder that drinking caffeine dehydrates. Topical hydration products that are physician-grade include Eraclea Hydration Serum.

Firm Up
Apply products specifically made for the neck. They can nourish as well as regenerate. Physician-grade products include Sente Neck Firming Cream, which is formulated with patented Heparan Sulfate Analog (HSA) technology ((in the same family as injectable hyaluronic acid fillers) to rapidly and profoundly hydrate and strengthen the skin’s natural ability to repair itself. This cream improves the appearance of crepey skin and horizontal neck lines. It also contains caffeine, an ingredient known to help tighten and brighten the skin.

Get Even
For fading dark spots, use a physician-grade brightener such as Eraclea Reveal (containing Nicinamide PC, Synovea® HR a safe and effective hexylresorcinol that is used as a skin lightener and is clinically proven to be four-times more effective than Hydroquinone. Licorice Extract – used for its antioxidant and lightening properties. Kojic Acid is used as a skin toner and lightener.) or SkinBetter Even Tone. Even Tone, featuring the patented a ground-breaking, non-hydroquinone, non-retinol formula that delivers a visibly dramatic reduction in the appearance of hyperpigmentation.

Smooth Those Lines
Retrinals and Retin-A are the best to smooth wrinkles. Apply in the evening to help exfoliate and stimulate collagen. Consider a physician grade skin smoothing cream like SkinBetter AlphaRet. AlphaRet is the latest innovation in retinoid renewal delivering remarkable results, with little-to-no irritation compared to other retinoids and retinoid-based products.

Posture
Be aware of your posture as you read your smart phone or work at the computer. Constantly bending your head down can exaggerate wrinkles. Try sleeping on your back so you don’t press wrinkles into your cheeks or chest.

FOR ADVANCED NECK CARE….

Pelleve radio-frequcncy treatments can firm and tighten the skin. This is an in-office procedure with very minimal downtime. See before and after pics here

Kybella treatments can permanently remove fat and produce secondary tightening of skin. This is an in-office injection performed by Dr Moore.

For more information, simply ask your Provider at your next office visit or call Pat at 817-795-7546 ext 304 or orders@acderm.com


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November 13, 2020 Newsletter

Eczema is not just a childhood disease. Adults can get any type of eczema, including atopic dermatitis (AD), even though many people consider eczema only a childhood disease. Eczema can occur at any stage of life. A peak time for developing adult-onset AD is in your 50s.

For some children, the AD never goes away, so it’s a lifelong disease. This happened to Peter Moffat, the award-winning writer of the British TV series Criminal Justice. You can read about how AD affects his life by going to: Adults with eczema too often suffer in silence.

Even if you had AD as a child, your skin can look and feel differently when you have AD as an adult. That’s actually one of the most striking differences between AD in adults and AD in children.

In adults, the skin tends to be extremely dry and scaly where the AD appears. If you’ve had AD for years, patches of your skin may be thick, leathery, and darker (or lighter) than the surrounding skin. Years of scratching causes this. The thickened skin can itch all the time. Adults also tend to get AD on different parts of their bodies than do children. When an adult has AD, it’s most likely to form in one or more of these areas:

  • Backs of the knees
  • Crooks of the elbows
  • Back of the neck
  • Face

Adults, unlike children, often have AD around their eyes. You’ll often see thickened, darker skin circling the eyes, as shown in the picture on this page. The skin around the eyes also tends to be very itchy.

AD shows up with many of the following symptoms in both adults and children:

  • Appear anywhere on the skin
  • Be intensely itchy
  • Cause sleep loss due to the itch
  • Make you feel depressed, anxious, or both
  • Lead to skin infections
  • Increase your risk of developing asthma, hay fever, and other allergies
  • Decrease your quality of life if left untreated

The numbers are showing that more children and adults are developing AD than ever before. Dermatologists are not sure why this increase in AD cases is happening. What they have discovered is that AD can worsen without treatment. While AD causes some obvious signs and symptoms, other types of eczema can cause intensely itchy patches of skin. These include:

  • Nummular eczema
  • Neurodermatitis
  • Hand eczema
  • Dyshidrotic eczema
  • Pityriasis alba

Each of these skin conditions requires different treatment, so it’s important to know which one you have. By seeing a board-certified dermatologist, you’ll get the expertise you need for an accurate diagnosis. A dermatologist can also create a treatment plan tailored to your individual needs. And that can bring welcomed relief.

Dr. Moore treats atopic dermatitis and may have a clinical trial with free medicine and treatment. Please ask about this on your next visit in our office.
(Source AAD.org)


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November 12, 2020 Newsletter

Psoriasis, a condition that manifests with itchy raised areas of red skin that often scale and flake, has been found to affect more than 8 million people in the US. These red, scaly bumpy growths of skin often appear on the scalp, knees, elbows, face or other parts of the body and are often quite painful. Many patients suffer most from the appearance of plaque psoriasis, feeling rejected or distanced by other people afraid of this non-contagious skin disease.

Newer treatments called biologics are restricted for use for about 25% of Psoriasis patients with extreme manifestations of the disease. Only about 6% of psoriasis patients use biologic treatments. These treatments involve injections and can have severe side affects as these treatments lower the ability of your immune system to fight off other disease.

Topical treatments for psoriasis are used by about 90% of patients. There has been no new mechanism of action for topical treatment of psoriasis for over 20 years. Just recently new studies have shown promise for a new medication for the topical treatment of psoriasis.

The New England Journal of Medicine has published in its July 2020 issue that a new topical cream called Roflumilast has shown positive results in treatment of plaque psoriasis. Patients with moderate psoriasis treated with a 0.3% cream or a 0.15% cream experienced an almost clear condition after 6 weeks of treatment (28% and 23% of patients respectively). Patients with mild cases of psoriasis experienced a clear state of skin after 12 weeks of use the 0.3% cream (93% of these cases). Ninety-seven percent of adverse reactions were rated mild or moderate in severity.

These initial test results show positive potential for a new and effective once-daily topical treatment for psoriasis patients with mild to moderate cases of the disease. The product seems well tolerated and is significantly successful in reducing or removing psoriasis without injections or immunity suppression.

Dr. Moore and her research team are enrolling patients in Arcutis Clinical Trials for this new topical treatment of psoriasis. This same medication is being tested with other inflammatory skin conditions such as Seborrheic Dermatitis and Atopic Dermatitis. Please contact our Clinical Trials (click here) department if you or someone you know might be a candidate for this free treatment. Contact us at 817-795-7546 extension 339
(Source New England Journal of Medicine, July 2020)


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