Off-Label Pearl

Dr. Ted Rosen reviews a case study suggesting dermal microinjections of botulinum toxin A (BTX-A) can improve facial flushing and erythema in patients with refractory rosacea. Botulinum Toxin Microdroplets for Refractory Rosacea Erythema By Ted Rosen, MD, FAADEditor-in-Chief  What would you do if a rosacea patient had persistent severe facial erythema and telangiectasia despite the […]

Off-Label Pearl

Dr. Ted Rosen discusses using dupilumab to treat acquired perforating dermatosis, an unsightly, usually itchy or painful skin condition for which surefire interventions are lacking.  Dupilumab for Acquired Perforating Dermatosis By Ted Rosen, MD, FAADEditor-in-Chief Acquired perforating dermatosis is an umbrella term used to describe a variety of disorders that are characterized by trans-epidermal elimination […]

Off-Label Pearl

Dr. Ted Rosen discusses a simple, efficacious, and cost-effective solution for the treatment of erosive pustular dermatosis of the scalp. By Ted Rosen, MD, FAADEditor-in-Chief Zinc Oxide for Erosive Pustular Dermatosis of the Scalp Erosive pustular dermatosis of the scalp (EPDS) is a rare neutrophilic disorder primarily seen In older individuals. The exact etiology remains […]

Off-Label Pearl

Dr. Ted Rosen discusses using oral fluconazole (300 mg) to treat an itchy, red facial rash in a patient with a history of seborrheic dermatitis and multiple allergies to the preservatives in topical therapies. By Ted Rosen, MD, FAADEditor-in-Chief Oral Antifungal Treatment for Facial Rash A 58-year-old man has had an itchy, red facial rash […]

Off-Label Pearl

By Ted Rosen, MD, FAADEditor-in-Chief Ustekinumab for Cheilitis Granulomatosa A 20-year-old patient was referred due to refractory cheilitis granulomatosa of about one year’s duration. He had already failed systemic, topical, and intralesional steroids, as well as prolonged courses of doxycycline and minocycline.  There was no past medical history of note; specifically, no symptoms to suggest […]

Off-Label Pearl

By Ted Rosen, MD, FAAD, Editor-in-Chief Oral Acitretin for Multikinase Inhibitor-induced Hand-foot Skin Reaction Dermatologists are increasingly being asked to suggest treatments for cutaneous adverse effects associated with an ever-expanding set of cancer chemotherapeutic agents. The field of oncodermatology has only a few well-known experts, and therefore effective treatment of such skin disorders may prove […]

Off-Label Pearl: JAK Inhibitor Upadacitinib for Erosive Lichen Planus 

By Ted Rosen, MD, FAAD, Editor-in-chief Erosive lichen planus, commonly encountered on the oral mucosa, is notably symptomatic (pain) and often difficult to treat. Topical ultrapotent and systemic corticosteroids are considered the first-line treatments of choice. However, systemic steroids carry a plethora of potential side effects, and topical steroids may be difficult to utilize effectively […]

Off-Label Pearl

By Ted Rosen, MD, FAAD, Editor-in-chief Oral Clarithromycin for Yellow Nail Syndrome Yellow nail syndrome (YNS) is an uncommon disorder consisting of the classic triad: yellow, thickened and slow growing nails, as well as lymphedema and chronic pulmonary disease (most often pleural effusion and bronchiectasis). Nails grow only 0.2mm weekly compared with the typical 0.5mm […]

Off-label Pearl

By Ted Rosen, MD, FAAD, Editor-in-Chief Budesonide Powder for Peristomal Pyoderma Gangrenosum? Peristomal pyoderma gangrenosum (PPG) is an uncommon variant accounting for about 15% of all pyoderma gangrenosum (PG) cases.1 PPG is most often associated with underlying inflammatory bowel disease (ulcerative colitis and Crohn disease) but may also be seen near ostomy sites related to […]

Off-label Pearl

By Ted Rosen, MD, FAAD, Editor-in-Chief Acitretin for blockade-induced psoriasis  Immune checkpoint inhibitors (anti-PD-1 drugs) restore the anti-tumor actions of T-cells. However, by decreasing T-cell inhibition, these agents may then provoke a number of autoimmune disorders, including a worsening or induction of psoriasis. Stopping the immune checkpoint drug may be problematic, as treatment options may […]