Journal of Drugs in Dermatology最新文献

Background: Mild-to-moderate acne vulgaris (AV) is common among adults, and benzoyl peroxide (BPO) has a long history of efficacy in reducing AV lesions. The efficacy of BPO is comparable for concentrations from 2.5% to 10% used as leave-on therapy, but tolerability is usually best at lower concentrations formulated in well-designed vehicles and with newer formulation methods such as micronization. This study assessed the efficacy and safety of a 2.6% BPO cleanser (Complexion Clearing AV Cleanser, CCAC) in mild-to-moderate AV.

Methods: This was a single-center, open-label, 4-week study of subjects aged 18 to 45 years (n=28) with self-perceived sensitive skin and mild-to-moderate AV. CCAC was applied twice daily (morning and evening) on damp skin. Assessments included lesion counts, clinical photography with porphyrin analysis, patient self-assessment questionnaires, collection of adverse events, and standard tolerability ratings.

Results: Total lesion counts were significantly reduced by week 1 of CCAC cleanser use (-25.2%, P<0.05). At week 4, AV lesions were numerically reduced but did not reach statistical significance. Additionally, there was a significant reduction of porphyrin counts at week 1 (-19.4% right side face, -28.8% left side, P<0.05 vs baseline). CCAC was well tolerated, with no significant increase in tolerability ratings at any time point compared to baseline, and patients reported good satisfaction.

Conclusions: CCAC was efficacious in reducing AV lesions in as little as one week, and a trend in reduction was shown through week 4. Additionally, this 2.6% BPO cleanser was also shown to be very well tolerated and well-liked by subjects with self-perceived sensitive skin. J Drugs Dermatol. 2024;23(9):764-768. doi:10.36849/JDD.8219.

Chronic spontaneous urticaria (CSU) should be on every dermatology practitioner's radar. CSU is a skin disorder marked by wheals, angioedema, or both for more than 6 weeks. Patients with CSU experience unexplained, itchy wheals that appear and disappear, traveling around the body and lasting less than 24 hours per area. Angioedema accompanies wheals for up to 48 hours in around half of cases. CSU is a diagnosis of exclusion, relying heavily on patient history to differentiate CSU symptoms from other causes of urticaria or angioedema. But reassuringly, CSU has a simple diagnostic algorithm and a clear initial treatment path. First-line strategies include non-pharmacologic approaches, and second-generation antihistamines (2gAH) administered up to 4 times their standard dose. Omalizumab and cyclosporine (off-label) are second- and third-line options, respectively. However, many patients will continue to have CSU symptoms despite consistent maximum-dose treatment. Novel therapies, including biologic agents and small molecule drugs targeting mast cell activation and inflammatory mediators, show promise in treating CSU refractory to standard therapy. However, further research is needed to establish their efficacy and safety in clinical practice. J Drugs Dermatol. 2024;23:9(Suppl 2):s5-14.Access the CME Activity.

Topical corticosteroids are used extensively in dermatology. Class 1 high potency topical steroids (HPTS) can result in unwanted side effects such as skin hypopigmentation, atrophy, and acneiform eruptions. HPTS are only legally available by prescription to ensure appropriate use in the United States (US). The authors have noticed a recent increase in patients presenting with steroid acne after buying HPTS products in beauty supply stores. These products are marketed as fade creams to treat hyperpigmentation and uneven skin tone. We assessed skincare products containing HPTS (clobetasol or betamethasone) in 33 beauty supply stores in Miami, FL; Washington, DC; and Baltimore, MD. Out of 33 beauty supply stores, 14 (42.42%) contained HPTS skincare products, and they were all located in Miami. Out of 15 stores visited in Miami, 14 (93.33%) contained skincare products with clobetasol, and 5 (33.33%) contained skincare products with both clobetasol and betamethasone. Of the stores selling HPTS skincare products, the number of different brands available ranged from 1 to 7, with an average of 4.21 different brands per store. Our study reveals that HPTS are readily available in over-the-counter skincare products in many beauty supply stores. HPTS skincare products were only available in one of three cities suggesting there may be a regional supplier distributing these products. It may also indicate that there is less oversight of retail stores in Miami with HPTS products. More studies are needed to quantify the availability of these products in different locations throughout the US. Further Studies can help identify this problem and raise awareness among consumers of the dangers of HPTS skincare products in beauty supply stores. J Drugs Dermatol. 2024;23(9):709-712. doi:10.36849/JDD.7608.

Background: Algorithms on various social media platforms feed users what it considers "beautiful", impacting the aesthetic desires of patients as well as beauty ideals.

Objective: To discuss how algorithms on social media platforms personalize feeds and influence a patient's preference for procedures.

Methods: YouTube, Instagram, and TikTok's websites were searched for how their algorithms function. A narrative review of the literature pertaining to social media and cosmetic procedures was also conducted using PubMed.

Results/discussion: Social media platforms personalize feeds for their users. Identifying exactly what a patient is exposed to on social media and how that influences their preference for cosmetic procedures presents a challenge at various levels. Social media usage appears to at least influence cosmetic procedure consideration. The desired appearance may be impacted by location, repeated exposure, and familiarity.

Conclusion: While impossible to predict the next beauty trend, it is important to understand how algorithms and artificial intelligence may play an increasing role in a patient’s visual diet and how their aesthetic goals are thereby affected. Using social media platforms and understanding market trends can guide dermatologists to provide evidence-based education, dispel misinformation, and anchor patients in reality while understanding the cosmetic procedures that patients seek. J Drugs Dermatol. 2024;23(9):742-746.  doi:10.36849/JDD.8074.

Papulopustular eruptions are the most common dermatologic side effect of epidermal growth factor receptor inhibitor (EGFRI) therapy. Topical corticosteroids and oral tetracyclines are frequently used to manage these eruptions, though these treatments are limited by their adverse effects and efficacy. Results from preclinical studies suggest a role for topical aprepitant (HT-001) in the treatment of EGFRI-induced skin toxicities. Herein a case of EGFRI-induced papulopustular eruption with rapid treatment response to topical aprepitant (HT-001) 2% cream is described and the literature reviewed. J Drugs Dermatol. 2024;23(9):e173-e174. doi:10.36849/JDD.8617.

Acne can cause disfiguring sequelae, such as scarring, post-inflammatory erythema (PIE), and post-inflammatory hyperpigmentation (PIH). These post-inflammatory dyschromias pose a significant psychological burden on patients. This burden disproportionately affects skin of color (SOC) patients and can be the most distressing aspect of acne in SOC patients with skin types IV to VI. Multiple non-ablative lasers are used in the treatment of acne-related PIE and PIH. Combination therapies have shown promise in conditions such as rosacea, acne, and post-inflammatory dyschromia. Addressing both the inflammatory and scarring components of acne is key. Given the role of oxidation in the inflammatory cascade, including antioxidants could be an efficacious adjuvant with non-ablative lasers. This is a single-site, randomized, controlled clinical study of 25 subjects with skin types I to VI with facial PIE and/or PIH from acne. The primary objective was to investigate the clinical efficacy of non-ablative laser therapy followed by the topical application of Silymarin/Salicylic Acid/L-Ascorbic Acid/Ferulic Acid (SSAF) or control in the improvement in oily skin patients with facial PIE and PIH due to acne lesions. There was a statistically significant decrease in PIH and intralesional melanin in patients treated with a combination SSAF and non-ablative laser therapy. Improvement of both PIE and PIH was augmented in combination with SSAF and laser-treated patients compared with the laser-only group, with a concomitant increase in collagen density. This was even more strikingly marked in the SOC subjects, potentially providing an energy-based device (EBD)-based therapy in this population. Limitations of this study include small sample size and length of post-treatment follow-up. J Drugs Dermatol. 2024;23(9):769-773. doi:10.36849/JDD.8309.

Background: Poly-L-lactic acid (PLLA) is an injectable filler used for restoring facial fat volume loss that improves skin quality.

Objective: To evaluate the histological changes underlying the observed improvement in skin quality after repeated PLLA injections.

Methods: Ten healthy women were enrolled in this randomized, placebo-controlled, single-center study. Eligible subjects received 3 treatments every 4 weeks with either PLLA (treatment group) or saline (control group) injections, into both sides of the face. Follow-up visits were at week 18 after the last treatment. Assessments included live ratings, patient questionnaires, three-dimensional microtopography imaging analysis, and histological analysis from biopsies taken before and after PLLA treatment.

Results: At the 18-week follow-up, there was a significant improvement in investigator- and subject-rated global aesthetic improvement (GAIS) scores, as well as a decrease in wrinkle severity in PLLA-treated but not placebo-treated patients. Skin quality parameters of erythema, pore size, and roughness were significantly improved from baseline and compared with placebo at the 18-week follow-up as assessed by microtopographic analysis and investigator ratings. Histologic analysis revealed increased tissue remodeling and angiogenesis in PLLA-treated tissues at the 18-week follow-up and decreased elastin fragmentation compared with baseline. No treatment-related adverse events occurred.

Conclusion: Repeated PLLA treatments may improve skin quality through tissue remodeling and neovascularization. J Drugs Dermatol. 2024;23(9):729-734. doi:10.36849/JDD.8057.