More ‘low value’ dermatology practices put on notice  

As part of the Choosing Wisely initiative, the Australasian College of Dermatologists (ACD) has recommended against systemic non-sedating antihistamines for conditions such as eczema and psoriasis which are not mediated by histamine.

It said non-sedating antihistamines were of no clinical value for these indications. Instead, they should be managed with topical anti-inflammatory therapies and/or systemic immunomodulation.

The ACD said non-sedating antihistamines are only of value if treating pruritus in a setting of urticaria and according to the ASCIA guidelines.

In other recent ACD recommendations:

• Do not routinely prescribe or recommend topical steroids Class II and above on the face including periorbital areas, or flexural areas of skin (axilla/groin and natal cleft).
• In inflammatory skin conditions, review a diagnosis and/or treatment/adherence if the patient has not responded to adequate prescribed topical steroids after two weeks.

Bogus doctor convicted for providing cosmetic treatments

A Victorian woman who posed as a doctor to provide cosmetic treatments such as dermal fillers has been convicted and fined fined $15,000 after a prosecution case brought by AHPRA.

Ms Aliaa Mohammed Elmetwally Ismaeli Sherif was convicted of 10 charges under the Health Practitioner Regulation National Law after pleading guilty to operating a cosmetic clinic using the names ‘Feel Young Again’ and ‘The Good Life Anti-Aging’ in Wheelers Hill, Victoria.

The charges included falsely claiming to be a medical practitioner, giving medical advice to patients, injecting them with dermal fillers and botox, and providing unapproved antibiotics.

In delivering her sentence the magistrate described Ms Sherif’s offending as very serious, wilful, and noted that it had continued even after AHPRA issued a cease and desist letter.

Medical Board of Australia Chair Dr Anne Tonkin said: ‘We hope this matter serves as a deterrent to anyone considering such behaviour. Members of the public are encouraged to ensure the medical practitioner they are seeing is properly registered by checking the online register of practitioners.’

Long term exposure to guselkumab effective in psoriasis

The IL-23 inhibitor guselkumab maintains high levels of clinical response and PRO improvement through five years in patients with moderate-to-severe psoriasis.

Results from the VOYAGE 1 and 2 trials, comprising almost 2,000 patients, included clinical responses at week 252 respectively of 84.1% and 82.0% (PASI90); 82.4% and 85.0% (IGA0/1); 52.7% and 53.0% (PASI100); and 54.7% and 55.5% (IGA0).

About 70% of patients also achieved DLQI 0/1 – no effect of psoriasis on patient life – which was maintained through to week 252.

The most commonly reported adverse events (>10%) were nasopharyngitis, upper respiratory tract infection, hypertension, and arthralgia.

“These comprehensive results confirm that guselkumab, administered as a 100 mg  subcutaneous injection at weeks 0 and 4 followed by every-8-week dosing, maintains long-term efficacy for at least 252 weeks in the majority of patients.” the study authors said.

British Journal of Dermatology