Journal of Drugs in Dermatology最新文献

Background: Iron oxides, antioxidants, and pigmentary titanium dioxide are sunscreen additive ingredients that enhance visible light protection, reduce associated hyperpigmentation, and protect against certain photosensitive dermatoses There are currently no standardized recommendations for visible light protection with these additive ingredients, leading to varied clinical recommendations.

Objectives: This study aimed to evaluate dermatology practitioners' counseling practices for visible light protection.

Methods: An electronic survey was distributed to dermatology practitioners. Survey responses were compiled for analysis, and statistical significance was calculated using a standard 95% confidence interval.

Results: 91.68% of 974 respondents actively counsel patients about visible light protection, primarily emphasizing its role in exacerbating pigmentation in patients with melanin-rich skin (70.92%). Of these, 10.34% recommended sunscreens with visible light protective additive ingredients specifically for patients with melanin-rich skin, and 48.89% recommended them for managing melasma or post-inflammatory hyperpigmentation. Iron oxide additive ingredients were most frequently recommended (90.92%), followed by antioxidants (69.08%) and pigmentary TiO2, (58.85%). 8.32% of respondents reported not counseling patients about visible light protection, with major reasons encompassing the lack of standardized guidelines (50.62%), challenges in recommending suitably tinted sunscreens (27.16%), limited availability of sunscreen options (23.46%), and insufficient supportive data (18.52%).

Conclusion: There is a need for increased education and awareness regarding visible light protection strategies and the identification of patients who may benefit the most from a targeted photoprotective strategy. Establishing standardized guidelines and broadening the availability of sunscreen options conferring visible light protection may help address these gaps. J Drugs Dermatol. 2024;23(11):965-971. doi:10.36849/JDD.8159.

Introduction: Topical clindamycin phosphate 1.2%/adapalene 0.15%/benzoyl peroxide 3.1% (CAB) gel is the only fixed-dose, triple-combination formulation approved for acne treatment. In 3 clinical studies of participants with moderate-to-severe acne, CAB demonstrated superior efficacy to vehicle and component dyads, with good safety and tolerability. Detailed efficacy/safety data from individual clinical study participants are presented.

Methods: In two phase 3 (NCT04214652, NCT04214639) randomized, double-blind, 12-week studies, participants aged at least 9 years with moderate-to-severe acne were randomized to once-daily CAB or vehicle gel. Descriptive data - including lesion count changes, treatment success (at least 2-grade reduction from baseline in Evaluator's Global Severity Score and clear/almost clear skin), compliance, treatment-emergent adverse events (AEs), and cutaneous safety/tolerance assessments - were summarized from 6 CAB-treated cases.

Results: By week 12, all cases achieved >70% lesion reductions, 4/6 achieved treatment success, and 1/6 achieved a 2-grade reduction in severity. All cases were compliant with CAB treatment. No cases reported serious AEs. Transient increases occurred on cutaneous safety and tolerability assessments, with scores generally decreasing back to/below baseline levels by week 12.

Conclusions: In two phase 3 clinical trials, fixed-dose, triple-combination CAB demonstrated good efficacy/safety. All 6 CAB-treated cases achieved substantial (>70%) lesion reductions, with 5/6 achieving treatment success or 2-grade reduction in severity by week 12. Transient cutaneous safety/tolerability severity increases generally resolved to baseline values by week 12. These clinical study cases reinforce the importance of patient education regarding adherence, expectations, and AEs. J Drugs Dermatol. 2024;23(11):1017-1024. doi:10.36849/JDD.8639.

Background: Tyrosinase is the rate-limiting enzyme of melanogenesis and thus an ideal inhibitory target for treating hyperpigmentation. There are many commercially available tyrosinase inhibitors with limited clinical efficacy. A recent screen of 50,000 compounds found isobutylamido thiazolyl resorcinol (ITR) to be the most potent inhibitor of human tyrosinase.

Objective: To summarize the current evidence on the efficacy and adverse effects of ITR in treating hyperpigmentation.

Methods: A literature search was conducted using PubMed and Google Scholar databases in June 2022. Fourteen clinical studies investigating the use of topical ITR in hyperpigmentation treatment or prevention were identified.

Results: Most studies (n=13) investigated topical ITR as a treatment, while only one investigated ITR as a preventative measure against hyperpigmentation. All studies (n=14) found ITR to provide statistically significant improvements to hyperpigmentation conditions, including facial hyperpigmentation (n=3), melasma (n=5), post-inflammatory hyperpigmentation (PIH) (n=3), and UV-induced hyperpigmentation (n=3). Evidence suggests that the effective dosage and duration of topical ITR appears to be 0.1% to 0.2% ITR 2 to 4 times daily for 12 to 24 weeks. Successful prevention of UVB-induced hyperpigmentation has been seen following twice-daily topical ITR application for 3 weeks (P<0.001).

Conclusion: Topical ITR can significantly reduce hyperpigmentation, however, the evidence for its use is limited. Further investigation is warranted to identify the optimal dosage and application schedule of ITR, as well as compare the efficacy of ITR vs hydroquinone to determine if ITR is superior to the current standard of care. J Drugs Dermatol. 2024;23(11):986-991.  doi:10.36849/JDD.7985.

Background: Artificial intelligence chatbots (AIC) have sharply risen in popularity. Dermatology, heavily involving visual, clinical, and pathological pattern-recognition techniques, will be impacted by AIC. Thus, this study aims to categorize the attitudes and beliefs of American dermatologists towards AIC and their potential uses, benefits, and risks.

Methods: An online cross-sectional survey was distributed to dermatologists across the United States. Questions explored opinions on AIC along with perceived benefits, risks, and important considerations for the incorporation of AIC into the practice of dermatology. Demographic data and self-reported understanding of AIC were also collected.

Results: 192 complete responses were received. 53.6% of respondents were female. 44.3% were between ages 30 to 39. 41.1% had 0 to 10 years of experience as attending physicians. 76.5% of participants believed it is somewhat or very likely that AIC will be formally incorporated into dermatology. Higher self-reported understanding of AIC was associated with an increased perceived likelihood of AIC implementation as well as decreased perceived risk associated with AIC. Notably, 86% of respondents believed AIC would impact "patient education," while concerns regarding "misinformation" and "incorrect diagnoses" were prevalent (89% and 78.5%, respectively). Participants anticipated AIC's role primarily in administrative tasks, with 75.7% citing "reduced work burden on physicians" as a potential benefit.

Conclusion: Dermatologists in the United States foresee the integration of AIC into their practice, emphasizing its potential in administrative roles. Concerns revolve around the complexity of medical understanding and effective patient communication. As AIC continues to evolve, ongoing studies are crucial to evaluate their safety and efficacy in dermatological practice. J Drugs Dermatol. 2024;23(11):972-978. doi:10.36849/JDD.8239.

What is the ideal topical acne therapeutic? Topical therapeutics for acne vulgaris have advanced considerably over the last decade. Novel vehicular technologies have increased transdermal penetration of active molecules, enhanced their distribution across the skin surface, improved tolerability, and allowed for the incorporation of previously incompatible active compounds. Thus, fixed-combination topical therapeutics were successfully developed and are able to target multiple aspects of acne pathogenesis leading to synergism and increased efficacy. These advancements have paved the way to optimizing acne treatment while incorporating antibiotic stewardship which has become an urgent necessity. J Drugs Dermatol. 2024;23:11(Suppl 1):s4-10.

Skin cancer most commonly affects fair-skinned individuals1; however, it can appear in individuals of all skin tones. Photoprotective behaviors such as applying sunscreen should be practiced by all individuals regardless of skin tone. Herein, the authors discuss the cost and protection of popular sunscreens targeted towards patients with darker skin or skin of color (SOC), and suggest important considerations providers should take into account when advising about sunscreen recommendations for patients with skin of color. J Drugs Dermatol. 2024;23(11):e181-e182. doi:10.36849/JDD.8710e.

Thixotropic gels are the preferred choice in the collection of platelet-rich plasma as an easy solution to operator variability. One often unnoticed shortcoming is the entrapment of platelets in the gel layer's uppermost surface. We provide instructions to optimize platelet yield, ie, agitation to re-suspend platelets, setting the optimal G-force and time of centrifugation, and the essential use of a horizontal swing bucket centrifuge. We conclude that this technique represents a new clinical and research direction, particularly to optimize platelet counts. We therefore encourage others to utilize this technique in future endeavors. J Drugs Dermatol. 2024;23(11):979-985. doi:10.36849/JDD.7983.

Background: Botulinum toxin (BT) has become one of the most frequently sought aesthetic procedures for wrinkle reduction.

Objective: This study investigated the effectiveness and safety of a novel device using radiofrequency (RF) and high-intensity facial muscle stimulation (HIFES) in patients injected with BT.

Methods: Twelve patients were divided into an Active (N=10) and a Control group (N=2), where the Active received four treatments and the Control none. The facial expressions documented by digital photographs (neutral) and videos (frown, smile, surprise expressions) were taken at all visits (baseline, after last Tx, 1 and 3-month follow-ups) and were evaluated using the Global Aesthetic Improvement Scale (GAIS) and 3D automated analysis. The subject's therapy comfort and satisfaction were assessed.

Results: The Active group reported high satisfaction with treatment comfort (6.3±0.2 points on the 7-point Likert scale). 3D analysis showed reduced wrinkle severity (37.4%) and volume increase (+1.5 mL) on the cheeks at 3 months. GAIS evaluation demonstrated the most prominent improvement in smiling facial expression by 2.2±0.1 points. No adverse events were observed.

Conclusion: The study results suggest that the combination of HIFES and synchronized RF is a safe and effective treatment for improving facial appearance and muscle tone in patients injected with BT. J Drugs Dermatol. 2024;23(11):937-942.  doi:10.36849/JDD.7938.

Retinoids are derivatives of vitamin A prominently used in cosmeceuticals to reverse signs of photoaging. Retinaldehyde (retinal) is 10x more bioavailable than retinol and is gaining traction in the skincare industry for being the strongest over-the-counter retinoid. This study evaluated the efficacy and tolerability of a novel retinal formulation including peptides, ceramides, and lipids, designed to sustain the potency of the retinal and enhance delivery to reverse clinical signs of photoaging. This study was a trial of the test product (Retinal Night Advanced 0.1% Retinal Firming Treatment, Dr. Whitney Bowe Beauty, Greenwich, CT) in which 32 female subjects were enrolled. 47% of subjects had skin of color (Fitzpatrick Skin Type III-VI) and 57% had sensitive skin. Subjects applied the test product 3 nights weekly to the face, neck, and chest for 8 weeks. Fine lines of the face had 12% visible change by week 8 (P<0.0001). Fine lines on the chest showed progressive visible improvement of 11% at week 2 (P=0.0005) and 19% at week 8 (P<0.0001). There was a 19% improvement in visible hyperpigmentation of the face by the 8-week mark (P<0.0001). Visible texture of the face improved by 5% (P=0.0078) and pores improved by 20% at week 8 (P<0.0001). Patch testing revealed no signs of sensitization or irritation. This clinical study demonstrates that this retinal formulation is safe, well-tolerated, and effective in improving the appearance of fine lines, hyperpigmentation, texture, and pores. J Drugs Dermatol. 2024;23(11):992-997. doi:10.36849/JDD.8058R1 .