Publications by authors named "Evan Rieder"

43 Publications

Revisiting Solitary Pedunculated Lipofibromas.

Am J Clin Pathol 2021 Jun 14. Epub 2021 Jun 14.

Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY, USA.

Objectives: Pedunculated lipofibromas are soft, compressible, skin-colored nodules that typically present as an acquired solitary lesion, predominantly located on the buttocks and thighs. We aimed to differentiate between pedunculated lipofibromas and nevus lipomatosus superficialis. Although benign, this may be important as treatment options vary.

Methods: We describe 3 cases of solitary pedunculated lipofibromas occurring in older, obese adults that required clinicopathologic correlation for the correct diagnosis.

Results: The histopathologic features of pedunculated lipofibromas include a broad-based lesion with aggregates of mature adipocytes extending upwards into the dermis without an associated inflammatory infiltrate. The primary histopathologic differential diagnoses include fibroepithelial polyps with adipocytes and nevus lipomatosus superficialis, which is more frequently found in children or young adults and is typically characterized clinically by multiple lesions with a cerebriform to verrucoid surface.

Conclusions: While the precise relationship between pedunculated lipofibromas and nevus lipomatosus is still unknown, we propose using pedunculated lipofibroma as a more specific clinical term to refer to solitary pedunculated or broad-based fatty lesions with a smooth surface that occur in older patients and in a wide anatomic distribution.
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http://dx.doi.org/10.1093/ajcp/aqab075DOI Listing
June 2021

How We Do It: Body Dysmorphic Disorder for the Cosmetic Dermatologist.

Dermatol Surg 2021 Apr;47(4):585-586

Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York.

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http://dx.doi.org/10.1097/DSS.0000000000002506DOI Listing
April 2021

How We Do It: Body Dysmorphic Disorder for the Cosmetic Dermatologist.

Dermatol Surg 2021 Apr;47(4):585-586

Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York.

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http://dx.doi.org/10.1097/DSS.0000000000002506DOI Listing
April 2021

Psychosocial Stress and Mechanisms of Skin Health: A Comprehensive Update.

J Drugs Dermatol 2021 01;20(1):62-69

Although the relationship between psychosocial stress and skin health is commonly invoked in both the scientific and popular literature, its underlying mechanisms are still not well understood. In this review, we provide a comprehensive update on the pathophysiology of stress and its clinical impact on skin homeostasis. The recent characterization of a bidirectional HPA stress axis in the skin has illuminated peripheral stress pathways, with effects spanning inflammation, atopy, barrier function, dermal thinning, wound healing, and melanogenesis. Additionally, new research into the cutaneous microbiome suggests the development of stress-induced dysbiosis through the “gut-brain-skin” axis. These new findings help contextualize how lifestyle factors such as diet, personal care practices, and sleep patterns may mediate and sometimes amplify the cutaneous impacts of psychological stress. We aim to clarify these clinically important relationships and highlight areas of future study that have widespread academic, clinical, and commercial implications. J Drugs Dermatol. 2021;20(1):62-29. doi:10.36849/JDD.5608.
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http://dx.doi.org/10.36849/JDD.5608DOI Listing
January 2021

Art in Medical Education: A Review.

J Grad Med Educ 2020 Dec 2;12(6):686-695. Epub 2020 Dec 2.

Assistant Professor, Ronald O. Perelman Department of Dermatology, New York University Langone Health.

Background: The use of fine art in medical education has a long history. Numerous studies have investigated the potential benefits of incorporating art in medical education; however, there are gaps in knowledge regarding the efficacy, methodology, and clinical significance of these studies.

Objective: This scoping review of the literature aims to describe the available literature on the incorporation of art education in medical school and residency.

Methods: PubMed, Google Scholar, and MedEDPortal were queried from their inception dates through December 2019. English-language studies providing a detailed methodology and detailed analysis were included. A total of 37 studies were identified. Upon further screening of the studies' methodologies and results, 16 studies describing art education implemented with medical students and 12 studies describing art education implemented with residents were included for final review.

Results: Various methods of art education exist, including Visual Thinking Strategies (VTS), rigorous curricula, and unstructured roundtable discussions with art curators or artistically minded clinicians. Studies range in duration, art media, and type of analysis.

Conclusions: There has been an increasing effort to incorporate fine art education into medical training, primarily to enhance visual perception skills and empathy. Although there is limited research on its efficacy, and wide variations in study methodologies exist, results consistently indicate that participants find the incorporation of art into curricula beneficial. Further research analyzing which methodologies are most likely to yield statistically and clinically significant improvements in visual perception and empathy may lead to increased utilization of this teaching method.
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http://dx.doi.org/10.4300/JGME-D-20-00093.1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7771590PMC
December 2020

Cosmetic procedure use as a type of substance-related disorder.

J Am Acad Dermatol 2021 Jan 10;84(1):86-91. Epub 2020 Sep 10.

The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York. Electronic address:

Background: A role for addiction psychiatry in aesthetic treatment-seeking behavior has been evidenced for ultraviolet light tanning.

Objective: We aim to demonstrate an initial proof of concept for the presence of addictive behaviors in cosmetic procedure use.

Methods: Adults visiting a cosmetic dermatology practice with history of at least 1 cosmetic procedure and consideration of at least 1 cosmetic procedure in the past 12 months were included. Two previously validated instruments in the detection of alcohol use disorder, the Cut Down, Annoyed, Guilty, Eye-Opener (CAGE) questionnaire, and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) criteria were modified to evaluate participants for a substance-related disorder (SRD) in cosmetic procedures.

Results: Of 153 adults, 34 (22.2%) met modified CAGE criteria, and 40 (26.1%) met modified DSM-V criteria. Results from both instruments were significantly associated (P < .0002). Significant differences in consideration and use of cosmetic treatments were found in SRD positive versus negative groups (P < .0001 and P = .009, respectively).

Limitations: Preliminary criteria for SRD in cosmetic procedure use in this study has not yet been validated.

Conclusions: A type of SRD involving cosmetic procedures may exist, and qualifying individuals may have increased cosmetic treatment use. Future efforts to rigorously validate an instrument for SRD detection in cosmetic procedures use are warranted for future research and clinical application.
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http://dx.doi.org/10.1016/j.jaad.2020.08.123DOI Listing
January 2021

Observer-Reported Outcomes and Cosmetic Procedures: A Systematic Review.

Dermatol Surg 2021 01;47(1):65-69

Both authors are affiliated with The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York.

Background: Cosmetic procedures have demonstrated beneficial effects on physical appearance based on anatomic markers as well as patient-perceived self-image and quality of life. Recent studies of observer-reported outcomes (OROs) suggest an additional benefit from aesthetic interventions.

Objective: The authors aimed to review the evidence of OROs from cosmetic procedures performed on the head and neck.

Patients, Methods And Materials: PubMed, Embase, and Cochrane Library databases were searched for relevant studies, yielding 24 included original investigations.

Results: These studies captured 686 total patients, 8,257 observer evaluations, and a variety of interventions including face-lifts, blepharoplasty, rhinoplasty, and minimally invasive treatments including botulinum toxins and hyaluronic acid fillers. Forty-one distinct reported OROs were grouped into 12 descriptive domains. Domains were further grouped into 3 higher-order categories: aesthetics and wellness, social capacities, and skills and competencies. Improved perception after cosmetic intervention is most reproducibly demonstrated for the following ORO domains: age, attractiveness, sociability, relationship success, and occupational and financial competency.

Conclusion: The synthesized findings imply a tertiary layer of benefit for cosmetic intervention beyond anatomical and patient-centered outcomes through enhanced perceptions of others. These findings may inform the pre-procedure risk-benefit discussion with patients of cosmetic medicine and drive future research into longitudinal outcomes.
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http://dx.doi.org/10.1097/DSS.0000000000002496DOI Listing
January 2021

The "bumpy" adolescent nose: Acne associated angiofibroma-like nasal papules.

Pediatr Dermatol 2021 Jan 7;38(1):45-49. Epub 2020 Aug 7.

The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, NY, USA.

Background/objective: Papular scars are a recently described clinical phenotype of acne scarring characterized by papules occurring on the nose and chin. We have observed a similar presentation of nasal papules among patients seen in our clinic for acne and sought to further characterize the clinical and histopathological characteristics of this entity.

Methods: In this single-site case series, a retrospective review of electronic medical records of patients with nasal papules in association with acne vulgaris between April 2018 and April 2019 was performed. Clinical and histopathologic findings were recorded.

Results: We identified 20 patients who presented with a similar clinical phenotype of predominantly skin-colored, dome-shaped papules concentrated on the nose and chin in association with a history of more classic facial acne vulgaris. Papular lesions were seen predominately in adolescent Hispanic males. Concomitant acne on other areas of the face was identified in 18 patients at presentation while two patients had a history of adolescent acne. Biopsies were performed for five patients. Histopathologic examination demonstrated features of fibrosis and dilated thin-walled blood vessels, typical of angiofibromas.

Conclusion: We present a series of adolescent patients with large, flesh-colored to erythematous papules seen predominantly on the nose. These lesions are histologically indistinguishable from angiofibromas and may represent an under-recognized yet disfiguring sequela of acne that may disproportionately affect adolescents with skin of color.
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http://dx.doi.org/10.1111/pde.14319DOI Listing
January 2021

Paradigm Shifts in Understanding Motivation in Aesthetic Medicine.

Facial Plast Surg Aesthet Med 2020 May/Jun;22(3):170-171. Epub 2020 Apr 8.

Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, University of Illinois, Chicago, Illinois, USA.

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http://dx.doi.org/10.1089/fpsam.2020.0095DOI Listing
November 2020

In Response to "Perception Drift".

Authors:
Evan A Rieder

Dermatol Surg 2020 09;46(9):1259-1260

The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York.

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http://dx.doi.org/10.1097/DSS.0000000000002286DOI Listing
September 2020

Patient perception of beauty on social media: Professional and bioethical obligations in esthetics.

J Cosmet Dermatol 2020 May 24;19(5):1129-1130. Epub 2019 Aug 24.

Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, PA.

Recently, social media use has skyrocketed, especially with millennials. The use of filtered images and photo editing has led to a new trend of social media-induced dissatisfaction with appearance, termed "snapchat dysmorphia" and "selfie dysmorphia". It is important for practitioners to recognize and understand this trend in addition to knowing how to manage these patients. As clinicians, we have bioethical and professional obligations to educate ourselves on new and relevant trends, ensure adequate patient safety, and advocate for continued consumer education.
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http://dx.doi.org/10.1111/jocd.13118DOI Listing
May 2020

Over-the-Counter Hair Loss Treatments: Help or Hype?

J Drugs Dermatol 2019 03;18(3):312

This review of the current available OTC options is much appreciated in the December 2018 article by Bater and Rieder, however, most of the products mentioned have no current research or data in the past decade except for the supplements. In this field of alopecia, supplement data is expanding rapidly.
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March 2019

A Systematic Review of Patient-Reported Outcomes for Cosmetic Indications of Botulinum Toxin Treatment.

Dermatol Surg 2019 05;45(5):668-688

The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York.

Background: Botulinum toxin (BTX) injection is the most popular cosmetic procedure in the United States. Although facial rejuvenation is considered cosmetic, physical appearance has meaningful impact on quality of life (QOL), best measured by patient-reported outcomes (PROs). Patient-reported outcomes are now often required for Food and Drug Administration approval of new pharmaceuticals.

Objective: This review summarizes the PRO instruments and outcomes in evaluating patient QOL after aesthetic BTX administration.

Methods: PubMed, MEDLINE, Embase, Cochrane Library, CINAHL Plus, and PsycINFO databases were searched for prospective studies using PRO instruments to directly evaluate the success of cosmetic BTX intervention.

Results: Five psychometrically validated, facial rhytid-specific PRO tools are currently used in clinical research. Most studies addressing PROs after cosmetic BTX treatment use 1-item Likert scales evaluating overall satisfaction. BTX treatment generally resulted in improved satisfaction and QOL metrics, such as perception of youthfulness, attractiveness, restedness, affect, mood, and self-confidence. Combination treatments, whether of multiple facial areas or with multiple treatment modalities, may improve PROs even further.

Conclusion: Validated, specific PRO instruments can be used to better understand patient expectations in regards to cosmetic treatment, thus helping aesthetic dermatologists maximize patient satisfaction and retention.
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http://dx.doi.org/10.1097/DSS.0000000000001878DOI Listing
May 2019

Thread-Lifts: A Double-Edged Suture? A Comprehensive Review of the Literature.

Dermatol Surg 2019 07;45(7):931-940

Both authors are affiliated with the Ronald O. Perelman Department of Dermatology, NYU School of Medicine, New York, New York.

Background: Thread-lifting has experienced a recent surge in popularity as interest in minimally invasive techniques for facial rejuvenation continues to grow. By placing barbed sutures along specific trajectories to lift the superficial musculoaponeurotic system to address facial ptosis, thread-lifting carries several advantages over the traditional facelift. Over the past few decades, there have been ongoing advances in the implementation of thread-lifting using barbed sutures.

Objective: To review the current evidence regarding the safety and efficacy of thread-lifting for facial rejuvenation.

Materials And Methods: An analysis was conducted of PubMed indexed English language literature regarding thread-lifting using barbed sutures.

Results: Early studies using nonabsorbable barbed sutures described high revision and complication rates. Newer techniques implementing absorbable sutures have fewer adverse events, although the long-term efficacy of these procedures remains unclear.

Conclusion: Thread-lifts play a substantial role in minimally invasive techniques for facial rejuvenation. Additional studies are needed to better evaluate the safety and long-term efficacy of this quick, in-office procedure.
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http://dx.doi.org/10.1097/DSS.0000000000001921DOI Listing
July 2019

In Response to Dayan SH et al, "Assessment of the Impact of Perioral Rejuvenation With Hyaluronic Acid Filler on Projected First Impressions and Mood Perceptions".

Authors:
Evan A Rieder

Dermatol Surg 2020 06;46(6):856

The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York.

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http://dx.doi.org/10.1097/DSS.0000000000001880DOI Listing
June 2020

Over-the-Counter Hair Loss Treatments: Help or Hype?

J Drugs Dermatol 2018 12;17(12):1317-1321

Introduction: A limited number of treatments have been approved for androgenetic alopecia, however, myriad over-the-counter products for hair loss are available and readily purchased by consumers. This study aims to provide an overview of popular over-the-counter hair loss products and to review the available evidence regarding their use. Methods: Top-selling hair loss products were identified using sales data from the online retailer Amazon.com. The active ingredients, consumer ratings, quantity, and price were collected for each product. A search of the literature was conducted for ingredients that frequently appeared on the top-seller list. Results: Forty-two of the top 50 products met inclusion criteria, including orals (21.4%), topicals (35.7%), or shampoos/conditioners (42.9%). Common active ingredients included minoxidil, nutrients (ie, vitamins, minerals, proteins), and plant-based botanicals. 23.8% of products were FDA-approved treatments for androgenetic alopecia. Evidence for non-approved treatments is limited to small studies without generalizability. Discussion: While some over-the-counter treatments may be efficacious, more rigorous study is required. Dermatologists should be equipped to discuss the efficacy of these therapies as well as the risks and benefits associated with their use with patients. J Drugs Dermatol. 2018;17(12):1317-1321.
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December 2018

Volumizing Hyaluronic Acid Filler for Treatment of Infraorbital Hollows.

Authors:
Evan A Rieder

JAMA Facial Plast Surg 2018 12;20(6):525

The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York.

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http://dx.doi.org/10.1001/jamafacial.2018.0679DOI Listing
December 2018

Alopecia Areata and Habit Tic Deformities.

Skin Appendage Disord 2018 Oct 20;4(4):323-325. Epub 2018 Feb 20.

Departament of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.

Nail involvement is a very common finding in patients with alopecia areata (AA). Most commonly evidenced by nail pitting, nail abnormalities can affect up to 66% of AA patients. We present two cases of the unusual association between habit tic nail deformities and AA.
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http://dx.doi.org/10.1159/000486540DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6219232PMC
October 2018

To Form a More Perfect Dermatologic Union.

Dermatol Surg 2018 Sep;44(9):1243-1245

The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY.

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http://dx.doi.org/10.1097/DSS.0000000000001573DOI Listing
September 2018

Dermatologist Practices During Total Body Skin Examinations: A Survey Study.

J Drugs Dermatol 2018 May;17(5):516-520

Though screening for skin cancer is an essential practice in dermatology, limited data are published on dermatologists' total body skin examination (TBSE) behaviors. We surveyed 6500 dermatologists on their TBSE practices, including questions about less commonly examined body sites. We found varied TBSE practices among all dermatologists and discrepancies in examinations between dermatologists of opposite genders. J Drugs Dermatol. 2018;17(5):516-520.
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May 2018

Dermatology on Instagram: An Analysis of Hashtags.

J Drugs Dermatol 2018 Apr;17(4):482-484

Forty-two percent of Americans search for health-related information on social media platforms, and forty-five percent of consumers report that social media health information influences their decision to seek care.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6831082PMC
April 2018

Proximal Subungual Onychomycosis in the Immunocompetent: A Case Report and Review of the Literature.

J Drugs Dermatol 2018 Apr;17(4):475-478

Proximal subungual onychomycosis (PSO), which predominantly involves the nail plate from the proximal nail fold, is the rarest form of onychomycosis. Classically associated with an immunocompromised state, PSO is an uncommon diagnosis in individuals without immunodeficiency. We present a case of a healthy 51-year-old man, who presented with a three-month history of white discoloration of multiple toenails. Physical examination revealed white, opaque patches on the proximal third nail plates of multiple toenails. The affected digits also demonstrated proximal onycholysis, subungual debris, and mild paronychia. Laboratory examinations, including routine serologic studies as well as human immunodeficiency virus and antinuclear antibodies, were within normal limits. Proximal nail fragments of the left hallux showed sections of dystrophic nail plate with mounds of parakeratosis, collections of neutrophils, and hyphae that highlighted with periodic acid-Schiff staining. The patient was diagnosed with PSO and tinea pedis bilaterally and treated with oral fluconazole with gradual improvement. This case of PSO highlights the potential for its rare occurrence in a healthy host. However, the clinical presentation of PSO should trigger an evaluation for possible immunodeficiency.

J Drugs Dermatol. 2018;17(4):475-478.

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April 2018

In response to Lebwohl et al, "Psychiatric adverse events during treatment with brodalumab: Analysis of psoriasis clinical trials".

Authors:
Evan A Rieder

J Am Acad Dermatol 2018 03;78(3):e73

The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York. Electronic address:

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http://dx.doi.org/10.1016/j.jaad.2017.10.052DOI Listing
March 2018

Primary anetoderma with undifferentiated connective tissue disease.

Dermatol Online J 2017 Dec 15;23(12). Epub 2017 Dec 15.

New York University Health, New York.

Anetoderma is a rare benign elastolytic disorder that is characterized by focal loss of elastin fibers on histopathology and is often recalcitrant to treatment. We present a case of a patient with a 20-year history of pruritic and painful hyperpigmented atrophic papules clustered on the neck, axillae, inframammary folds, and right medial thigh. Although the histopathologyof her axillary lesions was consistent with anetoderma, her clinical presentation is unusual given the extent of involvement, reported pain and pruritus, and sharp demarcation of the distribution. The diagnosticuncertainty of this case led to added difficulty in management of a disease that is already notoriously difficult to treat and may significantly impact patient's quality of life.
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December 2017

Papular mucinosis, or localized lichen myxedematosis (LM) (discrete papular type).

Dermatol Online J 2017 Dec 15;23(12). Epub 2017 Dec 15.

New York University Langone Health, New York.

Lichen myxedematosus is condition characterized by localized areas of dermal deposition of mucin, presenting with firm papules localized to few areas of the body. The condition needs to be excluded from scleromyxedema, which, in addition to the firm papular eruption, has areas of induration and is usually associated with a monoclonal gammopathyand systemic symptoms. We present a 62-year-old woman with a several-year history of asymptomatic, firm papules over the face and arms with no evidence of thyroid disease or a monoclonal gammopathy,which is consistent with a diagnosis of localized lichen myxedematosus, the discrete papular variant. The patient is being treated with a topical calcineurininhibitor.
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December 2017

Patient-Reported Outcomes in Onychomycosis: A Review of Psychometrically Evaluated Instruments in Assessing Treatment Effectiveness.

Skin Appendage Disord 2017 Aug 21;3(3):144-155. Epub 2017 Apr 21.

The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY, USA.

Purpose: Onychomycosis is the most common nail disorder and causes morbidity and impaired quality of life (QOL). Patient-reported outcomes (PRO) are patients' assessment of their health status or treatment response. PROs help assess what is most bothersome to patients to identify targets for intervention. We sought to review the PRO instruments currently used to assess QOL and treatment response in onychomycosis patients.

Procedures: A systematic review was performed by searching PubMed, Embase, CINAHL, and PsycINFO databases through December 31, 2016, to identify all English language literature on onychomycosis, PRO, and QOL.

Results: Currently, 5 validated PRO instruments exist specifically for onychomycosis. Oral therapies were most extensively studied using PRO instruments. QOL data generally correlated with clinical change, although patients sometimes reported improvement without any clinically significant nail clearance. The only psychometrically validated PRO instrument used to evaluate treatment response is the OnyCOE-t™.

Conclusions: Clinicians may underestimate the impact of onychomycosis on patients. With recent initiatives from health-care management organizations to improve patient experience and the recent approval of expensive and nonsuperior topical antifungal medications, PROs will be increasingly important in onychomycosis to assess patient priorities and optimize treatment. Future research should evaluate these instruments in special populations and fingernail disease.
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http://dx.doi.org/10.1159/000469666DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5582516PMC
August 2017

The Next Turf War for Botulinum Toxin?

Authors:
Evan A Rieder

Dermatol Surg 2017 Dec;43 Suppl 3:S365-S367

The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York.

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http://dx.doi.org/10.1097/DSS.0000000000001272DOI Listing
December 2017

Frequency of total body skin examinations among US dermatologists.

J Am Acad Dermatol 2017 Feb;76(2):343-344

Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York.

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http://dx.doi.org/10.1016/j.jaad.2016.09.017DOI Listing
February 2017

Onychotillomania: An underrecognized disorder.

J Am Acad Dermatol 2016 Dec 26;75(6):1245-1250. Epub 2016 Jul 26.

Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, Florida.

Onychotillomania is an uncommon and likely underreported condition in which patients repetitively manipulate the different constituents of the nail unit. Onychotillomania is characterized by a range of nonspecific findings, including bizarre morphology of the nail plate and damage to the nail bed and periungual skin. Histopathological changes are also nonspecific, but may be viewed as analogous to lichen simplex chronicus and prurigo nodularis of the skin. Clinical history is essential to making this diagnosis, as effective treatment modalities may focus on behavioral therapies and psychiatric medications.
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http://dx.doi.org/10.1016/j.jaad.2016.05.036DOI Listing
December 2016

A Clinical Review of Laser and Light Therapy for Nail Psoriasis and Onychomycosis.

Dermatol Surg 2017 Feb;43(2):161-172

*All the authors are affiliated with The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York.

Background: There are considerable emerging data in the use of lasers and lights to treat onychomycosis and psoriasis of the nail subunit.

Objective: We aimed to review all of the medical literature on laser therapy of nail psoriasis and onychomycosis published since 1992.

Methods And Materials: We performed a PubMed literature search using the search terms "nail," "laser therapy," "laser surgery," "light," with search terms "psoriasis" and "onychomycosis." In addition, we performed extensive MeSH and bibliographic searches as delineated in the manuscript. Because of the poor quality of evidence, we were not able to complete a quantitative review and thus present our findings qualitatively.

Results: Although the trials are small, PDL (595 nm) and IPL with a 550-nm filter demonstrate compelling data in treating nail psoriasis. Laser studies of onychomycosis fall short on many levels. Q-switched Nd:YAG lasers with very short pulse durations and fractionated CO2 demonstrate the most promise for the treatment of onychomycosis.

Conclusion: The data for treating nail psoriasis and onychomycosis with laser and light therapy are rapidly emerging. With increased subject data, improved study methodology, and more precise output parameters, lasers may become an important modality in the treatment of nail psoriasis and onychomycosis.
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http://dx.doi.org/10.1097/DSS.0000000000000841DOI Listing
February 2017