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FDA Grants Dupixent Priority Review for Moderate-to-Severe AD in Adolescents

The FDA has granted Priority Review for Dupixent (dupilumab) as a potential treatment for adolescents with uncontrolled moderate to severe atopic dermatitis (AD).

Currently, there are no FDA-approved systemic biologic medicines to treat adolescents with moderate to severe AD. The target action date for the FDA decision is March 11, 2019.

The supplemental Biologics License Application (sBLA) is supported by data from a pivotal Phase 3 trial evaluating the efficacy and safety of Dupixent monotherapy in adolescent patients with moderate-to-severe AD, which were presented at the European Academy of Dermatology and Venereology in September.

Dupixent inhibits interleukin-4 and interleukin-13 (IL-4 and IL-13) signaling, which is one of the important contributors to Type 2 inflammation, a systemic response known to play a role in moderate to severe AD. Dupixent is currently approved in the US as a treatment for adults with

moderate to severe AD whose disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable; and as add-on maintenance treatment for patients 12 years and older with moderate to severe asthma with an eosinophilic phenotype or with oral corticosteroid-dependent asthma. In 2016, the FDA granted Breakthrough Therapy designation for Dupixent for the treatment of moderate-to-severe (adolescents 12 to 17 years of age) and severe (children 6 months to 11 years of age) AD not well controlled on topical prescription medications.

Dupixent is also approved for use in certain adult patients with moderate to severe AD in countries of the European Union, and other countries including Canada and Japan. In the US, more than 60,000 adult patients with atopic dermatitis have been prescribed Dupixent to date. Its safety and efficacy in adolescents with atopic dermatitis have not been fully evaluated by any regulatory authority.

Ortho Dermatologics Gears Up to Launch Bryhali Lotion

Ortho Dermatologics expects to start distribution of Bryhali (halobetsasol propionate) Lotion, 0.01%, to US wholesale pharmaceutical distributors later this month.

The company received final approval from the FDA for Bryhali Lotion on November 6. The Lotion, which is indi-cated for the topical treatment of plaque psoriasis in adult patients, is a new potent to superpotent corticosteroid in a novel vehicle lotion with safety established for dosing up to eight weeks.

Bryhali Lotion had initially received a tentative approval from the FDA due to the pending expiration of exclusivity for a related product. The FDA approval of Bryhali Lotion was based on data from two prospective, multicenter, ran-domized, double-blind clinical trials. In clinical trials, Bryhali Lotion was applied once daily for eight weeks and shown to be generally well-tolerated with no increase in epidermal atrophy. In Study 1 and Study 2, 37 percent and 38 percent of patients, respectively, treated with Bryhali Lotion achieved treatment success (at least a two-grade improvement from baseline in Investigator’s Global Assessment (IGA)

and an IGA score equating to “clear” or “almost clear”) at eight weeks, compared to eight percent and 12 percent of patients treated with vehicle. Data from both trials showed that Bryhali Lotion demonstrated significant treatment success over vehicle as early as week two (Study 1) and week four (Study 2), which continued through 12 weeks (four weeks post treatment). The most common adverse reactions, occurring in ≥1 percent of subjects treated with Bryhali Lotion through week eight, were upper respiratory tract infection (2 percent), application site dermatitis (1 per-cent) and hyperglycemia (1 percent).

Galderma’s Restylane Lyft Approved for Midface Injection Via Cannula

The FDA has approved the use of Galderma’s Restylane Lyft with a small, blunt-tip cannula for cheek augmentation and the correction of age-related midface contour deficien-cies in patients over the age of 21.

This approval is the second cannula indication for the Restylane family of dermal fillers. Restylane Silk for lip aug-mentation and Restylane Lyft for the midface are the only

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hyaluronic acid-based fillers on the market that are FDA-approved for use via cannula.

“I am thrilled that the FDA has approved Restylane Lyft for midface via cannula. I prefer using a cannula vs. a needle when injecting specific areas of the face,” says Anne Chapas, MD, a dermatologist in New York City and clinical trial investigator for Restylane Lyft for midface injection via can-nula, in a news release. “In my experience, the use of a can-nula may be associated with less potential damage to blood vessels, help minimize patient bruising, help decrease swell-ing, and allow for minimized downtime.”

A multicenter, open-label, prospective study was con-ducted to assess the safety and efficacy of Restylane Lyft with lidocaine for cheek augmentation and the correction of age-related midface contour deficiencies in conjunction with the use of a small blunt tip cannula in the midface. The 16-week study took place in four centers across the US, with 60 male and female subjects 22 years of age or older. At 16 weeks after treatment, 98.3 percent of subjects showed improvement in both the right and left midface based on the treating investigator’s assessment using the Global Aesthetic Improvement Scale (GAIS), a global 7-point scale for aesthetic improvement in appearance.

Following treatment, no severe related adverse events were observed. The majority of reported subject diary symp-toms after initial treatment were tolerable (88.3 percent) and resolved within seven days, the study showed.

Ilumya Now Available for Moderate to Severe Plaque Psoriasis

Ilumya (tildrakizumab-asmn) 100mg/mL from Sun Pharmaceutical Industries, Ltd. is now available in the United States. Ilumya is an injectable interleukin-23 (IL-23) inhibitor approved by the FDA for the treatment of moderate to severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy. Ilumya injections are administered by a healthcare provider every

12 weeks, following starter doses administered at Week 0 and Week 4.

A pooled analysis of Phase 3 studies presented recently at the European Academy of Dermatology and Venerology (EADV) Congress demonstrated the clinical results of Ilumya 100mg/mL were sustained over a three-year period, and the medicine was well-tolerated with very low drug-related serious adverse events and discontinuation rates. Most com-mon (≥1%) adverse reactions associated with Ilumya 100 mg treatment are upper respiratory infections, infection site reactions, and diarrhea.

“We saw that nine out of 10 patients who achieved 75 percent skin clearance, or PASI 75, at Week 28 after three doses of Ilumya 100mg maintained their skin clearance after three years on treatment. Skin clearance was also sustained over the long-term in 67.6 percent of patients who had reached PASI 90 after the first three doses of Ilumya,” says study investigator Andrew Blauvelt, MD, board-certified dermatologist and President of Oregon Medical Research Center. “These long-term data tell us that quarterly maintenance dosing of Ilumya offers clinically meaningful benefits over time, which is promising news for patients and clinicians.”

Additional analyses presented at Academy of Managed Care Pharmacy (AMCP) Nexus 2018 used the 10-year Markov model to demonstrate the cost-effectiveness of Ilumya as a first-line treatment. The data results demon-strated that Ilumya is among the most cost-effective options compared to non-targeted treatments, such as apremilast. Furthermore, Ilumya was more cost-effective than other biologic options including secukinumab, guselkumab, ixeki-zumab, adalimumab, ustekinumab and etanercept.

Sun Pharma says it is working closely with relevant stake-holders to ensure Ilumya is accessible to patients with mod-erate to severe psoriasis across the US who may benefit from this new treatment option.

New Study to Assess Treatments for Antibiotic-Resistant Skin Infections

Investigators from LA BioMed have scored a $5.3M grant from the National Institutes of Health to study the effective-ness of treatments for antibiotic-resistant skin infections.

The study, Short and Long Term Outcomes of Doxycycline Versus Trimethoprim-Sulfamethoxazole for Skin and Soft Tissue Infections Treatment, is slated to enroll 462 patients with skin infections who will be monitored for a year. The investigators will examine how well certain anti-biotics treat infections, how infections recur, and how those that do recur can be prevented.

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The first participants will be enrolled in the clinical trial later this month. Along with studying the effectiveness of skin infection therapies, the grant funding will also allow investigators to give comprehensive and accurate descrip-tions detailing individual and group outcomes from the clinical trials. Additionally, investigators will use profes-sional and experienced community partners throughout the trial, to ensure patient needs are met while they are enrolled in the trials.

Study Shows Topical Endocannabinoids Effective in Mouse Model of Lupus

Zylö Therapeutics’ patented Nanopod aerogel delivery technology was used to demonstrate the efficacy of endocan-nabinoids in a model of cutaneous lupus in a study presented at the meeting of the American College of Rheumatology.

She’s PsO Stylish…

As any fashionista can attest, Louise Roe embodies all things style—from her elegant clothing and make-up to her signature tresses and glowing skin.

The British fashion journalist and Front Roe blogger is no stranger to the red carpet and is best known for hosting MTV’s makeover show “Plain Jane,” Fox Asia’s “Fit For Fashion,” and covering glam events for NBC’s “Access Hollywood.”

Part of being red-carpet ready often involves showing a little skin whether with an off-the-shoulder dress, a revealing neckline, or a mini skirt—and this can be hard if you have psoriasis.

Ms. Roe is one of the millions of people who live with the inflamma-tory skin disease—and flares can get in the way of her liveli-hood.

“Working in fashion, there is a lot of focus on appear-ance and it’s not just clothes, but also skin care products and make-up trends and…I was hosting on the red carpet almost every night,” she says of the time leading up to her psoriasis diagnosis 10 years ago. “I was expected to wear dresses, but when you are dealing with a flare and your dress is sleeveless, it can be super stressful and I started to wear clothes just to be safe that would cover me completely.”

And if her symptoms got so bad that she couldn’t hide them, Ms. Roe would end up canceling personal and work plans.

She is now coming forward to share her experience as part of the Inside Perspective campaign with Celgene Corporation and Otezla (apremilast). “By sharing my story through this campaign, I hope to encourage others to better under-stand their condition from within and feel more confident in their skin, too,” she tells Practical Dermatology®.

“It’s a play on words,” Ms. Roe says of the campaign’s title. “It is educating people that psoriasis does start inside the body, not outside and [it’s] also

about shifting your perspective whether you are a sufferer or friend or family member of someone with psoriasis.”

Ms. Roe had the opportunity to swap worlds for a day with one of her fans who lives with moderate to severe plaque psoriasis and takes Otezla. Their experi-ences are chronicled in a video where they share their inside perspectives as well as the importance of looking beneath the surface and embracing who they are both inside and out. Learn more about the new campaign at PsOPerspective.com

Style Expert Louise Roe Opens Up about Life on the Red Carpet with Psoriasis

BY DENISE MANN

SPECIAL REPORT

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There is growing evidence that manipulation of the endo-cannabinoid system has immunomodulatory activity that could be clinically translated to a broad range of cutaneous and systemic inflammatory diseases, although data are lim-ited especially with respect to topical administration. The presented study evaluated local application of the endocan-nabinoid anandamide (AEA), using Zylö’s Nanopod delivery particles, in lupus-prone mice.

Mice treated with AEA-releasing nanopods (twice per week for 10 weeks) had significantly fewer and smaller skin lesions compared to both control arms. This improvement was noted where the nanopods were directly applied and where they were not applied, notably the face/snout region. At the time of sacrifice, whereby the mice were scored blindly using a modified CLASI tool, mice treated with AEA-releasing nanopods had significantly fewer macroscopic lesions, and significant histologic improvement was seen.

Together, these data demonstrate that topical administration with AEA-releasing nanopods significantly prevents the devel-opment of CLE in a well-established animal model of lupus. This work also reinforces the rationale of targeting the endocannabi-noid system for autoimmune rheumatic diseases and the utility of using the nanopod delivery system to enhance efficacy.

Adam Friedman, MD, Professor of Dermatology at the George Washington School of Medicine and Health Sciences and co-author of the abstract, says, “The Nanopod tech-nology improved cutaneous delivery of the cannabinoid studied, which typically has poor skin penetration, and allowed for sustained release that significantly impacted the therapeutic effect in an animal model of cutaneous lupus, highlighting the potential of this class of active agents and the delivery system as well.”

New from xMedica: Aesthetics Conference Features Energy Based Treatments for Sexual Wellness

Medical education consortium xMedica LLC of Atlanta has developed a new educational initiative, “Energy-Based Devices & Injectable Treatments for Improving Male & Female Intimate Wellness.” The goal of this conference is to present factual data in a CME setting to address this new arena for practitioners.

According to meeting chair, board certified dermatologist and Director of Skin Laser Specialists of NY and NJ, David J. Goldberg, MD, JD, “We recognized that there was a void in the market for an educational conference in this evolving area of aesthetic medicine. This program brings together experts across multiple specialties, including Dermatology, Gynecology/Uro-Gynecology, Plastic Surgery, Urology, and

Scott Peterson, PhD to Head Medical Affairs at Evolus

Dr. Peterson brings over 20 years of diverse research expe-rience ranging from preclinical early compound discovery to post-marketing clinical study design. He has been the recipient of numerous academic research awards from the NIH and the National Multiple Sclerosis Society. Earlier in his career, Dr. Peterson held roles of increasing responsibility at Allergan and SkinMedica. Prior to joining Evolus, he served as Head of US Medical Affairs for SkinCeuticals, L’Oreal.

Alastin Receives Patent for TriHex TechnologySpecifically, the United States Patent and Trademark

Office issued U.S. Patent No. 10,086,035 entitled “Compositions and Methods for Invasive and Non-invasive Procedural Skin Care” to Alastin. The patent covers topical compositions for promoting skin repair based on Alastin’s platform TriHex Technology. Products with Alastin’s TriHex Technology include Alastin’s Procedure Enhancement Line and their Restore & Renew daily skin care line.

Skin Cancer Foundation: Champions for Change Gala Raises $600,000

More than 400 guests attended the event, including Skin Cancer Foundation donors, industry and physician allies, celebrity support-ers and members of the media. Notable guests included Sofía Vergara, David Harbour, Condola Rashad, Kayli Carter andDolores Catania. Singer/songwriter Neil Sedaka performed a medley of his classic songs.

The Champion for Change Award was presented to Robert J. Friedman, MD, clinical professor at NYU School of Medicine, Department of Dermatology, for his dedica-tion to skin cancer education. The 2018 Media Award was presented to O, The Oprah Magazine, in recognition of its outstanding skin cancer-related editorial coverage.

MORE HEADLINES FROM DERMWIRE.COM

Courtesy of Skin Cancer Foundation.

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Internal Medicine to present a balanced overview of the optimal treatments and hands-on training on how to imple-ment these procedures safely into a practice.” Hear more from Dr. Goldberg on p. 70.

The program will open with a review of the diverse energy modalities that have evolved as effective treatment options for the most common conditions of concern to patients, including stress and urge urinary incontinence, atrophic vag-initis, dryness, and erectile dysfunction. Attendees will have the opportunity to review the literature in the key areas of Radiofrequency, CO2 and Erbium lasers, Li-ESWT, HIFEM, PRP, and other modalities.

According to Wendy Lewis, President, Wendy Lewis & Co Ltd, Global Aesthetics Consultancy, “There is also a need for practitioners to understand how to effectively incorporate these modalities into their practices in the most sensitive way. Attention will be given to the patient consultation and tips for starting the conversation on sexual health and well-ness treatments.”

To register, visit events.x-medica.com/step/

Study: Fine Water Particle Sprays Improve Skin Moisture

Spraying fine water particles onto the face in winter, when skin is dry, improved skin hydration and softening, accord-ing to a new study in Skin Research & Technology.

In addition, water retention remained constant at 360 minutes after spraying, the study showed.

The benefits occurred because the diameter of the sprayed fine water particles was smaller than the intercel-lular spaces in the skin, and the particles were non-charged. Typical steam and mist humidifiers generate larger water particles and increase indoor humidity that can promote mold growth.

The findings indicate that sprays of non-charged fine water particles may help moisten skin in low humidity envi-ronments, the study authors conclude.

Cooling Caps and Other Cooling Methods May Prevent Taxane-Induced Dermatologic Events

Cooling therapies such as cold caps, scalp cooling systems, frozen gloves, and frozen socks may offer the best protec-tion against the adverse effects of taxane-based chemother-apy, according to a new study in JAMA Dermatology.

“Taxanes induce dermatologic changes through direct cytotoxic effect,” says study author Adam Friedman, MD,

director of the Supportive Oncodermatology Clinic at the GW Cancer Center, professor of dermatology at the GW School of Medicine and Health Sciences, in a news release. “While they are an important tool in our chemotherapy armamentarium, cutaneous side effects can limit their use and therefore we want to establish the best approaches, both prophylactic and active, to limit their negative impact.”

Dr. Friedman and his team at GW performed a compre-hensive systematic review of 34 studies published between January 1, 1980 and August 13, 2018 to assess the efficacy and safety of interventions to prevent taxane-induced der-matologic adverse effects.

The team found cold therapy offers the most promising preventative intervention for taxane-induced dermato-logic events, followed by urea-based creams specifically for hand/foot side effects, while off-label use of topical lovastatin and systemic corticosteroids did not provide adequate protection.

“Most of the studies we looked at support the use of cold caps or scalp cooling systems to reduce hair loss,” Dr. Friedman explains. “These seem to be the most effective in preventing taxane-induced alopecia, and there is even evi-dence supporting their ability to prevent toxic events affect-ing both the skin of the hands/feet and the nails.”

Additional research is needed to establish routine proto-cols for cooling methods and to identify new approaches to mitigate these adverse events, says Dr. Friedman. Researchers must also determine more standardized outcome measures for successful hair, skin, and nail injury prevention, and the long-term efficacy and safety of these interventions.

New from Lumenis: NuEra Tight Radio Frequency Device

Lumenis has launched NuEra tight, a non-invasive, intelli-gent temperature-controlled technology for both superficial and deep heating that treats a variety of conditions, such as skin laxity and the appearance of cellulite.

The FDA-cleared technology is able to target problematic areas around the abdomen, flanks, buttocks, inner and outer thighs, upper arms, elbows, knees, bra and back fat, as well as around the eyes, mouth, cheeks and neck with powerful, temperature-controlled RF technology.

NuEra tight uses Automatic Power and Impedance Control (APIC), the next generation of temperature-control technology, to ensure safety and efficacy. The APIC automatically increases the RF power to the target tem-perature, delivering precise heating to the skin’s surface with predictable results. This powerful RF technology emits at 470kHz and high 250W power todeliver the required

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amount of heat—precisely and deeply—for optimally effective, comfortable treatment with consistently success-ful results.

Researchers Identify Genes Involved in Skin Cancer

Researchers at the Health Sciences department of the Universitat Jaume I (UJI) of Castellón, Spain, have identi-fied the genes responsible for sun sensitivity and skin can-cer vulnerability. The Skin Cancer Genetics and Human Pigmentation research group (Melanogén) has analysed the skin’s response to sun and the ability to get tan, and they have detected different genetic variants among the popu-lation of northern Europe. Results of this work appear in Photodermatology, Photoimmunology & Photomedicine.

The UJI study has analysed eight genetic variants related with pigmentation and sun sensitivity in saliva samples from 456 Spanish volunteers, 184 of which showed great vulner-ability to sunburns, an indicative sign of cutaneous cellular damage.

The study conducted by the Melanogén group, “looks into the features of the population of a Mediterranean origin, who are characterised by a darker skin than people

from an area with more intense radiation,” explains Dr. Martínez-Cadenas. Due to the increased intensity of ultra-violet radiation in the Mediterranean area, mainly during the summer months, evolution “has had an effect so that, for example, the proportion of people with the allele F374 in the SLC45A2 gene, responsible for darker skin, is more common in Spain than among northern European popu-lations. It is worth noting that more than 96 percent of African people, who withstand an excess of sun radiation, have this genetic variant in their genome, which grants them protection against the negative effects of ultra-violet rays and skin cancer,” adds co-researcher Bárbara Hernando.

Melanogén researchers highlight that the four genes that play a significant role in cutaneous sensitivity to sun among the Spanish population are MC1R, IRF4, HERC2 and SLC45A2. Researchers insist that prevention and early detection and specific monitoring of the most susceptible population to developing skin cancer, are key for curing the disease.

IBD Linked to PsoriasisA new meta-analysis comprising more than seven

million people suggests it may be time to add inflam-

with Wen-Qing Li, PhD In light of new research suggesting that cof-fee may, in fact, be the ultimate health drink, Practical Dermatology® spoke with Wen-Qing Li, PhD, Assistant Professor of Dermatology, Assistant Professor of Epidemiology at Brown

University in Providence, RI, about the results of his new study in JAMA Dermatology (jamanetwork.com) that sought to clarify the murky relationship between coffee intake and rosacea risk.

Why is this topic important to study?Dr. Li: Rosacea is a very common chronic inflammatory

skin disease, but the association between environmental and lifestyle factors and risk of rosacea has been poorly understood. Previously there have been some investiga-tions on caffeine and coffee intake and risk of rosacea that reported very inconsistent findings. There were also rumors that coffee intake may induce rosacea flares. As caffeine and coffee is rooted in our everyday life, we feel

it is interesting and also urgent to clarify whether caffeine intake and coffee consumption would change the risk of rosacea.

Describe the research and your findings.

Dr. Li: This study included 82,737 women in the Nurses’ Health Study II and analyzed the association between caffeine intake, caffeinated coffee consumption and the risk of rosacea. We found that increased caffeine intake, particularly from caffeinated coffee, may decrease the risk of developing rosacea. Such a protective effect of coffee on rosacea risk was not observed for decaffeinated coffee.

What is the next step?

Dr. Li: In the future, it would be interesting to further investigate the underlying mechanisms of the observed associations and explore the relationship of caffeine with different rosacea subtypes.

CL SE UP

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matory bowel disease (IBD) to the list of comorbidities associated with psoriasis The findings appear in JAMA Dermatology.

The meta-analysis included five case-control or cross-sectional studies with 1,826,677 individuals. These studies found that patients with psoriasis had 1.70-fold increased odds of Crohn’s disease and 1.75-fold increased odds for ulcerative colitis. Four cohort studies of 5,967,410 individu-als included in the meta-analysis found patients with pso-riasis had a 2.53-fold increased risk of developing Crohn’s disease and a 1.71-fold increased risk of developing ulcer-ative colitis.

“Patients with psoriasis should be informed about the increased risk of IBD,” says study author Yun Fu of Chang Gung Memorial Hospital in Linkou, Taiwan. “Gastroenterology consultation is indicated for patients with psoriasis presenting with bowel symptoms.”

Residents of Distinction Attend 2018 Coastal Dermatology Symposium

As part of the dermMentors Resident of Distinction Award program, sponsored by Beiersdorf Inc., five der-matology residents attended the 14th Annual Coastal Dermatology Symposium, held in Monterey, CA in October.

The 2018 dermMentors™ Residents of Distinction—Rana Abdat, MD, of Tufts University Medical Center; Jusleen Ahluwalia, MD, of the University of California-San Diego; Betty Kong, MD, of Northwestern University Feinberg School of Medicine; Angelo Landriscina, MD, of George Washington University; and Ming Lee, MD, of Boston University School of Medicine—attended scientific sessions as well as networking events with top thought leaders in dermatology.

DermMentors.org and the dermMentors Resident of Distinction Award program are sponsored by Beiersdorf Inc. and administered by DermEd, Inc.

COMMENT ON PRIVATE EQUITY TRENDI read Joel Schlessinger’s editorial about large corporate

groups buying practices across the US in the September edition of Practical Dermatology® magazine (online at PracticalDermatology.com/2018/09). On the surface, these sales seem like a profitable concept, but as Dr. Schlessinger pointed out, there are many pitfalls and speed bumps in the process and subsequent outcome.

I was reminded, being from big Pharma, that something like this happened in the pharmacy industry. Large pharmacy groups bought up real estate and took over the market. Walgreens and CVS went into areas where small pharmacies were located, causing them to close. Chains like Eckert disap-peared and Rite Aid and Osco were left by the wayside. The point is that the demise of the small clinical pharmacy, in medical buildings, was a victim of the large chain expansion. Now there are only the compounding pharmacies in major metropolitan areas and the “mom and pop” stores are in the small rural areas. The personality of the small pharmacy is gone…and I fear that the clinical dermatologist will end up the same and we the patient, customer, client will suffer the most with a loss of choices and quality care.. n

—Frederic CarrScottsdale, AZ

Editor’s Note: Our ongoing coverage of private equity in der-matology continues this month on p. 86. Ron Lebow, Esq, dis-

cusses the key information you’ll need to share with a potential practice buyer. His advice may be relevant, even if you’re not in the market to sell.

Letter and Corrections

CorrectionsIn the article “The Dermatology Market: A Tidal Wave

of Private Equity Investment,” published in the September 2018 issue of Practical Dermatology®, comments by Clifford Perlis, MD were misrepresented; they were presented out of context. As part of a presentation, Dr. Perlis had been asked to present what may be perceived by some as benefits of private equity investment in dermatology. However, he was neither presenting his personal views nor endorsing those views during the presentation. We regret the misrepresenta-tion and apologize to Dr. Perlis for the error.

The original infographic that appeared with the article “The Dermatology Market: A Tidal Wave of Private Equity Investment,” erroneously indicated that Goldman Sachs has an ownership interest in California Skin Institute. This is not correct. CSI consists of a medical group—CSI Medical Group, a California professional corporation—and an affiliated management company, California Skin Institute Management, LLC.

CSI Medical Group is owned 100 percent by Dr. Morganroth. We apologize for the error and any inconve-nience it has caused.