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The foam vehicles may increase compliance and satisfaction in some patients and as retinoids are commonly first line acne treatments, this new topical retinoid foam may be a useful option for some acne patients.

Although acanthosis nigricans of the posterior neck and intertriginous areas is common, acanthosis nigricans of the supra-alar creases is rare. We present the case of an obese 16-year-old African American boy with hyperpigmented plaques along the supra-alar creases of his nose. Clinicians should be aware of this rare manifestation, because newly diagnosed acanthosis nigricans should prompt examination for insulin resistance.

BackgroundThe chronic and relapsing course of psoriasis is often associated with poor adherence to treatment. Adherence to topical treatment is abysmal. Adherence to systemic treatments also decreases over time, with an overall adherence rate of 67% for injectable biologic medications. Whereas overall trends in poor adherence have been documented, the fine details of adherence in individual patients is not well characterized. PurposeTo assess adherence to adalimumab in patients with moderate to severe psoriasis. MethodsData on adherence were obtained from a 1-year open label trial including seven patients with moderate to severe psoriasis who agreed to participate in a randomized trial of standard physician education materials plus extended nurse education versus standard physician education materials alone. Adherence to treatment was recorded with electronic monitoring via Medication Event Monitoring System (MEMS) caps undisclosed to the patients. Patients were also instructed to note the time and date they used treatment in a journal. ResultsThe subjects exhibited a broad range of adherence behaviors. ConclusionsAdherence to adalimumab therapy for moderate-to-severe psoriasis is variable and can be very poor. The clinical impact of poor adherence to injectable biologic medications is not yet well characterized.

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