Dermatology Blog

The FDA has issued a safety alert for some vials of methotrexate, which may contain small flakes of glass. Sandoz is recalling the following products:

Product : Methotrexate Injection, USP, 50mg/2mL
NDC Number : 66758-040-02 (10 vial pack) and 66758-040-01 (Individual vial)

Product : Methotrexate Injection, USP, 250mg/10mL
NDC Number : 66758-040-08 (10 vial pack) and 66758-040-07 (Individual vial)

If you have one of the affected vials, call the dedicated Methotrexate Recall Hotline at 1-888-896-4565 (staffed around the clock) or email  Sandoz.methotrexaterecall@gencopharma.com. If you have already used some of the methotrexate and have experienced any side effects that you think might be related to the recall, contact your doctor right away.

I think this discovery is very exciting.  In the early online edition of the journal Nature, scientists report that they were able to observe the "healing" of a DNA strand that had been damaged UV radiation.  They observed an enzyme inject a single electron and proton into a damaged strand of DNA.  This enzyme known as photolyase was able to heal the DNA in a billionth of a second.

UV radiation causes damage to cells by creating chemical bonds in the wrong areas on DNA.  Photolyase actually breaks those incorrect bonds and puts them back together correctly.  Then the electron and proton get expelled back to photolyase which moves on to the next bond.

Of course knowing what's going on at the molecular level is just the beginning, but the possibilities of sunburn, skin cancer, and even wrinkle treatment are enormous.

Many teenagers have acne and one of the most difficult issues with treatment is consistency.  Teens have busy lives and often don't think about their skin care regimen every morning and night.

In the past tretinoin (Retin-A, Avita, Retin-A Micro, Renova) could not be used at the same time with benzoyl peroxide because they inactivate eachother.  Both topical medicines help fight acne by different means and using them together is more effective than using one medication alone.

In the past this meant using tretinoin at night and benzoyl peroxide in the morning, but often teens would get frustrated with what one of my patients called "always putting gunk on my face".

A new study just out shows that a new tretinoin formulation, Retin-A Micro Pump, used with benzoyl peroxide in the morning is as effective as splitting the application of tretinoin and benzoyl peroxide.

While this may be great news to teens who want to simplify their skin care routine, insurance companies aren't going to care that this is a more effective treatment.  It's likely that most insurance companies will not cover this new formulation.  Why pay for a more expensive treatment when the teen just needs to be more consistent with a cheaper option.

Scientists have recently discovered an important mechanism the skin uses to form scars after an injury. Normally when the skin is injured special cells come in and produce proteins like collagen that act as a scaffolding for the full repair of the skin.

In a study published in Nature Cell Biology, researchers found that one type of these specialized repair cells called fibroblasts which normally produce collagen, stop their production completely.  In addition, these fibroblasts actually release proteins that break down collagen. As these dormant cells accumulate in the wound they reduce the formation of excess scar tissue.

The scientists also discovered a protein that is responsible for making the fibroblasts go dormant.  They were able to apply this protein topically to the skin reducing the amount of scar tissue that was formed.

This experiment was done on rats so it still needs to be tested on humans.

In a recent study published in the Proceedings of the National Academy of Sciences investigators found that a sticky compound found in sunless tanners may help with wound healing after surgery.

Often when someone has surgery that requires taking out a sizable amount of tissue, like with removal of a breast mass or a large sebaceous cyst, a large hole remains after the skin is sutured.  This hole can often fill up with fluid that prevents wound healing so surgeons often have to leave a drain in the wound which is uncomfortable and often inconvenient.

The investigators found that a sticky gel containing polyethylene glycol and a polycarbonate of dihydroxyacetone (MPEG-pDHA) can be used to "glue" the hole shut preventing the build-up of fluid and the need for a drain.

Now this is where the story gets interesting.  This sticky gel is the same one that's used in sunless tanners to get the tanner to stick to the skin without getting rubbed or washed off.  If you've ever used sunless tanner you know that it doesn't last long, maybe a week at the most.  That's because DHA is a substance that's naturally made in the body so this gel is biodegradable and water-soluble.  In a wound it would help start the healing process and then disappear just as the tissue is "knitting" together.

The current "Band-aid gels" are made from animal products and they take a long time to break down, raising the risk of infection.

This new gel hasn't been tested in humans yet but in the next couple of years we may see fewer and fewer drains used after surgery.

A recent study published in The Journal of the American Academy of Dermatology shows that skin cancers that occur on the face, occur more commonly on the left side.

This shows that people need to be aware of all the situations that expose them to the sun. This includes not only professional drivers but also people who commute regularly.

A new report is out on the prevalence of herpes simplex virus, type 2 (HSV-2) in the United States between 2005 and 2008 and it shows some interesting statistics.

• About 16% of Americans between 14 and 49 years old have genital herpes.
• This percentage is about the same as 1999 to 2004 data.
• 81% of those infected with HSV-2 have not been diagnosed.
• More women and non-Hispanic blacks have HSV-2 than any other demographic.
• 21% of women have HSV-2 which is almost double the prevalence in men.
• 39% of non-Hispanic blacks have HSV-2 which is 3 times higher than the prevalence in whites.

Currently blood tests to determine the presence of antibodies to HSV-2 are not recommended routinely, but the following populations might benefit:

• People with multiple sex partners
• People who are HIV positive
• Men who have sex with men

Scientists have learned that lacking a certain omega-6 fatty acid causes severe dermatitis.  In a recent experiment investigators found that mice who don't have the gene that helps produce arachidonic acid, an omega-6 fatty acid, develop severe dermatitis that causes ulcers and severe itching.  The itching went away when arachidonic acid was added to their diet.

While it may sound like taking an omega-6 fatty acid will cure itching in people who have severe dermatitis, we can't make that leap yet.  There are many other factors that we don't understand about how omega-6 fatty acids function.  This just lets us know we need to learn more about this process.

In a study published in the Journal of the National Cancer Institute researchers found that with a sun safety program it is possible to get kids in school to consistently wear sun protection hats.  The study also showed that kids did not consistently wear the hats at home and wearing hats consistently didn't prevent new moles or freckles.

In the study fourth-graders at 22 schools were given 2 tightly woven wide brim hats to wear outside. One hat stayed at school and the other hat stayed at home. The schools that had the highest hat use had teachers and principals that encouraged the sun protection program and wore hats outside themselves.