Journal of Clinical and Aesthetic Dermatology最新文献

Objective: The authors sought to observe the effect of nanodiamond-zinc oxide (ND-ZnO)-containing skincare preparations on facial erythema and acne-like lesions in subjects with rosacea or rosacea-like symptoms.

Methods: An eight-week, real-world case series was compiled, with 35 included patients who exhibited facial redness and/or papulopustular features. Participants were assigned to one of two regimens: (1) ND-ZnO-containing cream applied once daily, or (2) ND-ZnO-containing serum applied twice daily with the cream layered on in the morning. Redness was assessed via expert grading using a standardized scale, while lesion counts (inflammatory and non-inflammatory) were evaluated by a board-certified dermatologist at baseline, Week 4, and Week 8. Participants also completed a self-assessment questionnaire on skin tone and radiance.

Results: Of the participants evaluated for redness, 94.7 percent showed improvement by expert grading. Self-assessment revealed that 95 percent reported brighter, more even skin tone. Mean erythema scores decreased from 0.86 at baseline to 0.69 at Week 4 and 0.54 at Week 8. Non-inflammatory lesions declined from 22 to 1, and inflammatory lesions resolved completely by Week 8. Representative case studies confirmed visible improvement in redness, skin texture, and clarity.

Limitations: The absence of a placebo control and the short duration limit generalizability and long-term assessment. Results should be confirmed in randomized controlled trials.

Conclusion: ND-ZnO-containing skincare preparations were effective in reducing facial redness and acneiform lesions, with improvements observed across multiple skin types. These findings support their potential use in the topical management of rosacea.

Psoriasis, seborrheic dermatitis, and atopic dermatitis are chronic inflammatory skin diseases affecting millions of people in the United States and worldwide across the human lifespan. The immune pathways underlying the pathogenesis of these dermatoses include Type I (IFN-γ, TNF-α), Type II (IL-4, IL-5, IL-13), and Type III (IL- 17A/F, IL-22, IL-23) cytokines. These cytokines function downstream of the enzyme phosphodiesterase-IV (PDE4), which makes PDE4 an upstream central regulator of inflammatory dermatoses. PDE4, therefore, is a key drug target for alleviating inflammatory skin diseases. In this brief review, we discuss and simplify into clinically relevant terminology the molecular findings of a 2024 study by Wang et al, which analyzed the structural properties of dermatologic PDE4 inhibitors and thereby provided molecular rationale as to why roflumilast has the greatest potency and is highly efficacious across multiple inflammatory dermatoses.

Objective: The increasing prevalence of autoimmune disease alongside the growing popularity of cosmetic treatments has placed physicians in a unique position to understand how utilizing such treatments can serve as both beneficial and potentially harmful interventions. The objective of this study was to analyze available literature and identify areas where additional research is needed to guide use of facial aesthetic treatments in patients with cutaneous autoimmune disease.

Methods: A literature search was performed on PubMed and Google Scholar for articles describing aesthetic treatments in the setting of autoimmune disease. Additional articles were found through examining the reference sections of resulting articles.

Results: This analysis revealed numerous gaps in the literature regarding therapeutic use of aesthetic treatments in the management of autoimmune disease. Several case reports and smaller studies suggested positive outcomes with some interventions, however larger-scale studies are needed to create generalizable guidelines for physicians regarding usage of aesthetic treatments as a therapeutic modality.

Limitations: Many studies regarding both efficacy and adverse outcomes of aesthetic treatments excluded patients with cutaneous manifestations of autoimmune disease. Few articles specifically sought to analyze how individual treatments can be used for therapeutic outcomes in this patient population.

Conclusion: Many cosmetic treatments can serve a therapeutic role in the management of autoimmune conditions with cutaneous manifestations. Treatments such as neurotoxin, filler, light-based devices, autologous platelet-rich plasma, microneedling, and chemical peels may be selectively chosen for use in management of certain autoimmune conditions.

The growing demand for aesthetic procedures leads to an influx of providers entering the field, many of whom lack formal training in aesthetic medicine. The absence of standardized education and certification poses significant risks to patient safety, including improper technique, adverse complications, and unethical practice. Without clear regulatory oversight, nonmedically trained individuals and inadequately trained healthcare professionals offer aesthetic treatments, leading to inconsistent outcomes and diminished public trust in the field. This article examines the urgent need for regulated training and certification to establish competency benchmarks and ensure patient safety. A tiered education model provides foundational, intermediate, and expert-level training, with standardized curricula covering anatomy, injection techniques, complication management, ethics, and legal considerations. Professional organizations and regulatory bodies play a key role in accrediting training programs, defining the scope of practice, and enforcing licensure requirements. Legislative measures, including mandatory certification, continuing education, and enforcement mechanisms, maintain high standards in aesthetic medicine. Implementing a structured training framework enhances provider competency, reduces adverse events, and reinforces ethical practice. Standardized regulation safeguards patient well-being and preserves the credibility and integrity of the aesthetic medicine industry.

Introduction: Hidradenitis suppurativa (HS) is a poorly recognized chronic skin condition that presents with inflamed recurring painful nodules, abscesses, and subcutaneous tunnels, mainly impacting intertriginous areas. Although extensively studied for its dermatological implications, recent research suggests a potential correlation between HS and cardiovascular disease. Studies reveal a heightened prevalence of cardiovascular risk factors, such as obesity, metabolic syndrome, and smoking, in individuals with HS. Most researchers attribute HS's elevated cardiovascular risk to these coexisting factors.

Objective: This review aims to identify whether or not HS's underlying chronic inflammatory nature can contribute to atherosclerosis development, thereby elevating the risk of cardiovascular events and, specifically, major adverse cardiovascular events (MACE). Recognizing the association between HS and cardiovascular disease is crucial for comprehensive patient care.

Methods: A PubMed search was performed to locate clinical trials, systematic reviews, and clinical reviews published to date concerning this topic.

Results: This review consolidates existing literature on the topic, summarizing key findings and emphasizing the need for further research to clarify the mechanisms linking HS and cardiovascular conditions and delineating best clinical practices to mitigate risk.

Limitations: Many publications attribute the increase in cardiovascular disease to comorbid risk factors. Despite limited research on cardiovascular (CV) risk in patients with HS, emerging evidence indicates an increased risk of adverse CV outcomes in this population, consistent with data from other chronic inflammatory diseases indicating that the inflammatory nature of the disease itself is elevating cardiovascular events. More clinical research is needed to strengthen this hypothesis and improve patient outcomes.

Conclusion: An integrated, multidisciplinary approach combining dermatological and cardiovascular perspectives is vital for optimizing patient care and navigating the complexities of managing HS and its associated cardiovascular comorbidities.

Objective: This review aims to understand medication adherence and its influence on efficacy for existing and novel topical treatments for molluscum contagiosum.

Methods: A PubMed search was performed on clinical studies from 2000 to 2023 assessing adherence and treatment efficacy for topical and non-topical therapies used to treat molluscum.

Results: Adherence to individual topical treatments for molluscum is poor and limits their utility in clinical practice, despite demonstrated safety, painless administration, and advantages for pediatric and home use. Studies suggested lower adherence for topical rather than procedural treatments due to delayed effects, long treatment duration, and uncertain perceived benefits. New topical agents, VP-102 (ie, cantharidin 0.7% drug-device combination) and SB206 (ie, berdazimer gel 10.3%), showed promising efficacy in clinical trials, but their ability to address adherence is unclear.

Limitations: There is a lack of sufficient clinical studies on topical medications for molluscum contagiosum, limiting our overall understanding of adherence and practical efficacy.

Conclusion: Several studies suggest that commonly used topical medications for molluscum suffer from poor adherence, reducing treatment efficacy. Addressing adherence to these medications may promote the utility of topicals to deliver the need for safe, painless, and efficacious treatments for molluscum. Larger, well-designed trials accounting for adherence are needed before evidence-based treatment recommendations can be made for topical molluscum treatments. Our findings propose that in-office topicals like cantharidin may overcome nonadherence and enhance efficacy compared to daily home-administered topical medications.

Scalp psoriasis is a chronic immune skin disease affecting up to 80 percent of patients with psoriasis. Treatments include topical steroids, keratolytics, tar, anthralin, vitamin D analogs, and retinoids. However, treatment can be difficult due to the presence of hair. Roflumilast 0.3% cream was approved in 2022 for the treatment of chronic plaque psoriasis, including intertriginous areas. Here, we present the case of a 28-year-old female patient with scalp psoriasis, who had previously trialed both topical and systemic treatments for her disease without success. Use of once daily roflumilast 0.3% cream resulted in rapid scalp psoriasis clearance, with results seen as early as Day 3 and complete clearance by Day 5 of treatment without adverse events or tolerability concerns.

Objective: Melasma is an acquired pigmentary disorder for which tranexamic acid (TA) injection has shown promising results in earlier studies. This study aimed to evaluate the effectiveness and safety of intradermal TA as an adjuvant therapy for melasma in individuals with Fitzpatrick Skin Type IV-V.

Methods: We conducted a double-blind, randomized, split-face controlled trial of 34 female patients with melasma. All subjects were randomized to receive either 10mg of intradermal TA or placebo injection on the right or the left side of their face. The primary outcome was improvement of melasma lesions assessed by modified Melasma Area and Severity Index (mMASI) score and mexameter examination which includes Melanin Index (MI) and Erythema Index (EI). Measurements were done at baseline and every two weeks for 12 weeks. Additionally, side effects of therapy and subject satisfaction assessment with patient global assessment (PtGA) were also documented.

Results: This study showed the reduction of mMASI score was larger and faster in intervention group compared to control group whereas the reduction of MI and EI was not significantly different between both groups. The majority of subjects did not experience any serious side effects. The subjects in the treatment group also reported significantly higher proportion of very good response compared to control group.

Limitations: This was a single-center study with a small sample size and the inability to control confounding variables.

Conclusion: Based on our results, intradermal TA injection appears to be an effective and safe adjuvant therapy for melasma in individuals with Fitzpatrick Skin Type IV-V.

A key strategy for pain management in dermatologic procedures is the use of local anesthesia, yet the injection itself often causes significant discomfort. This article explores evidence-based strategies to minimize pain during anesthetic administration in office-based dermatologic settings. Techniques discussed include buffering and warming lidocaine, selecting the optimal needle gauge, orienting the bevel properly, as well as adopting advanced injection methods such as subdermal bleb formation and parallel needle insertion. Additional methods like tactile distraction, hand stabilization, and psychological engagement are also emphasized. Together, these approaches enhance patient comfort, procedural efficiency, and overall satisfaction with dermatologic care.

Background: Actinic keratosis (AK) is a common dermatologic condition that can progress to squamous cell carcinoma if left untreated. Field therapy plays a critical role in managing both visible and subclinical lesions within sun-damaged skin.

Objective: The author sought to provide one nurse practitioner's perspective on the evolving role of field therapy in AK management, emphasizing patient-centered care, real-world challenges for all advanced practice providers (APPs), and personal experience.

Methods: This commentary reflects clinical observations, patient interactions, and the author's own experience undergoing multiple field therapies, including topical 5-fluorouracil, imiquimod, tirbanibulin, and photodynamic therapy. Emphasis is placed on treatment selection, education, and adherence strategies.

Results: Field therapy is effective when personalized to the patient's lifestyle, skin type, and preferences. Empathetic counseling and tailored treatment regimens improve outcomes and satisfaction. Newer therapies such as tirbanibulin and daylight photodynamic therapy offer promising options with improved tolerability.

Conclusion: APPs are uniquely positioned to lead in early AK treatment and prevention. Combining clinical expertise with patient education and empathy enhances the impact of field therapy. The author's dual perspective as a provider and patient offers valuable insight into the real-world application of evidence-based dermatologic care.