Journal of Drugs in Dermatology最新文献

Scarring alopecia, also known as cicatricial alopecia, is a group of hair loss disorders characterized by inflammatory destruction of hair follicles, leading to hair loss and scar tissue formation. Treating scarring alopecia is challenging due to the irreversible damage caused by the inflammatory process. Consequently, early intervention targeting inflammation is crucial for improving prognosis.1 Recently, several reports have emerged supporting the use of platelet-rich plasma (PRP) as a non-conventional therapy for scarring alopecia, suggesting its potential benefits in mitigating inflammation and halting disease progression. While there is a growing body of evidence demonstrating the efficacy and safety of PRP in nonscarring alopecia, such as androgenetic alopecia (AGA) and alopecia areata (AA), there remains a scarcity of evidence regarding the clinical benefits of PRP in scarring alopecias.2-7 In this study, we conducted a literature review exploring the effectiveness and safety of PRP in treating scarring alopecia. Eleven studies describing PRP treatment outcomes were identified. Overall, PRP demonstrated a positive impact, slowing disease progression with reduced signs of inflammation and no reported adverse effects. However, it is important to note that the evidence supporting the utility of PRP in scarring alopecias is currently limited to case reports. Therefore, immunomodulatory therapies should remain the mainstay therapy for scarring alopecias until further investigations are warranted. J Drugs Dermatol. 2024;23(12):1076-1082. doi:10.36849/JDD.7813.

Cutaneous collagenous vasculopathy (CCV) is an underreported cutaneous microangiopathy that primarily involves the lower extremities. Optimal treatment of CCV has not been well-defined, which may be in part due to the rare nature of the condition; however, a few case reports have demonstrated a reduction in the appearance of CCV-associated telangiectasias with vascular laser therapy. Here, we present two cases of CCV successfully treated with pulsed dye laser (PDL) therapy and summarize the existing literature on this topic. J Drugs Dermatol. 2024;23(12):1121-1123. doi:10.36849/JDD.7904.

Introduction: Targeted therapy has improved clinical outcomes for various types of cancer. However, their use is associated with dermatologic adverse events that impact quality of life and consistent therapies.

Objectives: The US Cutaneous Oncodermatology Management (USCOM) multidisciplinary-guided algorithm for preventing and managing cutaneous targeted therapy-related adverse events provides practical recommendations for cancer patients and survivors.

Methods: The USCOM advisory board (panel) identified 6 commonly occurring cutaneous adverse events associated with targeted therapies. Practical recommendations for prevention and management were developed based on the results of a literature search, clinical expertise, and opinion.

Results: Acneiform rash, pruritus, xerosis, paronychia, hyperpigmentation, and hand-foot skin reaction were selected as common targeted therapy-related cutaneous adverse events. The panel provides practical steps for preventing and treating these cutaneous conditions.

Conclusions: The USCOM multidisciplinary-guided algorithm is for healthcare providers treating oncology patients receiving targeted therapies. Cutaneous targeted therapy-related adverse events necessitate prompt and accurate diagnosis and multidisciplinary management that includes a dermatologist and the oncologic team, limiting disruption of cancer treatment and optimizing quality of life and treatment outcomes. J Drugs Dermatol. 2024;23:12(Suppl 1):s3-14.

Background: International Dermatology Outcome Measures (IDEOM) is a non-profit organization whose mission is to improve the availability of evidence-based, consensus-driven outcome measures for dermatological diseases. IDEOM facilitates collaboration between stakeholders from various backgrounds, including researchers, patients, physicians, and industry representatives, to develop objective benchmark metrics that enable better treatment and management of dermatologic conditions.

Summary: The 2023 IDEOM Annual Meeting was held June 23-24, 2023. Workgroups in psoriatic disease, hidradenitis suppurativa, geriatric dermatology, connective tissue disease, vitiligo, itch, actinic keratosis, acne, and cutaneous T-cell lymphoma discussed the progress of their respective outcome-measures research. This report summarizes each workgroup’s updates since the 2022 annual meeting and their next steps as established during the 2023 IDEOM Annual Meeting. J Drugs Dermatol. 2024;23(12):1114-1120. doi:10.36849/JDD.8363.

Background: Topical clindamycin phosphate 1.2%/adapalene 0.15%/benzoyl peroxide 3.1% (CAB) gel is the only fixed-dose triple-combination approved for acne (indicated in patients 12 years and older). As topical acne treatment in pediatric patients may be complicated by tolerability and/or a perceived lack of efficacy, post hoc analyses were used to investigate efficacy/safety of CAB in children and adolescents.

Methods: Data were pooled from 2 phase 3, double-blind, 12-week studies (NCT04214639; NCT04214652). Participants aged 9 years and older with moderate-to-severe acne were randomized (2:1) to once-daily CAB or vehicle gel. Endpoints included treatment success (at least 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. Treatment-emergent adverse events (TEAEs) and cutaneous safety/tolerability were evaluated. Post hoc analyses were conducted in adolescents aged 12 to 17 years (CAB, n=123; vehicle, n=50) with descriptive data shown for children aged 10 to 11 (CAB, n=3; vehicle, n=2).

Results: At week 12, 51.5% of CAB-treated adolescents achieved treatment success vs 24.9% with vehicle (P<0.01). CAB also provided inflammatory/noninflammatory lesion reductions of 78.3%/73.7% vs 50.5%/42.9% with vehicle (P<0.001, both). Most TEAEs were of mild-to-moderate severity, and <2.5% of participants discontinued due to adverse events. Only the 3 children treated with CAB achieved treatment success, with lesion reductions ranging from 76% to 100%. One CAB-treated child experienced TEAEs and none discontinued.

Conclusions: In 2 pooled phase 3 studies, once-daily CAB gel was well tolerated and efficacious in pediatric participants with acne, with over half achieving treatment success at week 12. J Drugs Dermatol. 2024;23(12):1049-1057. doi:10.36849/JDD.8643.

Background: There are numerous over-the-counter products for treating acne, although many formulations have tolerability issues and lack the cosmetic elegance desired by adult patients.

Objective: The objective of this study was to evaluate the efficacy and tolerability of a non-prescription, active acne regimen in adult patients of all Fitzpatrick skin types.

Method: Thirty-five male and female subjects with Fitzpatrick skin types I-VI were enrolled in this single-site, monadic 8-week study. The acne treatment regimen included a clarifying cleanser, balancing serum, and broad-spectrum sunscreen formulated with synergistic ingredients designed to mitigate acne and reduce post-acne sequelae including post-inflammatory hyperpigmentation (PIH) and post-inflammatory erythema (PIE).

Results: After 8 weeks of use, there was a statistically significant reduction in inflammatory lesions by 63%, non-inflammatory lesions by 41% and investigator global assessment by 51%. Additionally, there was significant improvement in tactile smoothness, visual smoothness, skin softness, and luminosity. Post-acne sequelae including PIH and PIE improved significantly by 27%. No tolerability issues were identified by the investigator and subjects gave the regimen an excellent tolerability rating. 78.5% of subjects agreed that, after 8 weeks of product use, their skin appeared more radiant and looked better than before starting the study.

Conclusion: In this study, a well formulated, cosmetically elegant active acne regimen was found to be highly effective and well tolerated when used by adult acne patients of diverse ethnicities. In addition, the regimen improved cosmetic aspects of the skin including PIH and PIE, which are important when treating adult acne sufferers. J Drugs Dermatol. 2024;23(12):1042-1048. doi:10.36849/JDD.8458.

Many dermatologic medications have the potential to induce ocular complications. Traditional medications, including corticosteroids, retinoids, antibiotics, antihistamines, and immunosuppressants, have been associated with eye dryness, irritation, allergy, infection, atrophy, pigmentary changes, increased intraocular pressure, and impaired vision. Novel therapeutic agents such as biologics raise new concerns for ocular surface disease and conjunctivitis. Dermatologists should recognize these oculocutaneous side effects for appropriate decision-making, coordinating interdisciplinary care, and optimizing patient outcomes. J Drugs Dermatol. 2024;23(12):1108-1113. doi:10.36849/JDD.8236.

Dermatologists are likely to periodically encounter candidiasis in clinical practice, especially given the increased risk with the use of new broad-spectrum IL-17 blocking psoriasis agents such as bimekizumab. Oral candidiasis may be white or red, classically presenting as cottage-cheese consistency plaques associated with symptoms of a burning mouth and dysgeusia. Standard first- and second-line antifungal medications can easily and safely be prescribed by dermatologists. In this article, we summarize clinical presentations and treatment algorithms for oral candidiasis relevant to the dermatologist. We also present indications and criteria for infectious disease referral or hospitalization. J Drugs Dermatol. 2024;23(12):e186-e190. doi:10.36849/JDD.8481e.