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New Developments in Tetracycline-Class Antibiotics

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New Developments in Tetracycline-class Antibiotics

Dr. Christopher Bunick & Dr. Adam Friedman

 

Tetracycline antibiotics are like the Snickers of dermatology. Instead of “Hungry? Grab a Snickers,” “Acne? Grab a tetracycline…” for months even though this goes against clinical guidelines and concerns regarding antimicrobial resistance (woof, thats a mouthful for a slogan). Like a Snickers, they fulfill a need, they’re good for a whole lot, but too much, not so good. We have seen some evolution in maximizing the clinical benefits of our therapeutic Snickers, such as subantimicrobial dosing, but more innovation is needed to get the most anti-inflammatory bang for our buck. Enter the concept of narrow spectrum antibiotics and sarecycline.

 Join host Dr. Adam Friedman on an investigative journey detailing how antibiotic structure and function can meet to yield novel properties with Dr. Chris Bunick, Associate Professor of Dermatology at Yale School of Medicine and captain of crystallography and cryo-electron microscopy. Hear first hand how a simple idea morphed into a groundbreaking program. Complete your understanding of how antibiotics can be anti-inflammatory. Love the new narrow spectrum lexicon (or try at least).

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This enduring activity is supported by an independent medical education grant provided by Almirall, LLC.
Learning Objectives
Upon completion of this podcast, learners should be able to:
  • Summarize the mechanism of action of tetracycline antibiotics and their role in acne
  • Define narrow spectrum antibiotic, and understand the clinical translation.

Disclosures

 

Adam Friedman, MD, FAAD – Grant/Research: Aclaris, CPN, Almirall. Consultant: SanovaWorks, Oakstone Institute, L’oreal, La Roche Posay, Galderma, Aveeno, Valeant, Microcures, Biogen, Pfizer, G&W Laboratories, Novartis, Occulus, Intraderm, Encore, Exeltis, Menlo, Lilly, Aclaris, Dermira, Berg, Allergan, Zylo Therapeutics, Hoth. Speakers’ Bureau: Regeneron, Dermira, Janssen, AbbVie. Major Stock Shareholder: Zylo, Minorcures.
Christopher Bunick, MD, PhD – Grant/Research: Almirall, Consultant: Almirall, Speakers’ Bureau: Almirall

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Insights On the Pediatric, Adolescent & Adult AD Patient

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New Developments in Tetracycline-Class Antibiotics

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iTunes Google Play Stitcher TuneIn Dr. Christopher Bunick & Dr. Adam Friedman   Tetracycline antibiotics are like the Snickers of dermatology. Instead of "Hungry? Grab a Snickers," "Acne? Grab a…

Current Understanding of the Pathophysiology, Etiology, Prevalence & Burden of AD

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iTunes Google Play Stitcher TuneIn Dr. Peter Lio and Dr. Adam Friedman   In part 2 of this 5 part podcast homage to Atopic Dermatitis, JDD Podcast host Dr. Adam…

NEW Webinar – What’s New in Acne Management: What We Have Learned from Increased Understanding of Acne Pathophysiology

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Featured Article

Featured Webinar

Join Leon H. Kircik, MD; Linda Stein Gold, MD;  and Jonathan S. Weiss, MD as they discuss the medical interventions that target one or more of the key factors contributing to the development of acne lesions.

  • November 10th, 2020
  • 7:00 PM – 8:00 PM EST
Register Now!

Join Leon H. Kircik, MD; Linda Stein Gold, MD;  and Jonathan S. Weiss, MD as they discuss the medical interventions that target one or more of the key factors contributing to the development of acne lesions.

Acne pathogenesis is multifactorial and not clearly understood; a key factor includes genetics and may result as in interplay of release of inflammatory mediators into the skin, follicular hyperkeratinization with subsequent plugging of the follicle, Cutibacterium acne (C. acnes), formerly Propionibacterium acnes or P. acnes, follicular colonization and excess sebum production.

C. acnes has been shown to mediate inflammatory processes at the site of the sebaceous follicle contributing to the formation of free radical species and generating pro-inflammatory cytokines. Excess sebum production and
C. acnes colonization lead to the formation of microcomedones leading to the development of open or closed comedones, inflammatory papules, pustules and cysts characteristic of acne.
Acne severity and grade (comedonal, papulopustular, mixed, nodular), skin type, presence of acne scarring and postinflammatory hyperpigmentation, menstrual cycle history (in women), skin current skin care regimen are
factors influencing treatment with classes of topical agents include: comedolytic (anticomedogenic), antimicrobial, antibiotic and antiinflammatory; each impact on the four main pathogenic features of acne.
Join Drs. Leon H. Kircik, Linda Stein Gold, and Jonathan S. Weiss as they discuss the medical interventions generally targeting one or more of the key factors contributing to the development of acne lesions: follicular hyperproliferation and abnormal desquamation (topical and oral retinoids, azelaic acid, salicylic acid, hormonal therapy), increase sebum production (oral isotretinoin, hormonal therapy), C. acnes proliferation (benzoyl peroxide, topical and oral antibiotics, azelaic acid) and inflammation (oral isotretinoin, oral tetracyclines, topical retinoids, azelaic acid).
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Recommendations for Preparing a Disaster Response Plan

| Aesthetics, COVID 19, Featured Articles, The Latest | No Comments
In a paper recently published by JDD, several experts developed a guide based on their own experiences navigating the challenges of this past year. In a paper recently published by…
Dermatologist looking at skin

What’s New in Dermatology – January 2021

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In the January 2021 issue of the JDD, groups of experts reflect on lessons learned this year in several articles offering guidance and recommendations for practice management and patient care…

Top 10 Most Talked About Articles of 2020

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As 2020 comes to a close, we are excited as we look to 2021. We are incredibly grateful to the researchers who have chosen to publish their work with JDD.…

NEW Webinar – Differentiating Approach to Acne Therapy: Women Vs. Men

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Featured Article

Featured Webinar

Join Leon H. Kircik, MD and Julie Harper, MD as they discuss the mechanisms by which androgen/AR regulate sebocyte activity in acne vulgaris.

  • October 27th, 2020
  • 7:00 PM – 8:00 PM EST
Register Now!

Join Drs. Leon H. Kircik, MD and Julie Harper, MD as they discuss Acne severity and grade (comedonal, papulopustular, mixed, nodular), skin type, presence of acne scarring and postinflammatory hyperpigmentation, menstrual cycle history (in women), and more, as well as the factors influencing treatment with classes of topical agents.

Acne vulgaris is a chronic inflammatory dermatologic disease affecting an estimated 80% of the population at some point in their life; 85% of adolescents and young adult s may experience acne and prevalent in adults with more adult women being afflicted than adult men, raising the possibility that gender difference in skin may influence the pathogenesis of acne and
treatment response.
Dermatologists indicate late-onset or adult -onset acne is becoming increasingly common in women in their 20s to 50s and research shows a large number of women over age 25 have acne and the prevalence of acne remains constant until age 44 at which time there is a decrease in incidence.
Join Drs. Leon H. Kircik, MD and Julie Harper, MD as they discuss Acne severity and grade (comedonal, papulopustular, mixed, nodular), skin type, presence of acne scarring and postinflammatory hyperpigmentation, menstrual cycle history (in women), and more, as well as the factors influencing treatment with classes of topical agents.
Register Now!

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What’s New in Dermatology – January 2021

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In the January 2021 issue of the JDD, groups of experts reflect on lessons learned this year in several articles offering guidance and recommendations for practice management and patient care…

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Premiere Webinar Event: Recognizing the Role of The Sebaceous Gland in Acne

By JDD Webinars No Comments

Featured Article

Featured Webinar

Join Leon H. Kircik, MD and James Q. Del Rosso, DO, FAOCD, FAAD as they discuss the mechanisms by which androgen/AR regulate sebocyte activity in acne vulgaris.

Register Now!

Join Leon H. Kircik, MD and James Q. Del Rosso, DO, FAOCD, FAAD as they discuss the mechanisms by which androgen/AR regulate sebocyte activity in acne vulgaris.

Androgen and androgen receptor (AR) may play important roles in several skin related diseases including androgenetic alopecia and acne vulgaris and recent studies suggest AR and androgens play distinct roles in the skin pathogenesis, and AR seems to be a better target than androgens for the treatment of these skin diseases.

Tune in as Leon H. Kircik, MD and James Q. Del Rosso, DO, FAOCD, FAAD discuss the mechanisms by which androgen/AR regulate sebocyte activity in acne vulgaris, and how suppressing AR function by treating with antiandrogens alone, or in combination with antibiotics (i.e., to reduce bacterial infection) might be a potential therapeutic approach to treat acne more effectively.

The results of this open-label clinical study suggest that a topical cream containing retinol 0.5% in combination with niacinamide, resveratrol, and hexylresorcinol is efficacious and tolerable for skin brightening/anti-aging when used with a complementary skin care regimen including SPF 30 sun protection.

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Recommendations for Preparing a Disaster Response Plan

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What’s New in Dermatology – January 2021

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In the January 2021 issue of the JDD, groups of experts reflect on lessons learned this year in several articles offering guidance and recommendations for practice management and patient care…

Top 10 Most Talked About Articles of 2020

| Featured Articles, The Latest | No Comments
As 2020 comes to a close, we are excited as we look to 2021. We are incredibly grateful to the researchers who have chosen to publish their work with JDD.…

Systemic Antibiotics in the Management of Acne: Issues and Considerations for Optimal Care

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"Systemic Antibiotics in the Management of Acne: Issues and Considerations for Optimal Care"

Drs. Joslyn Kirby and Adam Friedman

 

WEEEEEEERE BACK! Join host Dr. Adam Friedman for lively and learned discussion with Dr. Joslyn Kirby on one of the most common, chronic, soul-crushing complaints… Acne Vulgaris. It is, from a pathophysiological standpoint, a biological sh*t show, but you need to understand it to develop the best treatment plans. We talk inflammation, first line approaches, setting patient expectations and compliance. We dive deep into the differences between broad-spectrum and narrow-spectrum antibiotics, when to use them, and for how long. (Spoiler alert: NOT TOO LONG!). In our efforts to be stewards of meaningful antibiotic use and adversaries of antimicrobial resistance, narrow-spectrum antibiotics are the future!

This enduring activity is supported by an independent medical education grant provided by Almirall, LLC.

Upon completion of this enduring, internet-based educational activity, participants should be able to:

  • Review current scientific understanding of pathophysiology of acne
  • Summarize acne treatment strategies utilizing systemic antibiotics
  • Differentiate safety and efficacy of broad and narrow spectrum antibiotics indicated for acne treatment
  • Cite the benefits of narrow spectrum antibiotic use in acne therapy
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Disclosures:
  • Adam Friedman, MD, FAAD – Grant/Research: Aclaris, CPN, Almirall. Consultant: SanovaWorks, Oakstone Institute, L’oreal, La Roche Posay, Galderma, Aveeno, Valeant, Microcures, Biogen, Pfizer, G&W Laboratories, Novartis, Occulus, Intraderm, Encore, Exeltis, Menlo, Lilly, Aclaris, Dermira, Berg, Allergan, Zylo Therapeutics, Hoth. Speaker’s Bureau: Regeneron, Dermira, Janssen, AbbVie. Major Stock Shareholder: Zylo, Minorcures.
  • Joslyn R. Sciacca Kirby, MD – No relevant disclosures.

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Insights On the Pediatric, Adolescent & Adult AD Patient

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New Developments in Tetracycline-Class Antibiotics

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iTunes Google Play Stitcher TuneIn Dr. Christopher Bunick & Dr. Adam Friedman   Tetracycline antibiotics are like the Snickers of dermatology. Instead of "Hungry? Grab a Snickers," "Acne? Grab a…

Current Understanding of the Pathophysiology, Etiology, Prevalence & Burden of AD

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Once-Daily Polymeric Tazarotene 0.045% Lotion for Moderate-to-Severe Acne: Pooled Phase 3 Analysis by Sex

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Skin of Color Update

Featured Article

Acne is a common dermatologic condition, affecting up to 85% of adolescents and young adults.1 The prevalence of adult acne appears to be increasing in both females and males; however, there are differences in treatment needs and physiology between the sexes that should be taken into account when prescribing acne treatments.

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Data from these studies were pooled and analyzed post hoc to evaluate outcomes by sex

Leon H. Kircik MD, Linda Stein Gold MD, Kenneth Beer MD, Jerry Tan MD, Hilary Baldwin MD, Eric Guenin PharmD PHD MPH, Robert Kang MS, Jognson Varughesei

Acne is a common dermatologic condition, affecting up to 85% of adolescents and young adults.1 The prevalence of adult acne appears to be increasing in both females and males; however, there are differences in treatment needs and physiology between the sexes that should be taken into account when prescribing acne treatments. While most patients experience onset during adolescence, persistent adult acne is more common in female patients.

Additionally, females are more likely to experience recurrences of acne throughout their lives, requiring long-term maintenance treatment.3,4 In terms of skin physiology, males tend to have less epidermal water loss, higher sebum production, and a lower pH than females.5 In females, sebum production is not only lower, it also decreases with age leading to drier skin later in life.5 Along these lines, females are more likely to report dry, sensitive skin,4 which may become more apparent with age.6 These differences between female and male patients with acne could affect treatment efficacy, tolerability, or adherence.

Topical retinoids are the mainstay of acne treatment due to their comedolytic and anti-inflammatory properties.7 Several retinoids are commercially available (eg, tretinoin, adapalene, trifarotene, and tazarotene)1,8 but studies have shown that tazarotene 0.1% cream may be more effective than tretinoin 0.025% or adapalene 0.1% or 0.3% in treating acne.9-11 While the efficacy and safety of topical retinoids are well established,12,13 adverse effects such as irritation, erythema, peeling, and dryness can occur in the first weeks of treatment, especially at higher concentrations.7,12 To address these issues, a new tazarotene 0.045% lotion formulation was developed utilizing polymeric emulsion technology.14 An oil-in-water emulsion—structured by a three-dimensional mesh matrix containing tazarotene along with hydrating and moisturizing agents—allows for more uniform release and increased absorption of ingredients. This easily spreadable and easy-to-use lotion formulation also allows for a lower tazarotene concentration, and when combined with optimized delivery of active and hydrating ingredients, may improve tolerability.14

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Article Cited in this Post

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What’s New in Dermatology – January 2021

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In the January 2021 issue of the JDD, groups of experts reflect on lessons learned this year in several articles offering guidance and recommendations for practice management and patient care…

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Acne, OCPs, and a Side Order of Practical Pearls for the Adolescent Patient

By Acne, Podcast Highlights No Comments

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JDD Podcast

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"Acne, OCPs, and a Side Order of Practical Pearls for the Adolescent Patient"

Dr. Adam Friedman and Dr. Lawrence Eichenfield

JDD Podcast host Dr. Adam Friedman gets first-hand insight from internationally acclaimed pediatric dermatologist Dr. Lawrence Eichenfield on his recent study entitled “Hormonal Contraceptives and Acne: A Retrospective Analysis of 2147 Patients” published in the June 2016 edition of the Journal of Drugs of Dermatology.

Want a refresher on the use of OCPs in Acne? Interested in learning how to initiate a patient based survey study? Just curious how a leader in the field gets an uninterested adolescent to be compliant and engaged in his/her acne care? These are just a few of the practical pearls provided.

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Article Cited in this Post
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New Developments in Tetracycline-Class Antibiotics

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The Latest Research & Discoveries in Acne, Rosacea, Anti-Aging, and Medical Dermatology

By Acne, JDD Highlights, Rosacea No Comments

Dermatology News

JDD Highlights

The June issue of the Journal of Drugs in Dermatology is available now. This month, we focus on Acne and Rosacea, with special features on Public Health, Anti-aging, Aesthetic, and Medical Dermatology.

Read the JDD Now

Acne, Rosacea, Public Health, Anti-Aging, Aesthetic, and Medical Dermatology

The June issue of the Journal of Drugs in Dermatology is available now. This month, we focus on Acne and Rosacea, with special features on Public Health, Anti-aging, Aesthetic, and Medical Dermatology.

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Events
January 13, 2021

Sign Up To Attend Free ODAC Virtual Workshops

Sign up now to attend Free ODAC Virtual 2021 Workshops Sign up now to attend Free ODAC Virtual 2021 Workshops The virtual ODAC conference, taking place January 14 – 17,…
Atopic DermatitisPodcast Highlights
January 11, 2021

Insights On the Pediatric, Adolescent & Adult AD Patient

iTunes Google Play Stitcher TuneIn Dr. Peter Lio, Dr. Lindsay Finklea & Dr. Adam Friedman   You can't truly understand someone until you walk a mile in their shoes. This…
Podcast
January 8, 2021

Insights On the Pediatric, Adolescent & Adult AD Patient

You can't truly understand someone until you walk a mile in their shoes. This is true to so many aspects of daily life, especially when it comes to chronic, relapsing,…

Skin Immune Response: Friend or Foe?

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JDD Multimedia

Translational Lecture Series

Dr. Jenny Kim will review skin’s important role as an immune organ and what happens when dysregulation occurs.

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Skin Immune Response: Friend or Foe? - Exploring the Role of Inflammation and Microbes in Acne Pathogenesis

featuring Dr. Jenny Kim

In this edition of the GW Translational Lecture Series, Dr. Jenny Kim reviews the skin’s important role as an immune organ and what happens when dysregulation occurs.

Presenter

  • Jenny Kim, MD, PhD is a Professor of Clinical Medicine at the David Geffen School of Medicine at UCLA and Chief of Dermatology at the Greater Los Angeles Healthcare System Veterans Affairs.

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Insights On the Pediatric, Adolescent & Adult AD Patient

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November JDD Highlights

By JDD Highlights
The November 2019 JDD is here!
This month, we focus on lasers, light sources, and devices! Take a look at our editorial highlights, editor’s picks, and more below:
Get More from the JDD - Subscribe Today!

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June 16, 2020

A Must-Read: The Business of Dermatology

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June 1, 2020

Controversies in Photoprotection

Adam Friedman, MD, FAAD is Professor and Interim Chair of Dermatology and serves as Residency Program Director, Director of Translational Research, and Director of the Supportive OncodermatologyProgram in the Department…
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May 18, 2020

Does This Skin Cancer Really Need Mohs?

The discussion was led by Dr. Vishal Patel and Dr. Sailesh Konda, and was moderated by Dr. William Hanke. In recognition of National Skin Cancer Month, the Journal of Drugs…