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NPs and PAs in Dermatology
 
Clinical Considerations for Derm NPs and PAs
image description here In this month's Clinical Considerations for NPs and PAs, the discussions surround the role of Staphylococcus strains in atopic dermatitis, the reporting of patch test readings in kids, and, finally, the use of propranolol in treating infantile hemangiomas.
Read my takeaways and the full stories below!
 
CLINICAL CONSIDERATIONS
 
Do you target staph strains in your AD patients?
According to this study, patients with more severe AD were more likely to have flares associated with Staphylococcus aureus. Patients with less severe disease had flares associated with Staphylococcus epidermidis. This data is insightful with respect to the bacterial environment on the skin of AD patients as differentiated by severity. However the clinical implications are not yet clear. Perhaps this data will have implications regarding when to target or not target Staphylococcus in the disease cycle of AD patients.
How would this data impact your practice?
 
Positive patch test reports underreported
Acute Contact Dermatitis is prevalent in the pediatric population. Dr. Sharon Jacob, professor of dermatology at Loma Linda University, confirmed that results of patch test readings are underreported. She points out the need to perform a delayed reading at 72-120 hours after initial application.
Do you perform patch testing on children in your practice, if so, how do you report positive results?
 
Another look at propranolol for infantile hemangiomas
The decision to treat an infantile hemangioma follows the risk versus benefit discussion with the patient's family and often hinges on perceived safety of the proposed treatment options. Parents and providers may opt to delay treatment in the hope of a spontaneous resolution rather than initiate treatment. Propranolol and Prednisolone have 90% response rates. A recently published single-site, non-inferiority study with a randomized design suggests that efficacy and safety of propranolol was comparable to steroids as a first-line therapy for infantile hemangioma.
This article discusses long-term safety considerations.
 
JOB OPPORTUNITIES
 
 
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