- 2224 Walker Road, Suite 300
Windsor, Ontario, Canada
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- Acne Treatment, Atopic Dermatitis, Acne Vulgaris, Alopecia Areata, Evidence Based Medicine, Acne, and 13 morePsoriasis, Patient reported outcome measures, Clinical Practice Guidelines, Performance-based outcome measures, Rosacea, Medicine, Public Health, Health Sciences, Biotechnology, Medical Anthropology, Biology, Bioinformatics, and Medical Dermatologyedit
- Clinical dermatologist with wide research interests including - skin imaging, QoL measures, outcome evaluations, shar... moreClinical dermatologist with wide research interests including - skin imaging, QoL measures, outcome evaluations, shared decision making and evidence based practice. Focus areas are Acne, Rosacea, Hidradenitis Suppurativa.edit
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Background Most people with acne are at risk of developing acne scars, but the impact of these scars on patients' quality of life is poorly researched. Objective To assess the perspective of patients with acne scars and the impact of... more
Background Most people with acne are at risk of developing acne scars, but the impact of these scars on patients' quality of life is poorly researched. Objective To assess the perspective of patients with acne scars and the impact of these scars on their emotional well-being and social functioning. Methods A 60-minute interview of 30 adults with acne scars informed and contextualized the development of a cross-sectional survey of 723 adults with atrophic acne scars. Results The main themes identified in the qualitative interviews included acceptability to self and others, social functioning, and emotional well-being. In the cross-sectional survey, 31.6%, 49.6%, and 18.8% of the participants had mild, moderate, and severe/very severe acne scarring. The survey revealed that 25.7% of the participants felt less attractive, 27.5% were embarrassed or self-conscious because of their scars, 8.3% reported being verbally and/or physically abused because of their scars on a regular basis, and 15.9% felt that they were unfairly dismissed from work. In addition, 37.5% of the participants believed that their scars affected people's perceptions about them, and 19.7% of the participants were very bothered about hiding their scars daily. Moreover, 35.5% of the participants avoided public appearances, and 43.2% felt that their scars had negatively impacted their relationships. Limitations The temporal evaluation of the impact was not estimated. Conclusion Even mild atrophic acne scarring can evoke substantial emotional, social, and functional concerns.
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BACKGROUND After dermatitis, acne is the second skin disease most contributing to the burden of skin diseases worldwide. Recently, seven core outcome domains have been identified that together form an Acne Core Outcome Set (ACORN... more
BACKGROUND After dermatitis, acne is the second skin disease most contributing to the burden of skin diseases worldwide. Recently, seven core outcome domains have been identified that together form an Acne Core Outcome Set (ACORN project). One of these was satisfaction with acne treatment. OBJECTIVE Our aim was to identify studies that described the development of patient-reported outcome measures (PROMS), evaluated one or more measurement properties of a PROM, or evaluated the interpretability of a PROM in patients with acne regarding treatment satisfaction. METHODS The COSMIN search strategy for identifying PROMS on acne treatment satisfaction was used. We searched Pubmed, MEDLINE, Embase, LILACS, Web of Science, Cochrane Library, Emcare, PsychINFO and Academic Search premier (June 2020). Study selection, data extraction, and assessment of methodological quality according to COSMIN guidance were carried out independently by two authors. RESULTS Only one study could be included, describing the development of a treatment satisfaction measure in patients with acne. The development was assessed as inadequate, and data on measurement properties were lacking. Additionally, we found 188 studies reporting treatment satisfaction solely as an outcome, using a wide variety of methods, none of them standardised nor validated. CONCLUSIONS We could not find a PROM on treatment satisfaction to recommend for a core outcome set in acne. There is an unmet need for a PROM measuring treatment satisfaction in acne that is robustly developed, designed and validated.
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The 2nd Annual Symposium on Hidradenitis Suppurativa Advances (SHSA) took place on 03‐05 November 2017 in Detroit, Michigan, USA. This symposium was a joint meeting of the Hidradenitis Suppurativa Foundation (HSF Inc.) founded in the USA,... more
The 2nd Annual Symposium on Hidradenitis Suppurativa Advances (SHSA) took place on 03‐05 November 2017 in Detroit, Michigan, USA. This symposium was a joint meeting of the Hidradenitis Suppurativa Foundation (HSF Inc.) founded in the USA, and the Canadian Hidradenitis Suppurativa Foundation (CHSF). This was the second annual meeting of the SHSA with experts from different disciplines arriving from North America, Europe and Australia, in a joint aim to discuss most recent innovations, practical challenges and potential solutions to issues related in the management and care of Hidradenitis Suppurativa patients. The last session involved clinicians, patients and their families in an effort to educate them more about the disease.
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Background Rosacea treatment success is usually defined as a score of 1 ("almost clear") or 0 ("clear") on the 5-point Investigator Global Assessment (IGA) scale. Objective To evaluate whether after successful... more
Background Rosacea treatment success is usually defined as a score of 1 ("almost clear") or 0 ("clear") on the 5-point Investigator Global Assessment (IGA) scale. Objective To evaluate whether after successful treatment, "clear" subjects had better outcomes than "almost clear" subjects. Methods A pooled analysis was performed on 1366 rosacea subjects from 4 randomized controlled trials with IGA before and after treatment (ivermectin, metronidazole or vehicle). Assessments included the Dermatology Life Quality Index (DLQI) questionnaire and subject assessment of rosacea improvement. In one trial, patients were followed after the treatment period to measure time to relapse (IGA score ≥ 2). Results At end of treatment, more "clear" than "almost clear" subjects had a clinically meaningful difference in DLQI (59% vs. 44%; P<0.001) and a final DLQI score of 0-1 indicating no effect on quality of life (84% vs. 66%; P<0.001)....
Research Interests: Quality of life, Treatment Outcome, Medicine, Humans, Internal Medicine, and 15 moreRosacea, Female, Male, Recurrence, Clinical Sciences, Aged, Middle Aged, Adult, Randomized Controlled Trial, Metronidazole, Ivermectin, Randomized Controlled Trials as Topic, Surveys and Questionnaires, Dermatology Life Quality Index, and Dermatologic agents
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Research Interests: Gastroenterology, Treatment Outcome, Adolescent, Medicine, Prospective studies, and 15 moreHumans, Internal Medicine, Female, Male, Acne Vulgaris, Clinical Sciences, Acne, Adult, Randomized Controlled Trial, Tretinoin, Reference Values, Severity of Illness Index, Adverse effect, Patient selection, and sebum
Rosacea is a chronic facial inflammatory dermatosis characterized by background facial erythema and flushing and may be accompanied by inflammatory papules and pustules, cutaneous fibrosis and hyperplasia known as phyma, and ocular... more
Rosacea is a chronic facial inflammatory dermatosis characterized by background facial erythema and flushing and may be accompanied by inflammatory papules and pustules, cutaneous fibrosis and hyperplasia known as phyma, and ocular involvement. These features can have adverse impact on quality of life, and ocular involvement can lead to visual dysfunction. The past decade has witnessed increased research into pathogenic pathways involved in rosacea and the introduction of novel treatment innovations. The objective of these guidelines is to offer evidence-based recommendations to assist Canadian health care providers in the diagnosis and management of rosacea. These guidelines were developed by an expert panel of Canadian dermatologists taking into consideration the balance of desirable and undesirable outcomes, the quality of supporting evidence, the values and preferences of patients, and the costs of treatment. The 2015 Cochrane review "Interventions in Rosacea" was used...
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Atrophic scarring occurs throughout the course of inflammatory acne and across the spectrum of severity. This study evaluates perceptions of the general population toward individuals with clear skin and acne scars. An online survey... more
Atrophic scarring occurs throughout the course of inflammatory acne and across the spectrum of severity. This study evaluates perceptions of the general population toward individuals with clear skin and acne scars. An online survey administered in the USA, UK, Japan, Germany, France and Brazil to respondents 18 years and over presented three facial pictures of clear skin or digitally superimposed acne scars (but no active acne lesions) in a random fashion. At least one clear and one scar picture were presented to each participant. Among the 4618 responders, 33% themselves had facial acne scars. The skin was the first thing noticed about the face by 41% when viewing pictures with scars vs 8% viewing clear skin (p < 0.05). Those with scars were less likely to be considered attractive (17% vs 25%), confident (25% vs 33%), happy (23% vs 30%), healthy (21% vs 31%) and successful (17% vs 24%), and more likely to be perceived as insecure (15% vs 8%) and shy (23% vs 14%) compared with th...
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There are no current instruments to facilitate population screening for rosacea. To develop and evaluate a screening instrument for rosacea applicable for population surveys. A rosacea-specific screening instrument (Rosascreen),... more
There are no current instruments to facilitate population screening for rosacea. To develop and evaluate a screening instrument for rosacea applicable for population surveys. A rosacea-specific screening instrument (Rosascreen), consisting of a subject-completed questionnaire and screening algorithm, was developed based on current diagnostic criteria for rosacea. Three iterations were pilot tested and refined for clarity and sensitivity in adult outpatients with and without rosacea. Three subject groups were consecutively evaluated with iterations of the questionnaire at each centre (overall N = 121). The final version had a sensitivity of 93% to 100% for key diagnostic criteria, and use of the algorithm had a sensitivity of 100% for detection of rosacea and specificity of 63% to 71%. Most subjects found the questionnaire easy to understand and complete. Rosascreen, a subject-completed questionnaire and diagnostic algorithm, is a highly sensitive screening instrument that may facili...
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Oral contraceptives (OCs) can reduce acne by lowering the production of adrenal and ovarian androgens, by inhibiting 5-alpha-reductase, which in turn, reduces the levels of dihydrotestosterone, and by stimulating sex hormone binding... more
Oral contraceptives (OCs) can reduce acne by lowering the production of adrenal and ovarian androgens, by inhibiting 5-alpha-reductase, which in turn, reduces the levels of dihydrotestosterone, and by stimulating sex hormone binding globulin (SHBG), thus reducing the levels of free testosterone. In newer OCs, such as Tricyclen and Diane-35, the progestin component is minimally androgenic and anti-androgenic respectively, thereby enhancing the favorable profile of these products in the treatment of hyperandrogenic disorders, including acne. The efficacy of these agents and their long-term safety profile supports their use in various grades of acne in females: * As adjunctive therapy to topical agents for women with mild non-scarring acne desiring oral contraception * As primary therapy for patients with moderate non-scarring acne in combination with topical therapy and systemic antibiotics * As one of two preferred methods of contraception in patients with scarring and severe inflamm...
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Rosacea (including facial erythema) has a negative impact on psychological and emotional health. This survey aimed to assess the impact of facial erythema on subconscious perceptions and the initial reactions of others and how this... more
Rosacea (including facial erythema) has a negative impact on psychological and emotional health. This survey aimed to assess the impact of facial erythema on subconscious perceptions and the initial reactions of others and how this affects attitudes in different settings. The survey also measured the impact of facial erythema on a person's emotional and psychological wellbeing. A total of 6831 participants from eight countries completed online computer-assisted web interviewing psychological assessments based on the implicit association test. Traditional questionnaires provided data on the impact of facial erythema and perceptions of people with rosacea from other participants. Facial erythema was strongly associated with poor health and negative personality traits with participants reporting negative impacts of rosacea emotionally, socially and in the workplace. Nearly 80% reported difficulty in controlling facial erythema but those with physician-diagnosed rosacea had signific...
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This paper reviews current evidence presented by recent studies on the impact of acne on psychosocial health. Study methodologies, including case-control and cross-sectional surveys, have demonstrated psychological abnormalities including... more
This paper reviews current evidence presented by recent studies on the impact of acne on psychosocial health. Study methodologies, including case-control and cross-sectional surveys, have demonstrated psychological abnormalities including depression, suicidal ideation, anxiety, psychosomatic symptoms, including pain and discomfort, embarrassment and social inhibition. Effective treatment of acne was accompanied by improvement in self-esteem, affect, obsessive-compulsiveness, shame, embarrassment, body image, social assertiveness and self-confidence. Acne is associated with a greater psychological burden than a variety of other disparate chronic disorders. Future studies with a longitudinal cohort design may provide further validation of the causal inference between acne and psychosocial disability provided by the current literature.
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ROSASOL Cream is a novel topical formulation of 1% metronidazole in a vehicle containing sunscreens (SPF 15). This product has demonstrated efficacy in the treatment of inflammatory lesions, erythema, and telangiectasiae associated with... more
ROSASOL Cream is a novel topical formulation of 1% metronidazole in a vehicle containing sunscreens (SPF 15). This product has demonstrated efficacy in the treatment of inflammatory lesions, erythema, and telangiectasiae associated with rosacea.
Research Interests: Dermatology, Medicine, Humans, Rosacea, Pubmed, and 3 moreMetronidazole, Erythema, and Drug combinations
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Research Interests: Dermatology, Adolescent, Medicine, Humans, Female, and 15 moreMale, Psoriasis, Calcitriol, Clinical Sciences, Aged, Middle Aged, Adult, Randomized Controlled Trial, Glucocorticoids, Scalp, Betamethasone, Adverse effect, Pharmacology and pharmaceutical sciences, Dermatologic agents, and Drug combinations
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Previous publications have described practical considerations for initiating biologic therapy in psoriasis patients. However, most publications have focused on anti-tumor necrosis factor (TNF) therapy. To create an evidence-based,... more
Previous publications have described practical considerations for initiating biologic therapy in psoriasis patients. However, most publications have focused on anti-tumor necrosis factor (TNF) therapy. To create an evidence-based, practical tool that provides guidance on patient management for all biologics currently approved in Canada and the United States. Psoriasis publications regarding safety issues in the initiation or monitoring of adalimumab, alefacept, etanercept, infliximab, or ustekinumab therapy were identified through a PubMed search. Phase III trials and open-label extensions (regardless of indication) and relevant guidelines from Health Canada were used to compile this review. Although these biologic agents have demonstrated efficacy in patients with psoriasis and are generally considered safe and well tolerated, rare but serious safety issues (ie, demyelination, infection, tuberculosis, malignancy, lymphoma, cardiovascular outcomes, hepatitis, pregnancy, surgery, and...
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Disclosure: Prof Tan is an advisor, consultant, investigator, and/or speaker for: Almirall, Bausch Health, Boots Walgreens, Botanix, Galderma, Novan, Novartis, and Sun. Prof Fabbrocini reports financial support from Abbvie SRL, Aristea... more
Disclosure: Prof Tan is an advisor, consultant, investigator, and/or speaker for: Almirall, Bausch Health, Boots Walgreens, Botanix, Galderma, Novan, Novartis, and Sun. Prof Fabbrocini reports financial support from Abbvie SRL, Aristea Education SRL, Beiersdorf SpA, BioDue SpA, Boehringer Ingelheim Italia SpA, Consorzio Formazione Medica SRL, Costanzafarma SRL, Coswell SpA, Crinos SpA, Delife Pharma SRL, Dermaroller GmbH, Devital Service SpA, Dialecticon SRL, Difa Cooper SpA, Editamed SRL, Edizioni Minerva Medica SpA, EMF SRL, Eurestist Network Genie, Galderma Italia SpA, Galderma International SAS, General Topics SRL, Giuliani SpA, Giunti Editore SpA, Hippocratica Imaging SRL, IBSA Farmaceutici Italia SpA, Iromed Group SRL, Istituto Ganassini SpA, L’Oréal Italia SpA, Laboratoires Dermatologiques D’Uriage, Look Around SRL, Meda Pharma SpA, Medi K SRL, Medskin Solutions Dr Suwelack, Meetings & Words SRL, Micom SRL, Momento Medico SRL, New Congress SRL, Pacini Editore SpA, Pierre Fabr...
Rosacea, a chronic facial and ocular inflammatory disease, is readily visible with consequential adverse psychosocial impacts. Progress in epidemiology, pathophysiology, treatments, psychosocial and quality of life impact has led to... more
Rosacea, a chronic facial and ocular inflammatory disease, is readily visible with consequential adverse psychosocial impacts. Progress in epidemiology, pathophysiology, treatments, psychosocial and quality of life impact has led to improved outcomes. Additionally, there has been a transition to updated clinical criteria for diagnosis and classification, the phenotype approach, based on rosacea‐associated features.
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References 1. Bogusiak K, Puch A, Arkuszewski P. Goldenhar syndrome: current perspectives. World J Pediatr 2017;13:405–15. 2. GoswamiM, BhushanU, Jangra B.Goldenhar syndrome: a case report with review. Int J Clin Pediatr Dent... more
References 1. Bogusiak K, Puch A, Arkuszewski P. Goldenhar syndrome: current perspectives. World J Pediatr 2017;13:405–15. 2. GoswamiM, BhushanU, Jangra B.Goldenhar syndrome: a case report with review. Int J Clin Pediatr Dent 2016;9:278–80. 3. Vong A, Funamura J. Multidisciplinary management of oculoauriculo-vertebral spectrum. Curr Opin Otolaryngol Head Neck Surg 2018;26:234–41. 4. Chae JB, Park JT, Kim BR, Shin JW. Agminated eruptive pyogenic granuloma on chin following redundant needle injections. J Dermatol 2016;43:577–8. 5. Said J,Hoda ST,Muhlrad S. Pyogenic granuloma: a tumor thatmimics infection. JAAPA 2018;31:27–9.
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Combined use of a retinoid and antimicrobial is recommended for acne, however, local tolerability issues may compromise patient adherence and treatment outcome. This multicentre, single-blinded controlled study was designed to determine... more
Combined use of a retinoid and antimicrobial is recommended for acne, however, local tolerability issues may compromise patient adherence and treatment outcome. This multicentre, single-blinded controlled study was designed to determine whether modified adapalene/benzoyl peroxide (A/BPO, Epiduo, Galderma, France) regimens improve local tolerability during the first four weeks of treatment without impairing efficacy at Week 12. In total, 120 subjects with mild-to-moderate acne received, during the first four weeks, A/BPO daily overnight (A/BPO-EN), A/BPO daily for three hours (A/BPO-3h), A/BPO daily overnight and a provided moisturizer lotion (A/BPO-moisturizer), or A/BPO every other night (A/BPO-EoN). Local tolerance assessments included signs and symptoms, global worst score (GWS), and total sum score (TSS). Efficacy was assessed based on lesion counts, investigator global assessment (IGA), and total lesion count reduction. Adherence, subject satisfaction, and overall safety were a...
Research Interests: Dermatology, Medicine, Clinical Sciences, Acne, Regimen, and 4 moreMoisturizer, Adapalene, Tolerability, and Erythema
Acne is a disease of pilosebaceous inflammation. Pivotal in pathogenesis are the roles of hormones (insulin, insulin-like growth factor-1, androgens), Propionibacterium acnes, lipogenesis, and a proinflammatory lipid profile. Innate... more
Acne is a disease of pilosebaceous inflammation. Pivotal in pathogenesis are the roles of hormones (insulin, insulin-like growth factor-1, androgens), Propionibacterium acnes, lipogenesis, and a proinflammatory lipid profile. Innate immune responses are induced through interaction with toll-like receptors and inflammasome activation initially and subsequently through adaptive immune activation. These insights into pathogenic inflammatory pathways can translate into novel therapeutic approaches for acne. Semin Cutan Med Surg 37(supp3):S60-S62 ©2018 published by Frontline Medical Communication.
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Patients with skin of color are more likely to develop acne and postinflammatory hyperpigmentation (PIH). Many therapies for acne have demonstrated efficacy in darker skin types and in the treatment of PIH. Semin Cutan Med Surg... more
Patients with skin of color are more likely to develop acne and postinflammatory hyperpigmentation (PIH). Many therapies for acne have demonstrated efficacy in darker skin types and in the treatment of PIH. Semin Cutan Med Surg 37(supp3):S71-S73 © 2018 published by Frontline Medical Communications.
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Very few clinical trials have investigated the effect of topical acne treatment on scarring. Our objective was to evaluate the efficacy of adapalene 0.3%/benzoyl peroxide 2.5% gel (A0.3/BPO2.5) in atrophic acne scar formation in patients... more
Very few clinical trials have investigated the effect of topical acne treatment on scarring. Our objective was to evaluate the efficacy of adapalene 0.3%/benzoyl peroxide 2.5% gel (A0.3/BPO2.5) in atrophic acne scar formation in patients with acne. In this multicenter, randomized, investigator-blinded, vehicle-controlled study, subjects with moderate or severe facial acne (Investigator's Global Assessment [IGA] score 3 or 4; ≥ 25 inflammatory lesions; ten or more atrophic acne scars) applied A0.3/BPO2.5 or vehicle daily per half face for 24 weeks. Subjects with acne requiring systemic treatment were excluded. Assessments included investigator atrophic acne scar count, Scar Global Assessment (SGA), acne lesion count, IGA, skin roughness and skin texture, subject self-assessment of clinical acne-related scars and satisfaction questionnaire, tolerability, and safety. Included subjects (n = 67) had mainly moderate acne (92.5% IGA 3); mean scores at baseline were approximately 40 acn...
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Scientific advances are continually improving the knowledge of acne and contributing to the refinement of treatment options; it is important for clinicians to regularly update their practice patterns to reflect current standards. The... more
Scientific advances are continually improving the knowledge of acne and contributing to the refinement of treatment options; it is important for clinicians to regularly update their practice patterns to reflect current standards. The Global Alliance to Improve Outcomes in Acne is an international group of dermatologists with an interest in acne research and education that has been meeting regularly since 2001. As a group, we have continuously evaluated the literature on acne. This supplement focuses on providing relevant clinical guidance to health care practitioners managing patients with acne, with an emphasis on areas where the evidence base may be sparse or need interpretation for daily practice.
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Acne affects approximately 95% of the population at some point during their lifetime.1 This common disorder can range from mild to severe forms, cause sometimes extensive scarring, and can last well into the fourth and fifth decades.... more
Acne affects approximately 95% of the population at some point during their lifetime.1 This common disorder can range from mild to severe forms, cause sometimes extensive scarring, and can last well into the fourth and fifth decades. Effective therapeutic agents are available to both treat acne and prevent ongoing disease. Despite this, dermatologists frequently see patients with significant acne scarring because many patients delay seeking medical attention for acne and many practitioners procrastinate over using effective antiscarring options. In patients who already demonstrate scarring, repeated courses of antibiotics only result in recurring acne and additional scarring. This, in turn, exacerbates the despair and other adverse psychosocial effects of the disease. There are a variety of agents and devices to help acne patients with scarring. However, successful treatment cannot be guaranteed, and in most cases residual scarring will be evident. Thus, the most effective way of managing acne scarring is to prevent its occurrence in the first place. Although we currently have a number of effective antiacne agents to control the disease, such as antibiotics and hormonal agents, isotretinoina is the only agent that has been shown to induce long-term drug-free remission and curative potential.
Research Interests: Dermatology, Medicine, Canada, Population, Humans, and 6 moreDisease, Cutaneous, Psychosocial, Acne Vulgaris, Acne, and Adverse effect
Rosacea is currently treated according to subtypes. As this does not adequately address the spectrum of clinical presentation (phenotypes), it has implications for patient management. The ROSacea COnsensus panel was established to address... more
Rosacea is currently treated according to subtypes. As this does not adequately address the spectrum of clinical presentation (phenotypes), it has implications for patient management. The ROSacea COnsensus panel was established to address this issue.
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Little is known about the interaction between dermatologists and their patients in facilitating treatment decisions for psoriasis. Our objective was to determine dermatologists' perceptions of the needs of psoriasis patients in... more
Little is known about the interaction between dermatologists and their patients in facilitating treatment decisions for psoriasis. Our objective was to determine dermatologists' perceptions of the needs of psoriasis patients in treatment decisions. Dermatologists were invited to complete an 18-item online survey on the treatment of psoriasis, including questions on decision-making roles, factors they considered important to patients in treatment decisions, and patients' needs for decision support. Seventy dermatologists completed the survey (15% response rate). The highest rated factors in decision making were access to physicians for discussion (86%) and information about the risks and benefits (80%); the latter was more frequently reported by those ≥ 50 years (p = .021). Treatment-specific factors of greatest importance were side-effect profile (87%) and cost (80%). Potential hindrances were patient misconceptions about disease, inadequate patient education materials, pa...
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Informed shared decision making is a mutual process engaging both doctor and patient and informed by best medical evidence and patient values and preferences. Our aim was to identify the needs of psoriasis patients in decisions on... more
Informed shared decision making is a mutual process engaging both doctor and patient and informed by best medical evidence and patient values and preferences. Our aim was to identify the needs of psoriasis patients in decisions on selecting treatment. Psoriasis subjects participated in an online survey on decisional role, postdecisional conflict, and treatment awareness. Of 2,622 people invited to participate, 248 completed surveys. Their most recent treatment decision was either made by subjects alone (42%) or physicians alone (28%) or was shared (29%). Subjects perceived that their doctors lacked time to stay abreast of treatments, to provide counseling, and to access appropriate treatments. Deficiencies most frequently identified were information on options, clarification of values, access to physicians, and decision-making skills. Those with a body surface area (BSA) ≥ 3% more frequently indicated that having the skill or ability to make treatment decisions was important. The li...
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Most treatment guidelines for acne are based on clinical severity. Our objective was to expand that approach to one that also comprised individualized patient features: a case-based approach. An expert panel of Canadian dermatologists was... more
Most treatment guidelines for acne are based on clinical severity. Our objective was to expand that approach to one that also comprised individualized patient features: a case-based approach. An expert panel of Canadian dermatologists was established to develop demographic and clinical features considered to be particularly important in acne treatment selection. A nominal group consensus process was used for inclusion of features and corresponding appropriate treatments. Consensus was achieved on the following statements: follicular epithelial dysfunction contributes to acne pathogenesis; inflammation from underlying disease(s) or prior treatment may impact further patient management; management focusing on specific patient features and on addressing psychosocial factors, including impact on quality of life, may improve treatment adherence and outcomes; and case-based scenarios are a practical approach to illustrate the effect of these factors. To address the latter, eight case prof...
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Scalp psoriasis has a considerable impact on the quality of life (QOL) of patients, and most patients are dissatisfied with available treatments. Clobetasol propionate shampoo 0.05% has been shown to be effective and safe for moderate to... more
Scalp psoriasis has a considerable impact on the quality of life (QOL) of patients, and most patients are dissatisfied with available treatments. Clobetasol propionate shampoo 0.05% has been shown to be effective and safe for moderate to severe scalp psoriasis. We evaluated the effect of clobetasol propionate shampoo on QOL and the degree of participant satisfaction with the product. Participants received once-daily treatment for up to 4 weeks. Their QOL and degree of satisfaction were evaluated by questionnaires. The mean (standard deviation) Dermatology Life Quality Index (DLQI) score decreased significantly from 7.0 (4.9) at baseline to 3.2 (3.2) at week 4 (P<.001). Participants who considered the disease as having a small effect or no effect on their QOL increased from 45.6% at baseline to 81.7% at week 4. Most participants were satisfied with the cosmetic acceptability and the efficacy and safety aspects of the product, considered it better than prior treatments, and would u...