Robert J. Signore, DO

Dr. Signore is in private practice, Tinley Park, Illinois.

Dr. Signore reports no conflicts of interest in relation to this post.

Homeopathic medicine (HM) is one of the most widely used forms of complementary medicine in the world.¹ It is a low-cost nontoxic system of natural healing used by millions of people worldwide.² According to the Centers for Disease Control and Prevention’s National Center for Health Statistics, US adults spent $2.9 billion out-of-pocket on the purchase of HMs in 2007.³ Homeopathic medicine differs from herbal medicine in that HM does not contain substantial pharmacologic amounts of active substances in commonly used dilutions. Hence HMs do not interact with conventional drugs.¹ Homeopathic medicines are regulated by the US Food and Drug Administration as drugs per the Federal Food, Drug, and Cosmetic Act.⁴ The mechanism of action of HM is unknown.

But the world of medicine revolves around scientific research! Are there any clinical studies to support the use of HM in modern dermatology?

Lorraine L. Rosamilia, MD

Dr. Rosamilia is from the Department of Dermatology, Geisinger Health System, State College, Pennsylvania.

Dr. Rosamilia reports no conflicts of interest in relation to this post.

The Journal of Investigative Dermatology recently published a Canadian population-based cohort study outlining the risk for inflammatory bowel disease (IBD) with isotretinoin use. It examined approximately 47,000 acne patients treated with isotretinoin, 185,000 patients treated with topical acne medications, and more than 1,500,000 untreated patients aged 12 to 29 years during a 12-year period. The authors concluded there was no primary association between isotretinoin and IBD but that subsets of patients on isotretinoin or topical acne therapy could be at risk; therefore, acne itself was postulated as the link.

Anthony M. Rossi, MD

Dr. Rossi is a Fellow in Procedural Dermatology and Mohs Surgery, Memorial Sloan-Kettering and Weill Cornell/New York-Presbyterian Hospital, both in New York, New York.

Dr. Rossi reports no conflicts of interest in relation to this post.

The September 2012 issue of Dermatologic Surgery (2012;38:1477-1489) featured a randomized controlled trial of 4 different fractionated ablative lasers used in the treatment of facial photoaging. The authors utilized 4 different lasers on 12 participants, with the treatment area being the face (divided into 4 quadrants). The lasers tested included the Fraxel Repair (Solta Medical Inc) fractionated CO₂ 10,600-nm laser, Active and Deep FX (Total FX; Lumenis) fractionated CO₂ 10,600-nm laser, Quadralase (Candela) fractionated CO₂ 10,600-nm laser, and Pearl Fractional (Fx; Cutera) fractionated yttrium-scandium-gallium-garnet (YSGG) 2790-nm laser.

Philip R. Cohen, MD

Dr. Cohen is from the University of Houston Health Center, Texas; the Department of Dermatology, University of Texas MD Anderson Cancer Center, Houston; and the Department of Dermatology, University of Texas Medical School, Houston.

Dr. Cohen reports no conflicts of interest in relation to this post.

The June 2012 issue of Annals of Oncology (2012;23[suppl 5]:v6-v11) featured an abstract (L6.5) from the 4th WIN (Worldwide Innovative Networking in personalized cancer medicine) symposium on the efficacy of biomarkers and personalized cancer therapy that took place in Paris, France, on June 28 and 29, 2012. The authors provided an update on using personalized medicine for the treatment of a large cohort of oncology patients with advanced cancer. Complete molecular profiling of the patient’s tumor was performed and the patient was treated with matched therapy, when available, directed against the detected molecular aberration. The results were measured as a function of time to treatment failure and supported the use of a personalized molecular approach for patients with cancer.

Jonathan I. Silverberg, MD, PhD, MPH

Dr. Silverberg is from the Department of Dermatology, St. Luke’s-Roosevelt Hospital Center, New York, New York.

Dr. Silverberg reports no conflicts of interest in relation to this post.

A May 4, 2012, Wall Street Journal (WSJ) article discussed the increased usage of observational studies in clinical research despite being prone to methodological and statistical biases and possibly flawed results. Observational studies are commonly used to study associations between various exposures, such as environmental risk factors or treatment, and disease outcomes. Observational studies differ from prospectively controlled studies in that participants are assigned to an exposure or treatment group that is not controlled in the study. Typically, data are retrospectively collected from sources ranging from small single-site chart reviews to international epidemiologic databases and comprehensive health management organization cohorts. The WSJ article featured 2 studies from 2010: one published in the Journal of the American Medical Association (2010;304:657-663) and the other in the British Medical Journal (BMJ)(2010;341:C4444) on the use of osteoporosis drugs and risk for esophageal cancer. The studies found entirely conflicting results despite being performed on the exact same database.

Philip R. Cohen, MD

Dr. Cohen is from the University of Houston Health Center, Texas; the Department of Dermatology, University of Texas MD Anderson Cancer Center, Houston; and the Department of Dermatology, University of Texas Medical School, Houston.

Dr. Cohen reports no conflicts of interest in relation to this post.

Medical experimentation occurs daily and is essential to the development of new therapies. Medical experimentation also includes self-experimentation. Self-experimentation in dermatology is well-documented; indeed many investigators have subsequently published their own observations.