High Quality
Open the downloaded document, and select print from the file menu (PDF reader required).
THE LEADERIN NEWSANDMEETINGCOVERAGE
p16 Genetic Testing Has Limited Impact
BY BETSY BATES
Los Angeles Bureau
M
ONTEREY
, C
ALIF
. — Rec-ommend p16 mutation genetictesting only in patients withmultiple primary melanomas ora family history that includesmultiple cases ofmelanoma orpancreatic cancer, advised Dr.Susan Swetter at the annualmeeting ofthe California Soci-ety ofDermatology and Der-matologic Surgery.While it is true that a p16 ge-netic mutation confers a pro-foundly elevated risk ofmel-anoma—up to 80% by age80—few melanoma patients ac-tually carry the mutation, saidDr. Swetter ofthe Veterans Af-fairs Palo Alto (Calif.) HealthCare System and director ofthePigmented Lesion and CutaneousMelanoma Clinic at Stanford(Calif.) University Medical Center.“Ifyou take unselectedmelanoma patients in the gener-al population, their rates ofp16positivity are very low: only0.2%-2%,” she said, “and a reasonto perform a genetic test is ifyouhave a fair suspicion that it’s go-ing to be abnormal.”She noted that physicians andpatients alike have been receiving mailings from laboratories sug-gesting that melanoma patientsshould “alleviate their anxiety” by undergoing the p16 test.However, in many cases, thetest will add no new useful in-formation to a person’s knownrisk for melanoma.She cited the case ofa 64-year-old patient who desired a p16 ge-netic test because ofa personalhistory ofmelanoma and atypi-cal mole syndrome.The patient reported having no family history ofmelanomaor pancreatic cancer. Based oncurrent proposed criteria for con-sideration ofgenetic testing forthe p16 mutation, p16 testing would not be indicated in this pa-tient, who is considered at low
BY ALICIA AULT
Associated Editor, Practice Trends
T
he Food and Drug Adminis-tration soon will begin toscrutinize the warning labels ontanning beds, under a new feder-al law signed by the president inlate September.The Tanning Accountabilityand Notification Act was includ-ed in the Food and Drug Admin-istration Amendments Act of 2007. Four members ofCon-gress—Sen. Jack Reed (D-R.I.),Sen. Johnny Isakson (R-Ga.), Rep.Carolyn Maloney (D-N.Y.), andRep. Ginny Brown-Waite (R-Fla.)—originally sponsored theTAN Act.Under the new federal law, theFDA is being directed to deter-mine ifthe label is positionedcorrectly, whether it gives suffi-cient risk data, whether alterna-tive warnings would better com-municate risks, or ifthere is nowarning that could communi-cate the risk ofusing tanning beds adequately.To reach those determinations,the law requires the FDA to con-duct tests with consumers; theagency is to issue a report bySeptember 2008.
Ustekinumab combines efficacy and safety.
Two-Thirds ReachPASI-75 With NewBiologic Agent
TANAct Persistence Pays:FDAto Study UV Bed Risks
BY ROBERT FINN
San Francisco Bureau
M
ore than two-thirds of patients with moderateto severe plaque psoria-sis achieved at least a 75% reduc-tion in area and severity after justtwo subcutaneous doses of ustekinumab, according to phaseIII study results presented at the21st meeting ofthe World Con-gress ofDermatology.“With any drug you want effi-cacy, safety, and convenience,” Dr.Kristian Reich ofGeorg-August-Universität, Göttingen, Germany,one ofthe trial’s principal investi-gators, said during a Web-basednews conference. “We have an ef-ficacy that’s in the championshipleague ofantipsoriatic therapy.We have a safety that we haven’tseen so far, and [with] injectionsevery 3 months, we have a veryconvenient healinglike therapy.”Ustekinumab—formerlyknown as CNTO 1275—is a ful-ly human monoclonal antibodydiscovered by Centocor Inc. witha novel mechanism ofaction thattargets the cytokines interleukin-12 and interleukin-23.The phase III multicenterstudy involved 1,230 patientswith chronic plaque psoriasiswho were randomized to one of the following: placebo; two 45-mg doses ofustekinumab every4 weeks; or two 90-mg doses of ustekinumab every 4 weeks.
S
T E V E
G
L A D F E L T E R
/ S
T A N F O R D
U
N I V E R S I T Y
M
E D I C A L
C
E N T E R
For most patients, p16 genetic mutation testing will add no newinformation to their known melanoma risk, said Dr. Susan Swetter.
MELTUMP
The treatment oftumors of unknown malignant potential causes uncertainty.
PAGE 22
LiposuctionAlternative?
Despite warnings Lipodissolve mesotherapy gaining popularity.
PAGE 25
Dr. Dad
Physicians share how theybalance the demands of patients and parenthood.
PAGE 61
See
p16
page 23
CASE OF THE MONTH
INSIDE
FDA A
GREES TO
R
ELAX I
PLEDGE R
ULES
,
PAGE
17
Skin & Aller
gy
News
V
OL
. 38, N
O
. 11
The Leading Independent Newspaper for Medical, Surgical, and Aesthetic Dermatology
N
OVEMBER
2007
See
Two-Thirds
page 9See
TANAct
page 17
www.skinandallergynews.com
A
n adult male inpatient re-ceiving massive doses of corticosteroids to control cere- bral edema that developed af-ter a motor vehicle accidentrapidly developed a fuzzywhite lesion in an area ofscalpabrasions. The man, who hadadult-onset diabetes, sufferedthe head trauma, including theabrasions, after being thrownthrough the window ofhisice-cream truck. The lesionwas not present at the previ-ous day’s dermatology con-sult. What’s your diagnosis?
See
Case of the Month,
page 71.
C
O U R T E S Y
D
R
. D
I R K
E
L S T O N
Add a Comment