Journal of Drugs in Dermatology最新文献

Introduction: Lichen simplex chronicus is a debilitating condition characterized by lichenified skin secondary to intractable itch. Lichen simplex chronicus is challenging to treat, with current treatment options, such as topical calcineurin inhibitors, gabapentinoids, and dupilumab, commonly being ineffective, leaving patients with worsening symptoms and poor quality of life.

Case presentation: We report a case of lichen simplex chronicus in the setting of neuropathic pruritus successfully treated with nemolizumab in a 52-year-old woman. The patient did not report any side effects but reported significant improvement in quality of life.

Conclusion: Lichen simplex chronicus has a significant impairment on quality of life, as it has been linked to anxiety, depression, and poor sleep, underscoring the importance of proper disease management. Current treatment regimens for lichen simplex chronicus are often ineffective. Our observation suggests that nemolizumab may be effective in managing lichen simplex chronicus; larger studies are warranted to confirm these findings.

As cancer prevalence continues to increase in Nordic countries, the amount of dermatological adverse events, termed cutaneous adverse events (cAEs), will also increase. The Nordic European Cutaneous Oncodermatology Management (NECOM) group aims to provide evidence-based guidance on how to treat and manage cAEs with an emphasis on supportive skincare regimens to improve patients' quality of life. The presented real-world cases demonstrate the use of the previous 6 NECOM recommendations in clinical practice. Experts in supportive oncodermatology share real patient cases and cAE treatment plans to serve as a guide for future healthcare providers. The cases highlight the use of daily skincare regimens containing gentle cleansers, moisturizers, and sunscreen that help to protect the skin from severe skin toxicities and help repair the skin barrier. Patients who were prescribed a daily skincare regimen consisting of Lipikar Syndet AP+ cleanser, Lipikar Baume AP+M, Cicaplast baume B5+, and Anthelios UVMUNE SPF50+ sunscreen (La Roche-Posay) found that their cAEs were less severe and symptomatic. The products in the recommended skincare regimen have all been tested for tolerance on patients undergoing cancer treatment. NECOM advisors emphasize the importance of selecting the right skincare products that will best nourish and heal sensitive skin and encourage patients and clinicians to encourage a proactive approach to skincare before, during, and after cancer-targeted therapies.  .

Background: International Dermatology Outcome Measures (IDEOM) is a nonprofit organization committed to advancing the development and accessibility of evidence-based, consensus-driven outcome measures in dermatology. This mission is supported by a diverse group of stakeholders who collaborate to improve the research and treatment of dermatologic disease.

Summary: The 2024 IDEOM Annual Meeting was held on April 5-6, 2024. During the event, work groups in psoriatic disease, hidradenitis suppurativa, geriatric dermatology, connective tissue disease, vitiligo, itch, actinic keratosis, acne, and cutaneous T-cell lymphoma discussed research progress and conducted breakout sessions. This report summarizes each workgroup’s updates.

Key messages: This report outlines the key research advancements made by each IDEOM workgroup at the 2024 IDEOM Annual Meeting.  .

Many medications commonly used in dermatology come with package inserts that contain boxed warnings that are frequently not evidence-based. Boxed warnings are the most serious warnings that the US Food and Drug Administration (FDA) can issue for medications through various methods, like class labeling, despite the absence of factual, high-quality evidence. Currently, there are several medications labeled with these boxed warnings for which there is no evidence, and in many cases, there actually may exist refuting evidence. However, these warnings persist in the package inserts. This has led to much hesitancy in their use, contributing to the undertreatment, or even lack of treatment, of conditions for which these medications are efficacious. Furthermore, the negative physical and mental effects of the lack of effective treatment for patients with skin disorders are well-documented. The authors call for transparency regarding the evidence, or lack thereof, behind these boxed warnings on the part of the FDA.

Background: Acne pathophysiology and presentation may differ between pediatric/adolescent/young adult (9-24 years) and adult (≥25 years) patients. Fixed-dose clindamycin phosphate 1.2%/adapalene 0.15%/benzoyl peroxide 3.1% (CAB) gel demonstrated superior efficacy to vehicle and component dyads with good safety/tolerability in 3 clinical trials of acne. This post hoc analysis evaluated the efficacy/safety of CAB in pediatric/adolescent/young adult ("younger") vs adult participants.

Methods: In one phase 2 (NCT03170388) and two phase 3 (NCT04214652, NCT04214639) trials, participants aged greater than or equal to 9 years with moderate-to-severe acne were randomized to once-daily CAB or vehicle gel. Pooled data were analyzed for participants grouped by age: younger (9-24 years; n=515) and adult (greater than or equal to 25 years; n=142). Endpoints included the percentage of participants achieving treatment success (greater than or equal to 2-grade reduction from baseline in Evaluator's Global Severity Score and clear/almost clear skin) and least squares mean percent change from baseline in inflammatory/noninflammatory lesions at week 12. Treatment-emergent adverse events (TEAEs) were evaluated throughout.

Results: At week 12, approximately half of CAB-treated participants in both age groups achieved treatment success (9-24: 50.6%; greater than or equal to 25: 49.0%) vs less than one-fourth with vehicle (15.7%; 20.6%; P<0.01, both). Across groups, CAB yielded >70% reductions in inflammatory/noninflammatory lesions vs 45% to 62% with vehicle (P≤0.001, all). For all endpoints, CAB efficacy was similar across age groups. Most TEAEs with CAB were of mild-to-moderate severity, and there were no age-related trends in safety/tolerability.

Conclusions: Fixed-dose, triple-combination CAB gel was efficacious and well tolerated in participants with moderate-to-severe acne, regardless of age. Approximately half of the participants achieved clear/almost clear skin, with >70% reductions in lesion counts.

Background: The National Institutes of Health (NIH) funds a multitude of dermatology research. This study examines NIH funding for vitiligo studies and highlights key trends.

Methods: The NIH Research Portfolio Online Reporting Tool database was used to identify vitiligo research projects funded between 1985 and 2024, with results limited to project titles containing "vitiligo."

Results/discussion: The NIH awarded 166 grants for vitiligo research between 1985 and 2024. This study analyzed 144 of these awards, totaling $22,343,119. The greatest increase occurred between 1998 and 1999, with the average funding per grant rising by $124,316, leading to a total funding increase from $269,102 to $1,149,554. The most common funding mechanism was Non-Small Business Innovation Research (SBIR)/Small Business Technology Transfer (STTR). The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) was the leading administering institute. Medical schools were the most awarded organization type. The most common grant types were R01 (n=59, 41%) and M01 (n=21, 15%). Among the 144 funded projects, 48 were unique, with most focusing on pathophysiology (n=36) and treatment (n=8).

Limitations: Study limitations include incomplete data on NIH research funding, with 22 awards missing total cost information and 25 awards calculated using subproject sums.

Conclusion: From 1985 to 2024, NIH funding for vitiligo research fluctuated with an upward trend in recent years. The most common funding mechanism was Non-SBIR/STTR. Among organization types, medical schools received the most awards. Most vitiligo research projects have been completed and have focused on understanding the pathophysiology and treatment of vitiligo.  .

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory disease associated with obesity and metabolic dysregulation. Current therapies yield variable benefits and do not target metabolic drivers. Tirzepatide, a dual GLP-1/GIP receptor agonist, induces weight loss and exerts anti-inflammatory effects, offering a potential novel approach for the treatment of HS.

Objectives: To evaluate the efficacy and safety of tirzepatide in adults with moderate-to-severe HS.

Methods: In this open-label, single-center, single-arm proof-of-concept study, 20 adults with moderate-to-severe HS (Physician's Global Assessment greater than or equal to 3; BMI greater than or equal to 27) received once-weekly tirzepatide, titrated to maximum tolerated dose, for 24 weeks, followed by an 8-week washout. The primary endpoint was Hidradenitis Suppurativa Clinical Response (HiSCR) at week 24. Secondary endpoints included changes in PGA, Dermatology Life Quality Index (DLQI), pain visual analog scale (VAS), and Hospital Anxiety and Depression Scale (HADS). Analyses were conducted using an intention-to-treat approach.

Results: At week 24, 16 of 20 participants (80.0%; P<0.00001) achieved HiSCR. Improvements were also observed in DLQI, VAS, and PGA scores, with some benefits persisting through week 32. Treatment was well tolerated, with high adherence and favorable metabolic effects.

Limitations: Single-center, open-label design, modest sample size.

Conclusions: Tirzepatide demonstrated promising efficacy and tolerability in patients with moderate-to-severe HS and obesity. Larger randomized trials are warranted to confirm efficacy, durability, and safety.  .

Background: Cutaneous hyperpigmentation, which includes melasma, post-inflammatory hyperpigmentation, and solar lentigines, significantly impacts patients' quality of life. The overproduction of melanin is mediated by activation of the skin enzyme tyrosinase, leading to excess melanin deposition in the skin. Thiamidol (isobutylamido thiazolyl resorcinol) formulations have been previously shown to be effective in reducing the cutaneous pigmentation associated with this human skin enzyme.

Methods: A randomized study was performed with 90 subjects clinically presenting with facial hyperpigmentation (Thiamidol serum n=43; Thiamidol regimen n=47) as measured by colorimeter and individual typology angle (ITA0) to assess the efficacy of a Thiamidol-based serum (2X daily application; morning/night) or a Thiamidol-based regimen (day lotion with SPF 30 + serum in morning; night cream + serum at night) for 12 weeks with a 6-week regression period.

Results: A significant visible reduction in facial hyperpigmentation, assessed by increases in L* and ITA° values, along with an increase in skin radiance and shine, were observed as early as week 2, with continued improvement through week 12 in both the treatment groups relative to baseline. At week 12, changes in radiance and shine were trending toward enhancement in the regimen group compared with the serum group.

Discussion: This study demonstrates the clinical effectiveness of Thiamidol-containing formulations in the visible improvement of facial hyperpigmentation and in overall skin radiance and shine.

Conclusion: These data support the use of Thiamidol-containing formulations as part of the overall management strategy for individuals affected by facial hyperpigmentation.  .