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Alpha hydroxy acids are used extensively by patients and consumers for restorative cutaneous purposes. The current study of 32 patients evaluated the clinical and psychosocial effects of this cosmetic therapy. After 12 weeks, significant clinical improvements were found for facial skin tone and free wrinkling, as well as for patient-reported satisfaction with physical appearance and with marital or relationship quality.

Nonpharmacologic management of psychodermatologic conditions includes both structured and unstructured interventions that may ameliorate skin disorders, reduce psychological distress, and improve the functional status of the affected individual. Nonpharmacologic techniques are often referred to as psychocutaneous interventions. This article will review the data on psychocutaneous conditions that have been shown to improve with nonpharmacologic interventions. Suggested clinical approaches to facilitate the implementation of these modalities will be discussed. [ABSTRACT FROM AUTHOR]

The evolving field of facial volume restoration is changing our concept of facial rejuvenation. The older concept that "tighter is better" has been largely supplanted by a philosophy recognizing the importance of volume distribution as a defining characteristic of a more youthful face. It is well recognized that restoration of volume in the upper face can lessen or reverse the bottom-heavy, deflated appearance of the aging face. Perhaps of equal or greater importance is the change in light-reflectance patterns that illuminate the upper cheeks and the eyes. The resultant brighter and "perkier" cheeks can change the objective appearance and the patient's self perception of youthfulness. In this commentary, the author describes techniques to enhance outcomes and patient satisfaction and presents the results of a patient self-report pilot study assessing patient post-injection mood state and functioning. [ABSTRACT FROM AUTHOR]

Presents several letters to the editors of 'The Journal of the American Medical Association,' and responses. Challenges facing family practice and primary care; How a previous article regarding primary care and family practice failed to include service to underserved communities; The need to re-establish a primary care home for patients; Safety of urinary catheters; Thoughts on an article regarding the Cincinnati Radiation Tests.

A letter to the editor is presented in response to the article "Colorectal Cancer: A Summary of the Evidence for Screening and Prevention" in the December 15, 2008 issue.

Background: Concise patient-reported outcome (PRO) instruments addressing the consequences of facial acne vulgaris (AV) on patients’ functioning and activities of daily living (ADL) are needed., Methods: A 12-week, single-arm, prospective cohort study was conducted in patients ≥9 years old with moderate/severe non-nodular facial AV prescribed sarecycline as part of usual care. The primary endpoint included AV-specific patient- and caregiver-reported outcomes assessed with the expert panel questionnaire (EPQ, developed by 10 experts using a Delphi method) in patients (>12 years) and caregivers (for patients 9-11 years). Additional assessments included parental/caregiver perspectives on children’s AV., Results: A total of 253 patients completed the study. Following 12-weeks of treatment, there were significant (P ≤.0001) changes from baseline in the proportion of patients responding that they never or rarely: felt angry (31.6%), worried about AV worsening (28.9%), had thoughts about AV (20.9%), had a certain level of worries about AV (38.7%), altered their social media/selfie activity (23.7%), had an impact on real-life plans due to AV (22.9%), made efforts to hide AV (21.3%), felt picked-on/judged due to AV (15.0%), were concerned about their ability to reach future goals due to AV (13.8%), or had sleep impacted due to AV (18.2%). No significant change from baseline was observed for parent/caregiver’s understanding of the child’s AV concerns, from both patient and parent/caregiver perspectives., Conclusions: Over 12 weeks of AV management with oral sarecycline, patients reported significant reductions in AV-related effects on emotional/social functioning and ADL as measured by the EPQ, a simple PRO with potential for use in clinical practice. J Drugs Dermatol. 2024;23:1(Suppl 1):s4-11.

Background: Patient-reported outcomes (PROs) are emerging as a fundamental component of disease impact assessment in acne vulgaris (AV), complementing clinician-reported outcomes. No data is available on PROs for patients with AV using sarecycline in real-world settings., Methods: A single-arm, prospective cohort study that included patients ≥9 years old diagnosed with moderate or severe non-nodular AV was implemented as part of routine care in clinical practices (N=30). Patients received oral sarecycline (60 mg, 100 mg, or 150 mg) for 12 weeks, as part of usual care. The primary endpoint was Acne Symptom and Impact Scale (ASIS) responses from patients (≥12 years) and caregivers (for patients 9-11 years) at week 12 and change from baseline (CFB). Investigator’s Global Assessment (IGA) of AV severity and adverse events (AEs) were also recorded., Results: A total of 253 patients with AV completed the study (adults: 60.1%, females: 77.6%). ASIS mean scores significantly decreased (P <.0001) at week 12 for: signs (mean CFB ± standard deviation [SD]: –0.8 ± 0.7), impact (–1.0 ± 1.0), emotional impact (–1.2 ± 1.1), and social impact (0.6 ± 1.1). Significant reductions in AV severity (P <.0001) were reported by patients and caregivers. The IGA success rate was 58.9% and physician satisfaction with treatment outcomes was 88.1%. A total of 31 (10.3%) patients reported ≥1 AE during the study., Conclusions: Patients with moderate-to-severe AV receiving acne management with an oral antibiotic for 12 weeks experienced a significant improvement in AV-related symptoms and psychosocial burden. J Drugs Dermatol. 2024;23:1(Suppl 1):s12-18.

Management of patients who pick at their skin can be challenging. Etiologies and maintaining factors of skin picking are often unclear. Significant psychiatric overlay is often present, and the clinician is left with an overwhelming differential diagnosis and poorly focused management plans which can result in suboptimal clinical outcomes. The purpose of this article is to provide a conceptual framework for the evaluation and treatment of a patient presenting with excoriations. Ten diagnostic categories of pickers are described, and specific suggestions for treatment are offered.

Background: Acne profoundly affects patients' lives, but the effect of treatment is not fully characterized., Objective: The purpose of this study was to explore patients' experiences and viewpoints regarding treatment for mild to moderate acne vulgaris., Methods: This was an open-label, single-center study of 30 patients with mild to moderate acne vulgaris, treated with adapalene 0.1%/benzoyl peroxide 2.5% (adapalene-BPO gel) once daily for 12 weeks. An acne-specific quality of life questionnaire (Acne-QoL©) was conducted. Each subject's global assessment (SGA) was recorded at baseline and weeks 4, 8, and 12. Photographs were taken and video interviews were recorded. Local tolerability assessments and incidence of adverse events were documented., Results: A statistically significant number of patients were clear/almost clear (treatment success) at week 12 (P<.001). At week 12, patients experienced a 44.1% and 57.1% mean reduction in inflammatory and noninflammatory lesions, respectively. By week 12, 67% of the patients in the video population (n=27) believed they had achieved treatment success (P<.001). Patients reported higher Acne-QoL© scores at week 12 compared to baseline, indicating better quality of life after treatment with adapalene-BPO gel (P<.001 for all domains). No unexpected adverse or serious adverse events were reported., Limitations: This was an open-label study of 12 weeks duration., Conclusion: Overall, patients with mild to moderate acne treated with adapalene-BPO gel showed significant improvement in disease severity and quality of life. The video recordings chronicled the patients' experiences throughout the treatment process.

There are several words in our current vernacular that reliably elicit powerful cognitive, visual, and emotional reactions in the populace. Undoubtedly, "Botox()" is one of them. Beyond issues regarding the safety of the molecule, there are controversies surrounding the overall legitimacy of the cosmetic use of botulinum toxin type A-1. Many people question whether the cosmetic use of botulinum toxin type A-1 is a "legitimate" medical procedure versus a cosmetic indulgence. The authors report data obtained from a patient self-report questionnaire designed to assess positive or negative changes in feelings and functional status after botulinum toxin type A-1 treatment of the forehead and glabellar region. The authors developed concrete, succinct, and pointed questions pertaining to spheres of function (i.e., work, social, family, intrapsychic, and intimate functioning). Results of this pilot study serve as a persuasive preliminary database to argue that botulinum toxin therapy is more than simply an indulgence therapy.