Journal of Drugs in Dermatology最新文献

Although data suggest that antibiotic use by dermatologists is decreasing, our specialty still has the highest rates of oral antibiotic prescribing across all fields of medicine...

Background: Adult female acne presents challenges, including increased prevalence, distinct clinical manifestations, heightened skin sensitivity, treatment-related intolerance, and reduced treatment adherence. Integrating skincare into acne management is essential, particularly in Nordic European countries, where environmental factors influence skin physiology. The Nordic European Countries Acne Skincare Algorithm (NECASA) II algorithm serves as an evidence-based practical tool for clinicians in this region to select appropriate skincare based on individual patients' needs to optimize acne care for adult females.

Methods: Dermatologists from six Nordic European countries met to develop the NECASA II algorithm, which builds on the NECASA I framework. The advisors conducted a structured literature review and, combined with their clinical experience, established best practice recommendations for integrating skincare into adult female acne treatment regimens.

Results: The NECASA II algorithm recommends integrating skincare into adult female acne management based on acne severity, subtype, and patient characteristics. The panel concluded that all acne regimens should incorporate a physiologic pH cleanser, an emollient with humectants and lipids, and SPF 50+ sunscreen. Skincare monotherapy is recommended for mild acne, adjunctive skincare for moderate-to-severe acne, and maintenance skincare to prevent relapse following treatment.

Conclusions: Personalized skincare regimens, combined with prescription and nonprescription treatments, can mitigate adverse effects, improve treatment tolerance and adherence, and enhance overall outcomes.

Primary biliary cholangitis (PBC) can present with overlapping features of limited systemic sclerosis, commonly known as calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia (CREST). Here, we discuss the case of a PBC patient with CREST who experienced treatment-resistant and progressively worsening pruritic dermatitis that responded to upadacitinib with associated improvement of her liver enzymes and symptoms. This is the first documented report of a Janus kinase (JAK) inhibitor used to treat cutaneous symptoms in the setting of an autoimmune liver disease.

Background: Mohs micrographic surgery (MMS) has shown promising efficacy in female genital cancers, including Extramammary Paget’s disease (EMPD), dermatofibrosarcoma protuberans (DFSP), squamous cell carcinoma (SCC), and basal cell carcinoma (BCC). However, limited consolidated research exists on the clinical outcomes following MMS in female genital cancers. The aim of this systematic review is to synthesize and evaluate recent literature on the application and utility of MMS in the management of female genital cancers.

Methods: A comprehensive search was conducted of the PubMed and EMBASE databases on October 16, 2024, using the keywords "Mohs surgery" or "Mohs micrographic surgery" and "female genital" or "vulvar cancer" or "vaginal cancer" or "genital cancer" or "vulva" or "vagina." Studies were included if they directly discussed MMS for female genital cancers, particularly EMPD, DFSP, SCC, and BCC, with attention to clinical outcomes, were of the correct study type, and were published in peer-reviewed journals in English.

Results: Our results identified a 95% curative rate following MMS for EMPD, DFSP, SCC, and BCC, following analysis of 166 treated cases.

Conclusion: MMS provides superior outcomes as compared to traditional excisional approaches, potentially secondary to its precision-guided approach and histological analysis. Future studies should utilize larger patient cohorts and investigate rarer malignancies and combination therapies to optimize treatment guidelines for female genital cancers.

Background: Atopic dermatitis (AD) is a skin disorder characterized by reduced skin barrier function, which often leads to recurring infections, predominantly by Staphylococcus aureus and methicillin-resistant S. aureus, that exacerbate disease severity. Managing these infections is made challenging by antibiotic resistance and biofilm formation. Nitric oxide (NO) has emerged as a promising antimicrobial treatment that can disperse biofilm and may provide an alternative treatment for AD infections.

Methods: This study evaluated the antimicrobial efficacy of 3 topical NO-releasing formulations at various concentrations against established MRSA infections, from an AD-derived isolate, in a porcine wound infection model. Partial thickness wounds were inoculated and, after 48 hours of biofilm formation, were treated daily with NO formulations or vehicle control, or left untreated. Wounds were recovered for baseline, day 4, or day 7 bacterial enumeration.

Results: All tested NO-releasing formulations substantially reduced MRSA burden compared with baseline counts, and most effectively with the highest concentrations. 20% NO+GEL resulted in a significant reduction of 99.23% compared with baseline at day 7. The 16% NO+UNG treatment, compared with the untreated control, had bacterial reductions on day 4 and day 7 of greater than 99.5%. The greatest reduction of 99.97% (>3 Log CFU/mL) was observed for 6% NO+CREAM compared with the untreated control group at day 7.

Conclusions: NO-releasing treatments have considerable efficacy against MRSA infections and biofilm. These findings support the potential of NO as an antimicrobial treatment for AD patients, and further evaluation should be conducted to assess clinical efficacy.

Thinning hair affects the quality of life of affected men and women but has limited treatment options. A novel technology refines exosomes from stem cells to create a concentrated complex that is quickly absorbed into the scalp to deliver growth factors, peptides, coenzymes, minerals, amino acids, and vitamins (Exosome Regenerative Complex+®. BENEV, Inc.; Mission Viejo, CA). This study assessed the efficacy and safety of the Exosome Regenerative Complex applied following microneedling on the scalp of subjects with self-perceived thinning hair. Enrolled subjects were male (n=15) and female (n=15) with a mean (SD) age of 50.2 (10.9) years (range, 26-65 years). Subjects were treated on days 0, 30, 60, and 90, with a final assessment on day 120. Trichoscopy assessments showed this treatment significantly increased terminal and vellus hair counts (P<0.0001) and decreased hair shedding on day 120 (P<0.01), increased mean follicular units per cm² (P<0.0001), and decreased inter-follicular distance (P<0.0001). On day 120, the investigator rating for improved hair quality was 97% and improved hair growth was 83%. Subject satisfaction with treatment results was high with no reported adverse events. The combined use of an Exosome Regenerative Complex combined with RF microneedling appears to be an effective and well-tolerated treatment for hair loss in men and women. ClinicalTrials.gov NCT06571799.