Social media voices on the treatment of skin psoriasis with biologics.

Social media is an outlet for patients to share medical experiences with a large audience. However, the impact of such content on individual patient treatment decisions has yet to be fully explored. We characterized patient experiences posted on social media surrounding biologic use for skin psoriasis. We analyzed content from YouTube, Instagram, and TikTok and identified patient experiences with a variety of biologics, most commonly Humira (20.7%), Cosentyx (14.0%), and Stelara (14.0%). The biologic was described as burdensome in about half of all videos/posts (46.4%), and the most commonly cited reasons included adverse effects or abnormal blood tests (12.8%), cost or insurance issues (11.7%), lack or loss of efficacy (11.7%), and pain with injection or injection site reaction (11.7%). Nevertheless, the majority (60.9%) of videos/posts reported an overall positive experience with a biologic for their skin psoriasis, which may inspire reluctant patients to try a biologic recommended by their physician.

Management of Darier disease: A review of the literature and update.

Darier disease (DD) is a rare type of inherited keratinizing disorder with no definitive therapeutic approach. The objective of this study is to provide a detailed literature review of all the available treatment modalities of Darier disease, including those that are both surgical and non surgical, to compare their efficacies and to propose a novel therapeutic approach. A complete search of the literature for all articles describing the different treatments of Darier disease, with no restrictions on patients' ages, gender or nationalities, was performed with the use of PubMed. A total of 68 articles were included in the study: 3 prospective studies, 44 case reports/case series and 21 letters/correspondences/clinical images. The treatments described were topical, oral or physical. Retinoids (isotretinoin, tazarotene and adapalene) and fluorouracil were the two most effective topical treatments. Oral retinoids were the most effective oral therapy and were prescribed in the cases of generalized Darier disease. For localized and resistant skin lesions, physical therapies including surgical excision, dermabrasion and CO2 laser ablation were the first line choices. Limitations of this article include the inability to verify the accuracy of the published data, the relatively small sample size, the absence of randomized controlled clinical trials and possible unidentified confounding factors in various studies. In every therapeutic approach to Darier disease, consideration of patient comorbidities, disease distribution, severity and treatment accessibility is essential. Large and randomized clinical trials are necessary for the comparison of the efficacy and the safety of all the treatments of Darier disease and settling a consensus for management.

Comparison of microwave ablation, botulinum toxin injection, and liposuction-curettage in the treatment of axillary hyperhidrosis: A systematic review.

BACKGROUND: Primary focal axillary hyperhidrosis is a disorder of excessive sweating that can strongly impact quality of life. OBJECTIVE: The objective if this study was to compare microwave ablation (MA), botulinum toxin (BT) injection, and liposuction-curettage (LC) in the treatment of primary axillary hyperhidrosis based on subjective and objective criteria. METHODS: A systematic review of the literature published in French or English between 1 January 1991 and 1 February 2015 was completed using PubMed and Embase databases. RESULTS: 16 of 775 articles were selected based on relevance and criteria of inclusion and exclusion. The three methods proved to be efficient and safe; however, MA and BT had better results when compared to LC in the short term. Both MA and LC showed longer lasting results when compared to BT. However, in the long term, MA was superior to LC. CONCLUSION: MA, LC, and BT injections are safe and efficient minimally invasive alternatives for the treatment of axillary hyperhidrosis. Well-designed randomized controlled trials are needed to further compare the efficacy of these techniques.

Botulinum Toxin for the Treatment of Excessive Gingival Display: A Systematic Review.

BACKGROUND: To date, no standardized minimally invasive approach for the treatment of excessive gingival display exists. OBJECTIVES: This systematic review aims to assess the evidence in the literature regarding the role of botulinum toxin injection in the management of gummy smile. METHODS: All publications through December 2014 and pertaining to the subject were electronically searched in PubMed, Embase, Scopus, and Web of Science, and the bibliographies of retrieved articles were manually screened. RESULTS: Out of 33 articles, 29 were discarded based on exclusion criteria. Although all 4 selected articles were in line with a role for botulinum toxin injection in the treatment of gummy smiles and the importance of targeting the levator labii superioris alaeque nasi muscle, studies differed in the type and the dose of toxin administered and the technique adopted. CONCLUSIONS: Injection with botulinum toxin is a novel, safe, and cosmetically effective treatment for gummy smile when performed by experienced practitioners. However, further randomized controlled trials are warranted. LEVEL OF EVIDENCE 4: Therapeutic.