Alopecia Areata (AA) is an autoimmune disorder resulting in non-scarring hair loss on the scalp, face, and body. AA research has experienced significant advancements within the last century with the discoveries of the autoimmune nature of the disorder and the role of genetic and psychosocial factors. This review provides a comprehensive dive into the history and evolution of AA management with a focus on the recently FDA-approved JAK inhibitors baricitinib, ritlecitinib, and deuruxolitinib, and sheds light on emerging therapies.
Methods
A search was conducted on PubMed to investigate literature on the history of AA treatment, current AA treatment with a focus on therapy with JAK inhibitors, and the future directions of AA treatment.
Results
Caustic topical agents were used as the main AA therapy until recent decades. The last century saw significant advancements in understanding the etiology of AA as autoimmune, genetic, and psychosocial, influencing the directions of treatment research. In recent years, JAK inhibitors were found to be an effective, systemic AA treatment. Non-systemic AA therapies such as corticosteroid injections, topical minoxidil, contact immunotherapy, and red-laser light therapy remain effective treatments. JAK inhibitors continue to be the focus of AA treatment research, although other targets and new treatment modalities are being studied.
Conclusion
The treatment of AA has undergone significant advances within recent years, especially with the application of JAK inhibitors as systemic therapy. Future research should investigate the therapeutic potential of stem cell therapy, gene therapy, and energy-assisted drug delivery (LEADD) for AA.
{"title":"Alopecia Areata Treatment: Past, Present, and Future","authors":"Eliana L. Jolkovsky, David J. Goldberg","doi":"10.1002/der2.70008","DOIUrl":"https://doi.org/10.1002/der2.70008","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Alopecia Areata (AA) is an autoimmune disorder resulting in non-scarring hair loss on the scalp, face, and body. AA research has experienced significant advancements within the last century with the discoveries of the autoimmune nature of the disorder and the role of genetic and psychosocial factors. This review provides a comprehensive dive into the history and evolution of AA management with a focus on the recently FDA-approved JAK inhibitors baricitinib, ritlecitinib, and deuruxolitinib, and sheds light on emerging therapies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A search was conducted on PubMed to investigate literature on the history of AA treatment, current AA treatment with a focus on therapy with JAK inhibitors, and the future directions of AA treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Caustic topical agents were used as the main AA therapy until recent decades. The last century saw significant advancements in understanding the etiology of AA as autoimmune, genetic, and psychosocial, influencing the directions of treatment research. In recent years, JAK inhibitors were found to be an effective, systemic AA treatment. Non-systemic AA therapies such as corticosteroid injections, topical minoxidil, contact immunotherapy, and red-laser light therapy remain effective treatments. JAK inhibitors continue to be the focus of AA treatment research, although other targets and new treatment modalities are being studied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The treatment of AA has undergone significant advances within recent years, especially with the application of JAK inhibitors as systemic therapy. Future research should investigate the therapeutic potential of stem cell therapy, gene therapy, and energy-assisted drug delivery (LEADD) for AA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"5 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.70008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142861925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Isabella Castellanos-García, Luisa Valentina Ramírez-Zuluaga, Laura Sofia Páez-Cárdenas, Dennys Lintsay Villalba-Moreno, María Daniela Caicedo-León, Elisha Singer, Thais Pincelli, Alison J. Bruce, Miguel A. Aristizabal
Background
Cellulite is a localized skin condition that affects many women, particularly after puberty. It results from a complex interplay of several factors that lead to the characteristic dimpled appearance of the skin. Cellulite may cause psychological stress and negatively impact quality of life. Additionally, body skin laxity may further exacerbate cosmetic concerns in these patients. Consequently, multiple therapeutic options, including topical treatments, have been explored to address both cellulite and skin laxity.
Objectives
To review the pathophysiology of cellulite and skin laxity, as well as topical skincare options for their management.
Methods
A literature search from 2000 to 2024 was conducted using the databases PubMed, EBSCOhost, Scopus, and Google Scholar, with the key terms “cellulite,” “cellulite management,” “cellulite topical treatment,” “skin sagging,” “skin laxity,” and “loose skin.” The search included clinical trials, observational studies, book chapters, and review articles in English and Spanish.
Results
The pathophysiologic mechanisms underlying cellulite involve a combination of histological, hormonal, genetic, and lifestyle factors. Several topical agents, including retinoids and methylxanthines, have shown potential in improving the cosmetic appearance of cellulite and may contribute to localized fat reduction. Emerging botanical extracts hold promise as topical treatments for cellulite and skin tightening.
Conclusions
Cellulite and skin laxity are prevalent cosmetic concerns with multifactorial and complex pathophysiologic origins. Topical treatments for cellulite and skin tightening require further investigation. Although some studies have demonstrated positive outcomes with skincare products and topicals, robust evidence and studies with extended follow-up are still lacking. Additional research is necessary to evaluate the long-term efficacy of topical treatments as standalone therapies for cellulite and skin tightening.
{"title":"Cellulite & Skin Tightening: A Review of Pathophysiology and Topical Treatment","authors":"Isabella Castellanos-García, Luisa Valentina Ramírez-Zuluaga, Laura Sofia Páez-Cárdenas, Dennys Lintsay Villalba-Moreno, María Daniela Caicedo-León, Elisha Singer, Thais Pincelli, Alison J. Bruce, Miguel A. Aristizabal","doi":"10.1002/der2.70011","DOIUrl":"https://doi.org/10.1002/der2.70011","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cellulite is a localized skin condition that affects many women, particularly after puberty. It results from a complex interplay of several factors that lead to the characteristic dimpled appearance of the skin. Cellulite may cause psychological stress and negatively impact quality of life. Additionally, body skin laxity may further exacerbate cosmetic concerns in these patients. Consequently, multiple therapeutic options, including topical treatments, have been explored to address both cellulite and skin laxity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To review the pathophysiology of cellulite and skin laxity, as well as topical skincare options for their management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A literature search from 2000 to 2024 was conducted using the databases PubMed, EBSCOhost, Scopus, and Google Scholar, with the key terms “cellulite,” “cellulite management,” “cellulite topical treatment,” “skin sagging,” “skin laxity,” and “loose skin.” The search included clinical trials, observational studies, book chapters, and review articles in English and Spanish.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The pathophysiologic mechanisms underlying cellulite involve a combination of histological, hormonal, genetic, and lifestyle factors. Several topical agents, including retinoids and methylxanthines, have shown potential in improving the cosmetic appearance of cellulite and may contribute to localized fat reduction. Emerging botanical extracts hold promise as topical treatments for cellulite and skin tightening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Cellulite and skin laxity are prevalent cosmetic concerns with multifactorial and complex pathophysiologic origins. Topical treatments for cellulite and skin tightening require further investigation. Although some studies have demonstrated positive outcomes with skincare products and topicals, robust evidence and studies with extended follow-up are still lacking. Additional research is necessary to evaluate the long-term efficacy of topical treatments as standalone therapies for cellulite and skin tightening.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"5 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.70011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142861926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Arpita Yadav, Manoj K. Verma, Arun K. Sharma, Anu Chaudhary, Sudha Bhartiya
Background
Menopausal vasomotor symptoms (VMS), such as hot flashes (also known as night sweats), are experienced by 70% of women. These symptoms may be debilitating and last for many years. For 10%–20% of women, these symptoms are almost unbearable. Several pharmacotherapeutic approaches have been evaluated, and more are continually being developed. Although hormone therapy (HT) is often considered the most effective treatment, it is frequently accompanied by significant adverse effects. Consequently, there is a concerted effort to explore non-hormonal alternatives.
Objectives
The present study aims to provide a comprehensive overview of the key milestones and development trajectory of Fezolinetant from the preclinical stages to its FDA approval for the treatment of VMS.
Method
Fezolinetant's development trajectory was undertaken, employing a multifaceted information retrieval strategy. This approach leveraged scientific databases like PubMed, Google Scholar, and ScienceDirect, alongside authoritative resources including DrugBank and clinicaltrials.gov. Additionally, peer-reviewed journals and the official website of Astellas Pharma were meticulously examined to find the relevant information. The present study delves into various stages of Fezolinetant's development, including its medicinal chemistry, synthesis, mechanism of action, and pharmacodynamic and pharmacokinetic studies, as well as clinical data, and safety profiles.
Result
On May 12, 2023, the FDA approved Fezolinetant, a non-hormonal, selective neurokinin 3 (NK3) receptor antagonist, for treating mild to severe VMS marked on by menopause. It has been developed by Astellas Pharma under the brand name Veozah and is taken orally once a day, with or without meals, at a dose of 45 mg.
Conclusion
Fezolinetant represents a promising non-hormonal treatment option for women experiencing VMS. The key findings from the studies include the effectiveness of Fezolinetant in alleviating VMS symptoms and its favorable safety profile compared to hormonal therapy.
{"title":"Fezolinetant: A Non-hormonal NK3R Antagonist for the Treatment of Hot Flushes and Vasomotor Symptoms","authors":"Arpita Yadav, Manoj K. Verma, Arun K. Sharma, Anu Chaudhary, Sudha Bhartiya","doi":"10.1002/der2.70009","DOIUrl":"https://doi.org/10.1002/der2.70009","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Menopausal vasomotor symptoms (VMS), such as hot flashes (also known as night sweats), are experienced by 70% of women. These symptoms may be debilitating and last for many years. For 10%–20% of women, these symptoms are almost unbearable. Several pharmacotherapeutic approaches have been evaluated, and more are continually being developed. Although hormone therapy (HT) is often considered the most effective treatment, it is frequently accompanied by significant adverse effects. Consequently, there is a concerted effort to explore non-hormonal alternatives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The present study aims to provide a comprehensive overview of the key milestones and development trajectory of Fezolinetant from the preclinical stages to its FDA approval for the treatment of VMS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Fezolinetant's development trajectory was undertaken, employing a multifaceted information retrieval strategy. This approach leveraged scientific databases like PubMed, Google Scholar, and ScienceDirect, alongside authoritative resources including DrugBank and clinicaltrials.gov. Additionally, peer-reviewed journals and the official website of Astellas Pharma were meticulously examined to find the relevant information. The present study delves into various stages of Fezolinetant's development, including its medicinal chemistry, synthesis, mechanism of action, and pharmacodynamic and pharmacokinetic studies, as well as clinical data, and safety profiles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result</h3>\u0000 \u0000 <p>On May 12, 2023, the FDA approved Fezolinetant, a non-hormonal, selective neurokinin 3 (NK3) receptor antagonist, for treating mild to severe VMS marked on by menopause. It has been developed by Astellas Pharma under the brand name Veozah and is taken orally once a day, with or without meals, at a dose of 45 mg.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Fezolinetant represents a promising non-hormonal treatment option for women experiencing VMS. The key findings from the studies include the effectiveness of Fezolinetant in alleviating VMS symptoms and its favorable safety profile compared to hormonal therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"5 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.70009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142861193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Facial microneedling (MN) represents a contemporary approach to skin rejuvenation that has garnered increasing popularity in recent years. This technique is distinguished by its cost-effectiveness and widespread adoption across various age groups. While MN is associated with substantial improvements in skin appearance and texture, it is also accompanied by a range of potential adverse effects.
Aim
This paper outlines to present the categorized side effect and complications of MN.
Methods
In this paper, published studies and colleagues’ experiences were used to classify and present the results.
Conclusion
There is currently insufficient research on the complications and side effects of MN, highlighting the need for a comprehensive and organized review in this area. This study systematically investigates MN-related complications in six key areas: operator, patient, procedures and materials, sterile devices and skin, aftercare, and standard device classification and evaluation.
{"title":"Categorized Side Effect and Complications of Microneedling","authors":"Atefeh Mohammadnejad","doi":"10.1002/der2.70010","DOIUrl":"https://doi.org/10.1002/der2.70010","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Facial microneedling (MN) represents a contemporary approach to skin rejuvenation that has garnered increasing popularity in recent years. This technique is distinguished by its cost-effectiveness and widespread adoption across various age groups. While MN is associated with substantial improvements in skin appearance and texture, it is also accompanied by a range of potential adverse effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This paper outlines to present the categorized side effect and complications of MN.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this paper, published studies and colleagues’ experiences were used to classify and present the results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There is currently insufficient research on the complications and side effects of MN, highlighting the need for a comprehensive and organized review in this area. This study systematically investigates MN-related complications in six key areas: operator, patient, procedures and materials, sterile devices and skin, aftercare, and standard device classification and evaluation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"5 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.70010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142861192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ganesh Srinivas Pai, Avitus John Raakesh Prasad, Anusha H. Pai, Rahul Pillai
Background
Triple wave hair removal is an advanced method for achieving permanent hair reduction which has always been challenging. This technique combines the benefits of three different wavelengths of laser light to target a broader range of skin types effectively. This study employed three different equipment.
Aims
To establish the efficacy of triple wavelength hair removal in various skin types, sites and type of hair. To give importance to parameter selection and various techniques to be employed in various situations to achieve permanent hair removal.
Patients and Methods
This was an Investigator initiated, two center study of female's patients with hirsutism above age 18 years with skin type III−V, areas included are face, chin, chest and others between the period of August 2017 to February 2024.
Results
The amount of hair reduction was assessed using the physician GAIS (Global Aesthetic Improvement Scale) score: No results 0% reduction, Poor 0%−25% reduction, Average 25%−50% reduction, good 50%−75% reduction, and excellent 75%−100% reduction. Patients who completed minimum of four to maximum of six sessions were included in the study. An excellent reduction in 80% of the treated patients and good reduction in 15% of treated patients was observed.
Conclusion
This current study shows that a synergistic combination of three diode laser wavelengths used for hair removal is effective and safe to use in subjects of all skin types for facial and body hair and is an alternative in treatment of patients who responds poorly to diode wavelength.
{"title":"Triple Wavelength for Laser Hair Reduction: Parameter Selection and Optimisation of Results","authors":"Ganesh Srinivas Pai, Avitus John Raakesh Prasad, Anusha H. Pai, Rahul Pillai","doi":"10.1002/der2.70006","DOIUrl":"https://doi.org/10.1002/der2.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Triple wave hair removal is an advanced method for achieving permanent hair reduction which has always been challenging. This technique combines the benefits of three different wavelengths of laser light to target a broader range of skin types effectively. This study employed three different equipment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To establish the efficacy of triple wavelength hair removal in various skin types, sites and type of hair. To give importance to parameter selection and various techniques to be employed in various situations to achieve permanent hair removal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>This was an Investigator initiated, two center study of female's patients with hirsutism above age 18 years with skin type III−V, areas included are face, chin, chest and others between the period of August 2017 to February 2024.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The amount of hair reduction was assessed using the physician GAIS (Global Aesthetic Improvement Scale) score: No results 0% reduction, Poor 0%−25% reduction, Average 25%−50% reduction, good 50%−75% reduction, and excellent 75%−100% reduction. Patients who completed minimum of four to maximum of six sessions were included in the study. An excellent reduction in 80% of the treated patients and good reduction in 15% of treated patients was observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This current study shows that a synergistic combination of three diode laser wavelengths used for hair removal is effective and safe to use in subjects of all skin types for facial and body hair and is an alternative in treatment of patients who responds poorly to diode wavelength.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"5 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.70006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142641611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Valeria Antoniou, Elena Thomaidou, Ekatherine Prokopiou
Background/Objectives
Atopic dermatitis (AD) is a chronic inflammatory skin condition, commonly first occurring in early childhood. Although many treatments have currently been established, their effectiveness often varies, and it is not always adequate. The first biologic agent approved in the pediatric population, in severe AD cases, is dupilumab. In this review we aim to present the current data on dupilumab effectiveness and safety in the pediatric population.
Methods
Systematic search was conducted throughout PubMed, ScienceDirect, and clinicaltrials.gov, from which three clinical trials and four real-life studies were included. The studies were analyzed in terms of drug effectiveness (using EASI, IGA and SCORAD scoring systems) and safety profile (presence and occurrence of adverse events).
Results
EASI, SCORAD, and IGA scores were significantly improved in patients receiving dupilumab treatment irrespective of dosage. Conjunctivitis was the most consistently and commonly reported adverse event in both clinical trials (relative risk; RR = 2.4, 95% confidence interval [CI] [1.20, 4.84], p = 0.01) and real-life studies (10.8% of patients). Injection-site reactions and nasopharyngitis demonstrated an increased, yet nonsignificant RR. Compared to placebo, dupilumab exhibited a reduced RR of 36% in AD exacerbations (95% CI [0.43, 0.94], p = 0.0234) and 44% in skin infections (95% CI [0.36, 0.88], p = 0.0106).
Conclusions
Dupilumab appears to be a promising drug in the treatment of moderate to severe AD in pediatric population, with noticeable improvement in outcome scores. Among the adverse events, conjunctivitis is the most common; however, no long-term or life-threatening events were reported.
背景/目的 特应性皮炎（AD）是一种慢性炎症性皮肤病，通常在儿童早期发病。尽管目前已确立了许多治疗方法，但其疗效往往参差不齐，而且并不总是充分的。杜必鲁单抗是首个获准用于治疗儿童重症过敏性皮炎的生物制剂。在这篇综述中，我们旨在介绍目前有关杜比单抗在儿科人群中的有效性和安全性的数据。 方法 在PubMed、ScienceDirect和clinicaltrials.gov上进行了系统检索，从中纳入了三项临床试验和四项实际研究。从药物有效性（采用 EASI、IGA 和 SCORAD 评分系统）和安全性（不良反应的存在和发生）方面对这些研究进行了分析。 结果 无论剂量大小，接受杜比鲁单抗治疗的患者的 EASI、SCORAD 和 IGA 评分均有明显改善。在临床试验（相对风险；RR = 2.4，95% 置信区间 [CI] [1.20，4.84]，p = 0.01）和实际研究（10.8% 的患者）中，结膜炎都是最常见的不良事件。注射部位反应和鼻咽炎的RR有所增加，但不显著。与安慰剂相比，杜匹单抗可使 AD 恶化的 RR 降低 36%（95% CI [0.43，0.94]，p = 0.0234），皮肤感染的 RR 降低 44%（95% CI [0.36，0.88]，p = 0.0106）。 结论 杜匹单抗似乎是一种治疗儿童中重度AD的有前途的药物，其疗效评分有明显改善。在不良反应中，结膜炎是最常见的一种，但没有长期或危及生命的不良反应报告。
{"title":"Dupilumab Efficacy and Safety Assessment in the Treatment of Atopic Dermatitis in Pediatric Patients: A Systematic Review","authors":"Valeria Antoniou, Elena Thomaidou, Ekatherine Prokopiou","doi":"10.1002/der2.70002","DOIUrl":"https://doi.org/10.1002/der2.70002","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Objectives</h3>\u0000 \u0000 <p>Atopic dermatitis (AD) is a chronic inflammatory skin condition, commonly first occurring in early childhood. Although many treatments have currently been established, their effectiveness often varies, and it is not always adequate. The first biologic agent approved in the pediatric population, in severe AD cases, is dupilumab. In this review we aim to present the current data on dupilumab effectiveness and safety in the pediatric population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Systematic search was conducted throughout PubMed, ScienceDirect, and clinicaltrials.gov, from which three clinical trials and four real-life studies were included. The studies were analyzed in terms of drug effectiveness (using EASI, IGA and SCORAD scoring systems) and safety profile (presence and occurrence of adverse events).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>EASI, SCORAD, and IGA scores were significantly improved in patients receiving dupilumab treatment irrespective of dosage. Conjunctivitis was the most consistently and commonly reported adverse event in both clinical trials (relative risk; RR = 2.4, 95% confidence interval [CI] [1.20, 4.84], <i>p</i> = 0.01) and real-life studies (10.8% of patients). Injection-site reactions and nasopharyngitis demonstrated an increased, yet nonsignificant RR. Compared to placebo, dupilumab exhibited a reduced RR of 36% in AD exacerbations (95% CI [0.43, 0.94], <i>p</i> = 0.0234) and 44% in skin infections (95% CI [0.36, 0.88], <i>p</i> = 0.0106).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Dupilumab appears to be a promising drug in the treatment of moderate to severe AD in pediatric population, with noticeable improvement in outcome scores. Among the adverse events, conjunctivitis is the most common; however, no long-term or life-threatening events were reported.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"5 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.70002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142641147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joseph Gofman, Darcy Tocci, Daniel L. Fischer, Charles Gropper
Introduction
Eczematous drug eruptions (EDEs) can mimic common skin conditions like eczema or psoriasis, complicating diagnosis and treatment. These eruptions often present as papular or vesicular lesions, sometimes pruritic, with scaling and crusting. EDEs can manifest anywhere from days to years after initiating medications commonly prescribed in the primary care setting such as calcium channel blockers, ACE inhibitors, ARBs, thiazides, and statins. Misdiagnosis can lead to prolonged patient discomfort and unnecessary treatments. This review emphasizes the importance of accurate differentiation between EDEs and other dermatoses for improved patient outcomes.
Objective
This review aims to aid clinicians in the differentiation of EDEs from clinically similar conditions, such as eczema and psoriasis. It focuses on identifying commonly prescribed medications in primary care settings that trigger EDEs, discusses diagnostic strategies, and explores effective treatment options for managing these eruptions.
Methods
A comprehensive literature review was conducted using databases such as PubMed, Google Scholar, and the Cochrane Library, covering the period from January 1980 to January 2023. The search included terms like “eczematous,” “drug eruption,” “medication,” “drug induced,” “skin reactions,” “adverse cutaneous,” and “side effects.” Studies selected for review included literary reviews, systematic reviews, case reports, and case series focusing on the pharmacological agents responsible for EDEs. Articles were selected based on their focus on primary care medications and their connection to EDEs.
Results
The review identified a broad spectrum of medications implicated in EDEs, including calcium channel blockers, ACE inhibitors, ARBs, thiazides, and statins. Among these, calcium channel blockers were the most frequently associated with chronic, diffuse, and pruritic scaly papules and plaques. Other common offenders include ACE inhibitors and ARBs, which primarily trigger eczema-like rashes in elderly patients. Thiazide diuretics were associated with photosensitivity reactions leading to eczematous eruptions. Statins were found to compromise the skin barrier, contributing to the development of eczematous reactions, particularly in older individuals. The histopathological findings across cases frequently showed spongiosis, eosinophilic infiltrates, and acanthosis, complicating the differentiation from eczema without a thorough medication history.
引言 湿疹性药物疹（EDEs）可与湿疹或银屑病等常见皮肤病相似，从而使诊断和治疗复杂化。这些疹子通常表现为丘疹或水泡状皮损，有时伴有瘙痒、脱屑和结痂。EDE 可在开始服用初级保健常用药物（如钙通道阻滞剂、ACE 抑制剂、ARB、噻嗪类药物和他汀类药物）后数天至数年内出现。误诊可导致患者长期不适和不必要的治疗。本综述强调了准确区分 EDE 和其他皮肤病以改善患者预后的重要性。 目的 本综述旨在帮助临床医生区分 EDE 与湿疹和银屑病等临床类似疾病。本综述的重点是确定引发 EDEs 的初级医疗机构常用处方药，讨论诊断策略，并探讨管理这些疹子的有效治疗方案。 方法 使用 PubMed、Google Scholar 和 Cochrane Library 等数据库进行了一次全面的文献综述，时间跨度为 1980 年 1 月至 2023 年 1 月。搜索关键词包括 "eczematous"、"drug eruption"、"medication"、"drug induced"、"skin reactions"、"adverse cutaneous "和 "side effects"。被选中进行审查的研究包括文学评论、系统综述、病例报告和病例系列，重点关注导致 EDEs 的药物。文章的选择基于其对初级保健药物及其与 EDEs 的关系的关注。 结果 该综述确定了与 EDEs 有关的多种药物，包括钙通道阻滞剂、ACE 抑制剂、ARBs、噻嗪类药物和他汀类药物。其中，钙通道阻滞剂最常与慢性、弥漫性和瘙痒性鳞状丘疹和斑块有关。其他常见的药物包括 ACE 抑制剂和 ARBs，它们主要在老年患者中引发湿疹样皮疹。噻嗪类利尿剂与导致湿疹的光敏反应有关。研究发现，他汀类药物会损害皮肤屏障，导致湿疹反应的发生，尤其是在老年人中。不同病例的组织病理学结果经常显示海绵状增生、嗜酸性粒细胞浸润和棘层增生，这使得在没有详尽用药史的情况下与湿疹的鉴别变得更加复杂。 结论 早期识别 EDEs 并将其与湿疹或银屑病等常见皮肤病区分开来，对于有效治疗至关重要。综述强调了对服用常见心血管药物的患者的药物诱发疹保持高度怀疑的重要性。及时停用违规药物，并结合其他治疗方法，可以显著改善患者的预后。皮肤科医生和初级保健提供者应通力合作，优化治疗，尤其是在使用多种药物的情况下。需要进一步开展研究，以加深对 EDE 背后机制的了解，并完善诊断策略，从而最大限度地降低患者的发病率。
{"title":"Eczematous Drug Eruptions: Identification and Management of Pharmacological Culprits in Primary Care","authors":"Joseph Gofman, Darcy Tocci, Daniel L. Fischer, Charles Gropper","doi":"10.1002/der2.70004","DOIUrl":"https://doi.org/10.1002/der2.70004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Eczematous drug eruptions (EDEs) can mimic common skin conditions like eczema or psoriasis, complicating diagnosis and treatment. These eruptions often present as papular or vesicular lesions, sometimes pruritic, with scaling and crusting. EDEs can manifest anywhere from days to years after initiating medications commonly prescribed in the primary care setting such as calcium channel blockers, ACE inhibitors, ARBs, thiazides, and statins. Misdiagnosis can lead to prolonged patient discomfort and unnecessary treatments. This review emphasizes the importance of accurate differentiation between EDEs and other dermatoses for improved patient outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This review aims to aid clinicians in the differentiation of EDEs from clinically similar conditions, such as eczema and psoriasis. It focuses on identifying commonly prescribed medications in primary care settings that trigger EDEs, discusses diagnostic strategies, and explores effective treatment options for managing these eruptions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive literature review was conducted using databases such as PubMed, Google Scholar, and the Cochrane Library, covering the period from January 1980 to January 2023. The search included terms like “eczematous,” “drug eruption,” “medication,” “drug induced,” “skin reactions,” “adverse cutaneous,” and “side effects.” Studies selected for review included literary reviews, systematic reviews, case reports, and case series focusing on the pharmacological agents responsible for EDEs. Articles were selected based on their focus on primary care medications and their connection to EDEs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The review identified a broad spectrum of medications implicated in EDEs, including calcium channel blockers, ACE inhibitors, ARBs, thiazides, and statins. Among these, calcium channel blockers were the most frequently associated with chronic, diffuse, and pruritic scaly papules and plaques. Other common offenders include ACE inhibitors and ARBs, which primarily trigger eczema-like rashes in elderly patients. Thiazide diuretics were associated with photosensitivity reactions leading to eczematous eruptions. Statins were found to compromise the skin barrier, contributing to the development of eczematous reactions, particularly in older individuals. The histopathological findings across cases frequently showed spongiosis, eosinophilic infiltrates, and acanthosis, complicating the differentiation from eczema without a thorough medication history.</p>\u0000 </section>\u0000 \u0000 <sec","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"5 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.70004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142641148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Karen Montecinos, Barbara Kania, David J. Goldberg
<div> <section> <h3> Background</h3> <p>Semaglutide, a glucagon-like peptide-1 receptor agonist, has been utilized for the treatment of type 2 diabetes. Recently, it has gained popularity for its ability to aid in weight loss. However, rapid weight loss induced by semaglutide has been shown to lead to noticeable facial volume loss and the appearance of a prematurely aged face referred to as “Ozempic face.” As this term gains more popularity and increasingly more nondiabetic patients seek rapid weight loss options, there is growing concern among patients and healthcare providers regarding using semaglutide for weight loss as it may have a negative impact on facial esthetics.</p> </section> <section> <h3> Objective</h3> <p>The purpose of this paper is to investigate the semaglutide face phenomenon associated with GLP-1 agonist use for the treatment of obesity.</p> </section> <section> <h3> Methods</h3> <p>A comprehensive search on PubMed was conducted to identify the available information related to semaglutide regarding Ozempic face. The search was conducted using a combination of keywords, including “semaglutide,” “semaglutide face,” and “Ozempic face.”</p> </section> <section> <h3> Results</h3> <p>“Semaglutide face” is recognized as having similar characteristics to a naturally occurring aging face. However, the characteristics of an Ozempic face occur in people much younger than what is seen with the natural aging process. While some believe that this phenomenon is attributed to acute weight loss at a faster rate than normal, many physicians argue that the semaglutide face phenomenon is more likely to occur with the amount of weight lost overall rather than whether that individual used a semaglutide medication to achieve the weight reduction or not. Overall, the semaglutide face phenomenon is characterized by elastin and collagen loss, fat and muscle volume loss, and excessive sagging skin.</p> </section> <section> <h3> Conclusions</h3> <p>The semaglutide face phenomenon highlights the esthetic implications of using semaglutide for the promotion of accelerated weight loss. While this term is not medically recognized, the hollow or sunken look following rapid weight loss sheds light on the effect of semaglutide in facial fat redistribution and volume loss. The metabolic changes induced by GLP-1 agonists can impact adipose and muscle tissue, which can lead to changes in facial contour and overall appearance. While semaglutide-induced facial changes may resemble signs of premature aging, they are distinct in their rapid onset and association with signi
{"title":"Semaglutide “Ozempic” Face and Implications in Cosmetic Dermatology","authors":"Karen Montecinos, Barbara Kania, David J. Goldberg","doi":"10.1002/der2.70003","DOIUrl":"https://doi.org/10.1002/der2.70003","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Semaglutide, a glucagon-like peptide-1 receptor agonist, has been utilized for the treatment of type 2 diabetes. Recently, it has gained popularity for its ability to aid in weight loss. However, rapid weight loss induced by semaglutide has been shown to lead to noticeable facial volume loss and the appearance of a prematurely aged face referred to as “Ozempic face.” As this term gains more popularity and increasingly more nondiabetic patients seek rapid weight loss options, there is growing concern among patients and healthcare providers regarding using semaglutide for weight loss as it may have a negative impact on facial esthetics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The purpose of this paper is to investigate the semaglutide face phenomenon associated with GLP-1 agonist use for the treatment of obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive search on PubMed was conducted to identify the available information related to semaglutide regarding Ozempic face. The search was conducted using a combination of keywords, including “semaglutide,” “semaglutide face,” and “Ozempic face.”</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>“Semaglutide face” is recognized as having similar characteristics to a naturally occurring aging face. However, the characteristics of an Ozempic face occur in people much younger than what is seen with the natural aging process. While some believe that this phenomenon is attributed to acute weight loss at a faster rate than normal, many physicians argue that the semaglutide face phenomenon is more likely to occur with the amount of weight lost overall rather than whether that individual used a semaglutide medication to achieve the weight reduction or not. Overall, the semaglutide face phenomenon is characterized by elastin and collagen loss, fat and muscle volume loss, and excessive sagging skin.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The semaglutide face phenomenon highlights the esthetic implications of using semaglutide for the promotion of accelerated weight loss. While this term is not medically recognized, the hollow or sunken look following rapid weight loss sheds light on the effect of semaglutide in facial fat redistribution and volume loss. The metabolic changes induced by GLP-1 agonists can impact adipose and muscle tissue, which can lead to changes in facial contour and overall appearance. While semaglutide-induced facial changes may resemble signs of premature aging, they are distinct in their rapid onset and association with signi","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"5 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.70003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142320771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
Study Aim
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).
Methodology
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.
Results
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.
Conclusion
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.
{"title":"Uses of Dupilumab in Dermatology: A Systematic Review of the Randomized Controlled Trials","authors":"Asmaa Enad Alenazy, Yasmeen Mohammed Alanazi, Sumayyah Inad Alanazi, Nehal Hassan Alrohaimi","doi":"10.1002/der2.70005","DOIUrl":"https://doi.org/10.1002/der2.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Aim</h3>\u0000 \u0000 <p>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).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"5 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.70005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142320772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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