Journal of Drugs in Dermatology最新文献

Cutaneous lupus erythematosus (CLE) is an autoimmune disease with diverse clinical manifestations, including patchy hair loss resembling alopecia areata (AA). This report describes two cases of CLE presenting as AA mimickers, emphasizing the need to consider CLE in differential diagnosis for patchy hair loss. Early and accurate diagnosis is crucial for effective management and preventing scarring alopecia. J Drugs Dermatol. 2025;24(3):324-326. doi:10.36849/JDD.7793R1.

Neoadjuvant Hedgehog Pathway Inhibitor (HPI) therapy, utilizing sonidegib and vismodegib, has shown great potential in managing locally advanced basal cell carcinoma (laBCC). While effective, the tolerability of HPI therapy may be limited due to adverse effects (muscle spasms, alopecia). However, studies have shown a lower incidence of side effects with sonidegib, compared to vismodegib. In this report, we present the case of an 86-year-old male with laBCC on the left inner canthus treated successfully with neoadjuvant sonidegib for 25 weeks prior to Mohs micrographic surgery. This case highlights the utility of sonidegib as a potential neoadjuvant treatment modality for patients who are good candidates for surgery but would benefit from tumor reduction to achieve a more favorable outcome, especially in cosmetically sensitive areas. In addition, our patient experienced minimal side effects (muscle cramps at week 18) from sonidegib treatment. J Drugs Dermatol. 2025;24(3):329-331. doi:10.36849/JDD.8329.

Background: Hyaluronic acid (HA) fillers offer an advantage in being easily reversible with enzymatic hyaluronidase administration. Yet, there are no clear guidelines regarding the amount of hyaluronidase that should be administered given that commercially available fillers differ in constituent properties.

Methods: Six HA fillers were mixed with aliquots of human recombinant hyaluronidase (0 mL, 0.1 mL, 0.2 mL, and 0.3 mL). Filler dilution photography was obtained with the addition of various doses of hyaluronidase. Final filler and hyaluronidase mixture was then visualized on light microscopy at 40X magnification.

Results: None of the fillers responded to the direct addition of hyaluronidase alone. Active mixing was required to stimulate the enzymatic effect. Restylane products which have equal concentrations at 20 mg/mL exhibited similar rates of dissolution. In contrast, Juvederm products, which differ in concentration, exhibited variable rates of dissolution. Juvederm Volbella (15 mg/mL) was the most easily dissolvable filler, in contrast, Juvederm Ultra (24 mg/mL) was the least easily dissolvable filler. Microscopically, Juvederm fillers appeared more refined whereas the Restylane fillers appeared more globular following hyaluronidase.

Conclusion: This study demonstrates the in vitro response of different HA fillers to hyaluronidase. Each filler exhibited a variable dose effect. HA concentration (mg/mL) was the critical variable in determining the rate of hydrolysis. Therefore, HA concentration may be an important factor when calculating the dose of hyaluronidase needed to reverse HA fillers. J Drugs Dermatol. 2025;24(3):303-306. doi:10.36849/JDD.8428.

To report a rare case of severe oligoasthenoteratozoospermia which seems to be associated with long-term topical povidone-iodine (PVP-I) therapy. A 45-year-old man with secondary infertility was diagnosed with mild asthenospermia before undergoing in vitro fertilization (IVF). A repeat sperm analysis (SA) on June 30, 2022, after three months of using compound PVP-I liniment to treat fungal infection under a fingernail and toenail, revealed severe oligoasthenoteratozoospermia. After 77 days of drug withdrawal, sperm concentration, and normal morphology gradually returned to normal, but motility was only partially restored. It seems that the usage of PVP-I has a side effect of causing a decline in sperm quality. Although the exact mechanism of this adverse effect of PVP-I is unclear, men who are in fertility treatment should be informed of the potential risks. J Drugs Dermatol. 2025;24(3):e11-e13.  doi:10.36849/JDD.7342.

Sunscreens play an essential role in preventing skin cancer and photoaging. Nevertheless, concerns about their systemic absorption and environmental impacts persist. In this extensive literature review, we discuss the mechanisms of action, efficacy, and safety concerns related to sunscreen use, aiming to clarify current understandings and dispel prevalent myths. Despite ongoing debates regarding certain ingredients, the scientific consensus supports the use of sunscreens as a critical defense against ultraviolet (UV) radiation. Continued research is necessary to address safety concerns and to refine sunscreen formulations for optimal protection and minimal adverse effects. J Drugs Dermatol. 2025;24(2):142-146. doi:10.36849/JDD.8102.

Background: Psoriasis is a chronic, inflammatory disease associated with numerous negative physical and psychosocial impacts. Deucravacitinib is a novel, selective TYK2 inhibitor approved by the FDA for the treatment of moderate-to-severe plaque psoriasis in adults. Deucravacitinib has established efficacy and safety through several clinical trials, but many clinicians are unfamiliar with its safety profile given the lack of formal guidelines. Thus, this expert consensus panel aims to provide clinical recommendations on the efficacy, safety, and appropriate laboratory monitoring for deucravacitinib.

Methods: A comprehensive literature search of PubMed, Scopus, and Google Scholar was completed for English-language original research articles on the efficacy and safety of deucravacitinib. A panel of 10 dermatologists with expertise in managing psoriasis reviewed the relevant literature and crafted consensus statements regarding the efficacy, safety, and recommended laboratory monitoring for deucravacitinib. Using a modified Delphi process, each statement received supermajority approval and was assigned a strength of recommendation using the Strength of Recommendation Taxonomy (SORT) criteria.

Results: The literature search resulted in 101 articles that met search criteria. After screening the articles for relevance to the discussion topic, 14 articles were selected and distributed to the panelists for review prior to the roundtable discussion. The panel unanimously voted to adopt 6 consensus statements and recommendations, 5 of which were given a strength of "A," 0 were given a strength of "B," and 1 was given a strength of "C."

Conclusion: Deucravacitinib is an effective treatment for plaque psoriasis that is well-tolerated and has an excellent safety profile. The 6 consensus statements created by the panel provide expert recommendations regarding the efficacy, safety, and appropriate laboratory monitoring for deucravacitinib. The expert panel also concludes that deucravacitinib has a superior safety profile to traditional JAK inhibitors. After reviewing the clinical trials, the panel did not find evidence of a causal role for deucravacitinib in inducing laboratory abnormalities and did not recommend baseline and ongoing laboratory monitoring for patients treated with deucravacitinib. J Drugs Dermatol. 2025;24(2):147-155. doi:10.36849/JDD.8616.

Background: Seborrheic keratoses (SKs) are the most common skin lesions to prompt visits to a dermatologist. Patients may be concerned about unsightly appearance, irritation, or the possibility of skin cancer. They frequently ask if there is a topical treatment for these lesions.

Objective: We sought to determine an effective topical formula to improve the appearance of seborrheic keratosis and test the formula in a pilot observational study on a small number of patients.

Methods and materials: A topical mixture of antioxidants, hydrating, and keratolytic agents was applied to five SKs on four patients in a private dermatology clinic. Antioxidants included green walnut hull extract, green tea, ellagic acid from pomegranate, curcumin in turmeric, and rosemary. Urea, salicylic acid, zinc lactate, and glycerin promoted hydration and keratolysis. Lesions were covered with 3M Nexcare® dressings. Softened SK debris was removed with an emery board.

Results: The appearance of the SKs was improved in five cases.

Conclusions and relevance: A 5-to-17-day course of a topical mixture composed of antioxidant, keratolytic, and hydrating agents, followed by scooping of softened SK, improved the appearance of 5 SKs. The topical antioxidant mixture reported in this pilot study warrants further investigation. J Drugs Dermatol. 2025;24(2):183-187. doi:10.36849/JDD.7977.

Background: Lichenification, common in moderate to severe atopic dermatitis (AD) at any age, is often difficult to treat. This analysis assessed dupilumab vs placebo in AD lichenification by age and race-defined groups.

Methods: This post hoc analysis included pooled data from five clinical trials of dupilumab (NCT03054428, NCT03345914, NCT02277743, NCT02277769, NCT02395133), including 1,997 patients aged 6 to 88 years of all races with moderate to severe AD.

Results: Placebo/dupilumab randomized groups analyzed by age (n=1,535) included 123/244 children, 85/166 adolescents, and 460/457 adults; groups analyzed by self-reported racial background (n=1,902) included 132/234 Asian, 74/112 Black/African American, and 427/923 White patients. Dupilumab treatment resulted in nominally significant reductions vs placebo in Global Individual Signs Score lichenification from week 1 (adults/adolescents) or week 2 (children) through week 16. Lichenification measured by SCORing Atopic Dermatitis and Eczema Area and Severity Index improved similarly. By week 16, dupilumab significantly improved lichenification, with nominal significance vs placebo across all racial groups.

Conclusion: Dupilumab treatment resulted in rapid and sustained improvement in lichenification across anatomic regions in all ages. Lichenification improved to a similar extent across racial groups. J Drugs Dermatol. 2025;24(2):167-173. doi:10.36849/JDD.8585R1.

Hair loss disorders negatively impact quality of life. Topical and oral minoxidil are hair loss therapeutics that require daily use to achieve sustained benefits. Patients on topical minoxidil often report aesthetic and discomfort concerns (eg, greasy hair), which may limit adherence. Oral minoxidil is not FDA-approved for alopecia and carries a higher risk of systemic side effects. Efficacy between the 2 is similar. However, the impact of the route of administration on patient adherence and satisfaction remains unclear. Our study investigates whether topical or oral minoxidil yields greater adherence and satisfaction while comparing side effects. A survey was distributed to patients on minoxidil (n=50, response rate 98.0%) to assess ease of treatment, adherence, satisfaction, and side effects. Patients on oral minoxidil reported greater ease of treatment (P=0.0004) and styling their hair on treatment (P=0.0112). Fewer patients on oral minoxidil stopped treatment due to difficulty of use (0% vs 18.8%, P=0.0076). Oral patients missed less treatment days (x=0.15 vs x=1.2, P=0.0022) and reported greater satisfaction in hair volume (P=0.0098) and change of hair (P=0.0159). Side effects were similar, except for a higher incidence of hypertrichosis among patients on oral minoxidil (48.5% vs 6.25%, P=0.0015). These findings suggest that oral minoxidil is superior to topical in terms of ease of use, adherence, and satisfaction without increasing systemic side effects. By circumventing scalp application, oral minoxidil reduces the treatment burden and avoids the aesthetic and discomfort complaints that limit adherence. When establishing treatment plans, physicians should consider patient experience and its impact on adherence. J Drugs Dermatol. 2025;24(2):131-133. doi:10.36849/JDD.8424.