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50 Clinical Rounds SKIN & ALLERGY NEWS • January 2007

Psychology, OTCs Help Solve Many Skin Problems


BY ROBERT FINN Patients often stop treating their hand fection, but if you treat the sites externally slide and use the edge of the slide to file the
San Francisco Bureau dermatitis when it appears to be healed. for about 6 weeks, the patients will have ridges down. Within seconds every single
Dr. Lenahan shows patients a poster fewer problems. “If they’ve had this a long ridge on their fingernail will disappear. Af-
M O N T E R E Y , C A L I F . — An under- with the cross-sectional view of the lay- time, probably their spouse is also contam- terward, wrap the slide in tissue paper and
standing of patient psychology and a fa- ers of the skin. Although the stratum inated,” and should be treated as well, he hand it to the patient. “They think you’ve giv-
miliarity with over-the-counter prepara- corneum forms the actual skin barrier, said. en them one of the best tools ever,” he said.
tions can aid the diagnosis and treatment he tells patients that it’s the stratum lu- Systemic antibiotics may cause diarrhea, Liquid nitrogen, an excellent treatment
of several dermatologic conditions, said cidum—which has a waxy, white ap- and probiotics offer a good solution. Dr. for warts, is often painful. To reduce pain,
Dr. John A. Lenahan said at the annual pearance in the poster—that needs to Lenahan recommends Bio-K+, each dose of treat patients with L-M-X-5, a 5% lidocaine
meeting of the heal. He explains which contains at least 50 billion live lacto- gel, immediately after freezing the warts.
Pacific Dermato- it takes 6-8 weeks bacilli that can help restore intestinal flora. Dr. Lenahan said he had no conflicts of
logic Association. Staphylococcus after hands ap- For patients with nail ridges, find a glass interest related to his presentation. ■
When patients aureus bacteria pear normal for
complain of in- should be treated that layer to re-
tense pruritus, Dr.
Lenahan of the
University of Cal-
externally, as well turn, so they need
as with a systemic to continue pro-
antibiotic. tective measures
Bias Sways Expert Evaluation
ifornia, San Fran-
cisco, asks them, DR. LENAHAN
from the effects of
water for at least
Of Some Cosmetic Procedures
“ ‘Is your itch dri- that long.
ving you crazy?’ If they answer yes to When the patient presents with staph B Y T I M O T H Y F. K I R N tude toward the procedure: enthusiastic
that, 95% of the time they itch, what furuncles, recognize that Staphylococcus Sacramento Bureau (four), ambivalent (four), or doubtful (two).
they have is scabies.” Scabies mites are aureus bacteria can reside in many areas When the enthusiasts saw the before
nocturnal, and their activity keeps pa- of the skin, and these areas should be P A L M D E S E R T , C A L I F . — A new and after photographs in an unblinded
tients awake. This sleep disruption may treated externally as well as with a sys- study indicates that investigator bias of cos- fashion (so they knew which photographs
be responsible for the extra psychologi- temic antibiotic. Dr. Lenahan suggests metic procedure trial results, including were before and which after), there was
cal edge to the scabies itch, Dr. Lenahan treating the inside of the nose and oth- blinding and prejudice about the value of agreement among them, and they judged
claims, well beyond the itching one sees er skin folds with Bactroban and having the procedure performed, renders those re- an improvement of more than 25% in
with hepatitis, lymphomas, or drug re- patients shower with Hibiclens chlorhex- sults largely unreliable, Dr. David F. Horne most patients, with a greater than 50% im-
actions. idine soap. This alone won’t clear the in- said at the annual meeting of the American provement in two individuals.
Society for Dermatologic Surgery. When the doubters saw the same pho-
Dr. Horne presented data from his study tographs in an unblinded fashion, there
BRIEF SUMMARY OF
PRESCRIBING INFORMATION
of 10 patients who had a Food and Drug was little agreement. While they general-
Administration–approved, noninvasive ly said that most patients showed up to
TM
cosmetic device treatment (which he did 25% improvement, they also said there
not disclose), and then were evaluated were clearly nonresponders.
four times by different dermatologists. Ambivalent dermatologists who saw
The study showed that the evaluations the photographs in an unblinded fashion
differed depending on the evaluator bias, also determined that there were nonre-
For Topical Dermatological Use Only Rx only and that when 4 of 10 of those dermatol- sponders, but overall agreed that most
ogists were blinded to whether the pho- patients showed up to 25% improvement.
Indication For Use
MimyX Cream is indicated to manage and relieve the burning and
tographs they were shown were taken be- Three months earlier, the ambivalent
itching experienced with various types of dermatoses, including fore or after the procedure, they could not group saw the same photographs in a
atopic dermatitis, allergic contact dermatitis and radiation dermatitis. tell which was the before or the after pho- blinded fashion, so that they did not know
MimyX Cream helps to relieve dry, waxy skin by maintaining a moist
wound & skin environment, which is beneficial to the healing to 44% of the time, said Dr. Horne, a der- before from after, and there was less agree-
process. matologist in Boston. ment. They did agree that there was no
Contraindications The study’s subjects were photographed improvement or that the patients were ac-
MimyX Cream is contraindicated in persons with a known
hypersensitivity to any of the components of the formulation. before the procedure and 6 months after- tually worse afterward, Dr. Horne said.
Warnings ward. The pairs of photographs were then “Blinding expert evaluators to the pre-
In radiation therapy, MimyX Cream may be applied as indicated by given to 10 dermatologists expert in that and posttreatment status of standardized
the treating Radiation Oncologist. Do not apply 4 hours prior to a
radiation session. procedure for a standard evaluation with an photographs may have significant effects
Precautions and Observations improvement scale. The dermatologists on the perceived efficacy of a procedure
- MimyX Cream is for external use only. were identified and grouped based on atti- or device,” he said. ■
- MimyX Cream does not contain a sunscreen and should not be
used prior to extended exposure to the sun.
- If clinical signs of infection are present, appropriate treatment
should be initiated; use of MimyX Cream may be continued during
the anti-infective therapy.
- If the condition does not improve within 10 – 14 days, consult a
Beauty Is Truly in the Eye of the Beholder
physician.
- Keep this and other similar products out of the reach of children. L A S V E G A S — Age and gender influ- sponsored by the American Academy of
- MimyX Cream may dissolve fuchsin when this dye is used to define
the margins of the radiation fields to be treated. ence opinions on what makes a face beau- Facial Plastic and Reconstructive Surgery.
HOW SUPPLIED tiful, a recent study showed. The ethnicity of the models or the ob-
MimyXTM Cream is available in a 70 gram tube, NDC 0145-4200-01. Dr. David W. Kim and his associates at servers did not affect ratings, with one ex-
Store at 15°C to 30°C (59°F to 86°F). Do not freeze. the University of California, San Francisco, ception: the narrowest nasal tip was
Stiefel Laboratories, Inc.
Coral Gables, FL 33134 826801-0905 photographed the faces of four women— deemed unnatural in the younger white
two white women aged 30 and 60 years, model. However, the sex of observers
and two Asian women aged 30 and 60 made a difference, with females preferring
Rx only - Prescription Medical Device: Federal Law restricts this years—and used a computer program to a lateral apex to the eyebrow and males
device to sale by or on the order of a physician.
modify three aspects of their faces. They preferring a central apex.
created five eyebrow shapes, six nasolabi- The age of the model and of the observer
REFERENCES: 1. Del Rosso JQ, Bikowski J, Hawkes S, Sanglay L. Use of a
palmitoylethanolamide-containing non-steroidal cream for the treatment of atopic dermatitis:
al angles, and five nasal tip widths. affected scoring. A more lateral eyebrow
impact on the duration of and time between flares. Presented at: 2006 Meeting of the American
Academy of Dermatology; July 2006; San Diego, Calif. Poster 505. 2. Data on file. [TTF clinical
Eyebrows with the most lateral apex apex was preferred in the younger models,
results and protocol], August C. Stiefel Research Institute, Inc. were rated as the least attractive by 171 vol- but a more central apex was considered
MimyX is a registered trademark of Stiefel Laboratories, Inc., and Research in Dermatology is
unteers. The most attractive eyebrows more attractive in the older models.
also a trademark of Stiefel Laboratories, Inc. were those with the apex just short of that. “Standardized guidelines of facial aes-
A moderate nasolabial angle and narrow- thetic beauty cannot be applied universal-
er nasal tip generally were preferred, Dr. ly,” Dr. Kim said.
Kim said at an international symposium —Sherry Boschert