Dupilumab has shown promise as a therapeutic option in dermatology, particularly in conditions like atopic dermatitis (AD), prurigo nodularis, and alopecia areata. This systematic review aimed to analyze the efficacy, safety, and benefits of dupilumab based on findings from placebo-controlled trials in dermatological conditions.
The objective was to systematically review placebo-controlled trials evaluating dupilumab in dermatological conditions and analyze the outcomes related to efficacy, safety, and patient-reported outcomes (PROs).
A comprehensive search was conducted in electronic databases (PubMed/MEDLINE, Embase, Cochrane Library, Scopus, and Web of Science) using keywords related to “dupilumab,” “dermatology,” “randomized controlled trial,” and “placebo.” Inclusion criteria encompassed randomized controlled trials comparing dupilumab against placebo, reporting relevant outcomes, and excluding non-randomized studies or those with interventions other than dupilumab.
The review included nine placebo-controlled trials with a total sample size of 6797 participants. Dupilumab demonstrated significant improvements in clinical severity, PROs, anxiety/depression symptoms, and health-related quality of life (HRQoL) compared to placebo in patients with moderate-to-severe AD. In prurigo nodularis, dupilumab showed significant improvements in pruritus and nodule reduction compared to placebo. Promising results were observed in alopecia areata, particularly in patients with high baseline IgE levels, with improvements in SALT scores and hair regrowth. PROs such as itch, sleep, mental health, and overall quality of life were improved with dupilumab, especially with the 300 mg dose regimens.
The findings from placebo-controlled trials support the efficacy and safety of dupilumab in dermatological conditions, including AD, prurigo nodularis, and alopecia areata. Dupilumab appears to be a valuable therapeutic option, with potential benefits in improving clinical outcomes and PROs. Further research is warranted to explore its efficacy in other conditions and optimize dosing regimens for personalized treatment approaches.
Laser hair removal remains one of the most common procedures in cosmetic dermatology. It has always been challenging because of the higher competing epidermal melanocyte as the targeted hair chromophore is also melanin. As a result, to avoid unwanted side effects from laser therapy while maintaining high efficacy levels, the use of the right laser device, appropriate settings, and customized pre and posttreatment care are crucial. With more efficient versions of existing lasers in the market, the safety profile has been taken care of without compromising the efficacy. Diode lasers along with long pulsed Nd:YAG and alexandrite are considered as the safest hair removal lasers.
To summarize recent developments in diode laser hair reduction focusing on improvements in efficiency, safety, and patient compliance with recent innovations.
A review of recent literature updates in diode laser hair reduction technology focusing on multiwavelength systems, safety profiles, and innovations in laser device was searched using keywords diode laser hair removal and mutliwavelength diode laser devices.
Currently, 810 nm diode laser is the most extensively used technology for the long term elimination of unwanted hair, thus establishing itself as an efficacious and safe modality. The rapid multiple pass in motion technique with lesser fluence and gradual heating of the skin epidermis was more well tolerated in patients than the higher fluence single shot method. Most popular combination of triple wavelength was 755, 810, and 1064 nm, which is considered most effective with least complications.
Diode lasers still remain the gold standard in laser hair removal especially on darker skin types. Recent innovations in diode laser have significantly improved the efficacy, safety, and patient compliance with hair reduction. Multiwavelength platforms seems to be the way forward, however the basic principles and certain problems like minimal pain, treating thin hair, paradoxical hair growth, white hair removal still remains a challenge.
Regenerative medicine is a novel, developing field centered on efforts to repurpose the body's own molecular makeup to target specific problems. Specifically, the use of stem cells, platelet-rich plasma, and exosomes is rapidly expanding. Internationally, there remain different guidelines and a variety of medical uses, encouraging an exploration into the medical and cosmetic benefits offered.
This study aims to investigate current literature on the international perspectives of PRP, stem cells, and exosomes to present a global review on how these are obtained and utilized.
A literature search was conducted on PubMed reviewing PRP, exosomes, and stem cells, among other related topics, and their applications in medical, pharmacologic, and dermatologic fields. Research produced by various global regions was examined to identify similarities and differences.
Stem cells have been successfully implemented in the oncology and dermatology realms as a result of their plasticity and ability to quickly replicate and divide. Platelet-rich plasma is of strong interest due to platelets' extracellular vesicles and their unmatched abilities. Exosomes are actively being studied in the fields of neurology and rheumatology, among others. International guidelines are reviewed based on regulations of these materials. Potential ethical barriers of isolation and source utilization are explored.
The perspectives and findings considered here stress the potential expanding uses of PRP, stem cells, and exosomes on a global scale. We highlight the need for further clinical studies and international collaboration among varying guidelines to best utilize these tools in the field of dermatology and medicine.
Isotretinoin is widely recognized for its efficacy in treating severe acne. However, its use is associated with a variety of idiosyncratic reactions that can affect multiple organ systems and bodily functions, necessitating vigilant monitoring and appropriate management.
The aim of this review is to raise awareness of the broad spectrum of adverse effects linked to isotretinoin therapy, thereby enhancing the ability of healthcare providers to identify at-risk individuals and improve patient outcomes.
A comprehensive review of current literature was conducted to explore the range of idiosyncratic reactions associated with isotretinoin. The focus was on identifying the types of adverse effects reported and the necessary monitoring strategies to mitigate these risks.
Isotretinoin has been linked to a wide array of adverse effects, including, but not limited to, psychiatric issues (e.g., depression and suicidal behavior), hematological complications (e.g., neutropenia and agranulocytosis), gastrointestinal disturbances, cardiovascular effects, dermatological manifestations, hepatobiliary issues, ophthalmological changes, and orthopedic concerns. These reactions highlight the importance of careful patient monitoring during isotretinoin therapy.
Healthcare professionals prescribing isotretinoin must be aware of the potential for diverse idiosyncratic reactions and should implement appropriate monitoring protocols to ensure patient safety. By understanding and anticipating these adverse effects, healthcare providers can better manage the risks associated with isotretinoin use, ultimately improving the quality of care for patients undergoing treatment for severe acne.
Artificial intelligence (AI) in dermatology is both promising and challenging. This is important for clinicians to recognize most up-to-date knowledge and advancements.
Advantages include timely detection and diagnosis, enhanced accuracy, efficient triage, workflow automation, personalized treatment, outcome prediction, education support, telemedicine aid, research facilitation, cost-efficiency, scalability, and drug development. However, limitations include generalizability issues, image quality variations, data requirements, interpretability concerns, patient acceptance, liability, multidisciplinary coordination challenges, data bias risks, lack of explainability, potential loss of clinical skills, security and privacy risks, resource intensiveness, integration challenges, validation and regulation gaps, and limited clinical assessment. Bridging these gaps requires robust ethical frameworks, interdisciplinary collaboration, education, regulation focusing on patient safety and privacy, standardized data sets, transparency, and human oversight.
Despite the challenges, AI holds significant potential to revolutionize dermatology practice, improving patient outcomes, healthcare accessibility, and research advancements. Further research and interdisciplinary collaboration are crucial to maximize AI's benefits and address its limitations effectively.
The use of intense pulsed light (IPL) for hair removal has proven to be quite effective for conditions such as hypertrichosis and hirsutism, as well as other skin conditions related to the pilosebaceous unit. IPL was developed in the 1990s and uses a broad spectrum of light to penetrate the skin and reach the hair follicle, enabling treatment for various skin types and hair colors. This review covers the history, mechanism of action, effectiveness, patient selection, and clinical applications of IPL hair removal.
To conduct this review, a comprehensive literature search was conducted to identify relevant peer-reviewed articles in English discussing the clinical use or application-based outcomes of this technology specifically for hair removal. The search covered the period from January 1990 to May 2024.
The review of 33 peer-reviewed articles shows that IPL has significantly advanced hair removal treatment since its inception. A popular choice in clinical practice due to its efficacy, safety, and versatility, IPL hair removal has been successfully used in patients with skin conditions like acne, folliculitis, rosacea, and hyperpigmentation, offering additional benefits compared to laser hair removal.
IPL hair removal is a safe and effective option for reducing unwanted hair and improving skin appearance. It can also treat multiple skin conditions simultaneously with a low risk of side effects. Additionally, it's less painful than laser hair removal, making it an attractive option for long-lasting hair removal, especially for patients with co-existing dermatological conditions.
Regenerative medicine seeks to harness the natural healing abilities of the body and has scope for use in the treatment of dermatologic conditions. Stem cell therapy, platelet-rich plasma (PRP), and exosomes are emerging as key components in regenerative medicine, particularly in skin rejuvenation and repair.
The goal of this article is to review the basic science behind the function of stem cells, PRP, and exosomes in regenerative medicine.
A literature review was conducted using PubMed and Google Scholar, focusing on basic science literature regarding the structure, origin, mechanisms of action, and isolation of stem cells, PRP, and exosomes.
The evaluation found that stem cells facilitate skin regeneration by modulating the inflammatory milieu. PRP was shown to have positive effects on repairing skin elasticity and improving scars through the release of growth factors. Exosomes were found to enhance fibroblast proliferation and collagen synthesis.
Stem cell therapy, PRP, and exosomes each show mechanisms that render them useful in regenerative medicine. Future research is needed to further elucidate their mechanisms of action, standardize their isolation procedures, and optimize their potential for clinical application.
There is growing interest in the utility of oral supplements for improving overall health and wellness. Dietary supplements and nutraceuticals with antioxidant and anti-inflammatory properties have gained particular attention for their potential to optimize skin health. This review summarizes evidence for the following vitamins, minerals, and natural compounds in the realm of dermatology: niacinamide, vitamin D, vitamin C, vitamin E, zinc, omega-3 fatty acids, probiotics, polyphenols, Polypodium leucotomos, coenzyme Q10, and astaxanthin.
Niacinamide and vitamins C, D, and E may all protect against UV damage. Zinc and omega-3 fatty acids may be useful for the treatment of acne and for minimizing side effects from isotretinoin. There is convincing evidence for the utility of probiotics in complementing standard treatments for acne, psoriasis, and atopic dermatitis. Collagen supplements have demonstrated anti-aging effects but should not be routinely recommended due to their unreliable quality. Antioxidants such as P. leucotomos, coenzyme Q10, astaxanthin, and polyphenols may play a role in anti-aging and photoprotection.
Oral supplements may play a beneficial role in skin health, namely in terms of photoprotection, anti-aging, and inflammatory conditions such as atopic dermatitis, acne, and psoriasis. However, further high-quality studies are needed.
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