Magan Medical Clinic, Inc.
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Dermatology

Magan Medical Clinic, Dermatology
420 W Rowland St, 2nd Floor
Covina, CA 91723

(626) 331-6411 Phone (Appointment Desk open M-F, 7:30 am-5:30 pm)
(626) 251-1552 Fax

 

Dermatology Staff
Our wonderful dermatology staff. Board certified dermatologist
 Charles Chiang, M.D., F.A.A.D. is in the center

 

We provide quality dermatology care with compassion. Our specialty is medical dermatology, including:

  • Acne (both teenage and adult onset; we are enrolled in iPledge if Accutane is needed)
  • Eczema / atopic dermatitis (in both children and adults)
  • Psoriasis
  • Skin cancer / skin exams
  • Moles
  • Warts / molluscum
  • Rosacea
  • Pigmentation disorders
  • Alopecia areata (autoimmune non-scarring hair loss)
  • Scarring hair loss (autoinflammatory scarring hair loss)
  • Phototherapy (we have a nbUVB booth and Dr. Chiang completed a phototherapy fellowship at UCSF)
  • Hives
  • Itching (pruritus)
  • Nail disorders

  • Note: Cosmetic treatments are not performed in Dermatology but instead by Maganís Medical Aesthetics Laser Center.

If you have psoriasis or hair questions, Dr. Chiang possesses special expertise. He completed fellowships in both fields at University of California, San Francisco where he saw a wide spectrum of patients (including the most severe), performed clinical trials, and published research.

We take pleasure in serving our community including Covina, West Covina, San Dimas, Rancho Cucamonga, Baldwin Park, Azusa, Glendora, Upland, El Monte, Duarte, Monrovia, Arcadia, La Puente, and Diamond Bar.

Same day appointments often available. No referral is necessary if you have PPO insurance. We accept a wide range of insurance plans (unfortunately, we do not accept Medi-Cal as primary insurance, only as secondary insurance).

For appointments, please call (626) 331-6411. We look forward to serving you!


 

"Whatís New in..."

A monthly column by Dr. Chiang

 

April 2017

What's New in Eczema (atopic dermatitis)

What's new in Eczema (atopic dermatitis)

Last month we discussed a promising new topical for eczema & atopic dermatitis (sensitive itchy skin). This month, Iíd like to mention a new systemic therapy called dupilumab, which was just approved this year. Itís currently only available as a brand name called Dupixent. It is a human monoclonal antibody that blocks molecules that affect inflammation called IL-4 and IL-13 in the bloodstream.

It is FDA indicated for adult moderate to severe atopic dermatitis not adequately controlled by topical (applied directly so skin) medications. For my pediatric patients (ie, less than age 18), this medication is not currently indicated.

The two published phase 3 trials totaled 671 patients. The average participant age was 38. About 37% of those receiving the medication became almost clear or clear after 16 weeks. About 10% of the placebo group reached the same goal. This is good improvement, although not amazing.

Common side effects included:

  • Injection site reactions: (ie, redness and irritation where the needle was injected)
    • 10% in treated, ~5% in placebo
  • Conjunctivitis:
    • ~10% in treated, 2-5% in placebo
  • Keratitis: (eye issue)
    • 1-4% in treated, 0 in placebo
  • Herpes
    • Oral: 3-4% in treated, 2% in placebo
    • Non-oral: 1-2% in treated, ~1% in placebo

Cons include the side effect of it being a brand name is its cost of roughly $37,000/year. Many insurance plans may block this medication outright or make it extremely difficult to obtain. Also the patient does have to be okay with needles as he or she will have to self inject roughly every 2 weeks. The published studies only lasted for 16 weeks. The FDA product insert mentions a 52 week study but I have not yet seen it published (since the 16 week data was only published online Dec 2016, the 52 week data likely wonít be published until at least September 2017).

If you have eczema or other skin issues, please make an appointment for dermatology consultation at (626) 331-6411 to discuss your options.

Charles Chiang, MD, FAAD
Board Certified Dermatologist

References:

- Simpson EL, et al. Two Phase 3 Trials of Dupilumab versus Placebo in Atopic Dermatitis. New Engl J Med 2016
- Vorhees AV. Does dupilumab pass the test for atopic dermatitis? Dermatology World https://www.aad.org/dw/monthly/2017/january/does-dupilumab-pass-the-test-for-atopic-dermatitis?utm_source=AAD%20Newsletters Last accessed 4/2/17
- Thomas K. Severe Eczema Drug Is Approved by F.D.A.; Price Tag Is $37,000 a Year. NY Times https://www.nytimes.com/2017/03/28/health/drug-prices-fda-eczema-skin-disease.html?_r=0 Last accessed 4/2/17

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