Journal of Clinical and Aesthetic Dermatology最新文献

Basal cell carcinoma (BCC) is the most common skin cancer in the United States. Common treatment approaches for superficial, small, and/or low grade BCCs include topical therapy or curettage plus electrodesiccation and cryotherapy. For larger, high-grade, and/or certain subtypes of BCC, surgical therapy is typically pursued, occasionally under anesthesia for large lesions. While surgical therapy provides good clearance rates, it is not feasible for all patients. Therefore, it is important for physicians to understand alternative, less invasive approaches to treating BCC in order to provide patients with the best possible evidence-based care. In this case, we describe a combination topical treatment approach for a large nodular BCC in an elderly patient in a tough to excise inguinal region.

Hidradenitis suppurativa (HS) is a chronic skin condition characterized by nodules, abscesses, and tunnels that may develop in various parts of the body, particularly in the axillary, gluteal, and inguinal regions.¹ Treatment for HS varies based on clinical presentation and disease progression and encompasses antibiotics, hormonal therapy, biologics, topical treatments, and surgical procedures. Despite the array of available treatment options, patients typically require multiple treatment modalities to alleviate symptoms, which can include antimicrobial cleansers and washes, though there is limited evidence regarding their effectiveness in managing HS. Here, we evaluated real-world patient-assessed efficacy of sodium hypochlorite body wash in the management of hidradenitis suppurativa. Of the 165 participants enrolled, 145 completed a four-week study evaluating daily use of sodium hypochlorite body wash for hidradenitis suppurativa (HS), representing all Hurley stages and a wide range of disease durations. Significant improvements were observed across key symptoms, with the greatest reduction in pain (3.52 to 1.62, p<0.001), and over 60 percent of participants reported fewer and shorter flares. Most participants found the wash beneficial, with 88.8 percent recommending it, and there was strong support for the dab method among those who used it. These data support clinical utility of hypochlorite washes in the chronic management of HS.

The rising popularity of over-the-counter red-light therapy (RLT) devices has sparked interest in their efficacy and consumer behavior, particularly as they are increasingly promoted on social media. This cross-sectional study analyzed responses from a survey of 226 participants, with 88.5 percent identifying as female and 83.6 percent of Hispanic or Latino origin. The majority (60.4%) reported learning about RLT devices through social media, and 90.0 percent were willing to purchase one, with most respondents willing to spend between $101 to $300 USD (48.9%). The top motivations for use included anti-aging (50.2%), improving skin texture (37.9%), and reducing dark spots (30.8%). Significant associations were found between Hispanic ethnicity, male gender, and increasing age with a higher likelihood of considering RLT devices (p<0.001). Respondents were also skeptical of the value of higher-priced devices, with 58.8 percent doubting their superior efficacy. These findings highlight significant demographic influences on the interest in RLT devices, emphasizing the need for transparent product information and realistic consumer expectations to ensure satisfaction and trust in the technology.

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.