The Journal of dermatological treatment最新文献

Methods: A literature search was conducted on Drugs@FDA: FDA-Approved Drugs for the year 2024 to identify new dermatologic treatments.

Results: In 2024, the FDA approved seven new dermatologic therapies and expanded the indications for seven current therapies. These therapies treat conditions such as atopic dermatitis, hidradenitis suppurativa, prurigo nodularis, molluscum contagiosum, and alopecia areata, among others. Some of these advancements converge dermatology with rheumatology, gastroenterology, and oncology, which continue to transform therapy for patients with multiple diseases.

Conclusion: This paper provides a comprehensive overview of these developments and their implications for clinical practice.

Objective: This systematic review evaluates the efficacy of minoxidil alone versus minoxidil with low-level laser therapy (LLLT) for androgenic alopecia.

Study design: systematic review and meta-analysis.

Methods: An online search of PubMed, Web of Science, and MEDLINE was conducted. Randomized clinical trials comparing minoxidil monotherapy with minoxidil and LLLT combination therapy were included based on predefined criteria. The Risk of Bias 2.0 (RoB 2.0) tool was used for quality assessment.

Results: From 38 identified studies, 34 remained after excluding 4 duplicates. Further exclusions left 4 eligible studies comparing minoxidil alone with minoxidil and LLLT. The meta-analysis found no statistically significant differences in hair counts between the two groups at baseline, 12 weeks, and 8 weeks post-treatment [mean difference = -0.04, 95% CI -1.22 to 1.14, p = .95, I² = 0%]. Similarly, hair diameter showed no significant differences at the same time points [mean difference = 0.00, 95% CI -0.00 to 0.00, p = .98, I² = 38%].

Conclusion: The combination of minoxidil and LLLT does not significantly improve outcomes compared to minoxidil alone for treating androgenic alopecia.

This review explores the anatomical considerations and technical aspects of thread lifting for the forehead and eyebrow, focusing on the relationships between vascular structures, muscular anatomy, and age-related changes in the forehead-eyebrow complex. It highlights the critical importance of understanding neurovascular pathways, particularly the supratrochlear and supraorbital vessels, as well as the appropriate thread placement techniques necessary for optimal outcomes. The review demonstrates that I-shaped threads, when placed beneath the frontalis muscle, provide a safer and equally effective alternative to traditional U-shaped designs. Additionally, the review emphasizes the significance of preoperative assessment, especially the evaluation of tissue mobility and adhesion patterns, in predicting procedural success. The review concludes that combining thread lifting with volumising monofilaments offers a comprehensive approach to rejuvenating the forehead-glabellar region, while minimizing the risk of complications. This study's clinical impact lies in its potential to enhance both the safety and efficacy of thread lifting procedures, offering practitioners a refined technique for esthetic rejuvenation of the forehead and eyebrow complex.

Purpose: Mogamulizumab demonstrated improved outcomes vs. vorinostat across a range of disease and patient characteristics in patients with mycosis fungoides or Sézary syndrome in the MAVORIC trial.

Materials and methods: This post-hoc analysis further examined MAVORIC data to assess factors associated with long-term response (ORR >12 months), time to next treatment (TTNT), and impact of concomitant steroid use, lymphopenia, and mogamulizumab-associated rash (MAR) on patient response.

Results: A higher proportion of patients achieved ORR lasting ≥4, 6, 8, or 12 months in the mogamulizumab vs. vorinostat arm. Long-term response was also observed in mogamulizumab-treated patients with more advanced disease (stage IVA1 [17/20], B2 blood involvement [18/20], and SS [14/20]). PFS was significantly longer (9.4 vs. 3.1 months; p < 0.0001) in mogamulizumab vs. vorinostat-treated patients taking concomitant steroids. Mogamulizumab-treated patients experienced longer TTNT vs. vorinostat. Lymphopenia and MAR were associated with response to mogamulizumab.

Conclusions: MAVORIC demonstrated greater efficacy with mogamulizumab vs. vorinostat in relapsed/refractory patients with CTCL, including those with more advanced disease. Concomitant steroid use improved ORR and PFS but did not impact vorinostat outcomes. Overall responses occurred more frequently in mogamulizumab-treated patients that developed lymphopenia than those that did not. A higher percentage of patients with MAR had an overall response than those without MAR.

Objectives: As life expectancy rises and the population continues to age, physicians will be faced with an increasing number of elderly patients with keratinocyte cancer (KC). This study aims to better characterize KC surgery in patients over 80 years of age, with a particular focus on the incidence of postoperative complications.

Methods: A retrospective study was conducted on all patients aged 80 years and older who underwent surgery for KC at the University Hospital of Zurich in 2022. Data were collected from operative and postoperative notes within six months after surgery.

Results: A total of 565 tumors were removed from 345 patients, consisting mainly of basal cell carcinoma (46.5%) and squamous cell carcinoma (45.8%), including 24.2% clinically large tumors (>2 cm in diameter). A total of 26 complications were recorded, resulting in an overall complication rate of4.6%. Only one patient with a hematoma required surgical revision under local anaesthesia. Four cases of hemorrhage were solved by bed side ligations under local anaesthesia. Of the 26 recorded complications, 15 (58%) concerned wound dehiscence, requiring no further measures. The use of novel oral anticoagulants, lower extremity location, surgical specimen size >2 cm², and flap repair were found to be independent risk factors associated with a statistically higher incidence of complications.

Conclusions: This study demonstrated that dermatologic surgery adapted to the geriatric population is relatively safe and effective, even for larger KC of several centimeters in diameter.

Purpose: Livedoid vasculopathy (LV) is a chronic microvascular thrombosis disorder with an unclear pathogenesis, potentially involving hypercoagulability and inflammation. This systematic review aims to evaluate the efficacy and safety of Janus kinase (JAK) inhibitors and biologics in the treatment of LV.

Materials and methods: A comprehensive search was conducted in PubMed, EMBASE, and the Cochrane Library on June 10, 2024, to identify relevant studies evaluating the use of JAK inhibitors and biologics in LV treatment.

Results: A total of 15 articles were included in the review. Among the 41 patients treated with biologics and JAK inhibitors, 36 (87.8%) showed positive clinical responses, including significant improvements in pain relief. TNF-α inhibitors were the most commonly used monotherapy, followed by JAK inhibitors. Adverse events were infrequent, suggesting that these treatments generally have a favorable safety profile.

Conclusions: JAK inhibitors and biologics appear to be safe and effective alternatives for managing refractory LV. These findings provide a foundation for future studies to further validate their clinical effectiveness and long-term safety.

In this multicentric real-world observational retrospective study, we evaluated the efficacy and safety of dupilumab for atopic dermatitis in children <6 years of age who underwent a minimum of 16 weeks of therapy. The analysis focused on EASI (Eczema Area and Severity Index), CDLQI (Children's Dermatology Life Quality Index), and Itch NRS (Numeric Rating Scale) changes from baseline to 4, 16, 24, 48, 72, and 96 weeks of follow-up (when available). Overall 24 children were included, with a mean age of 4.4 years. The baseline mean EASI among these patients was 26.7 (range 11.2-42.5). Since week 16 of therapy, all patients achieved and sustained at least 50% (EASI-50) atopic dermatitis improvement from baseline for the remainder of the follow-up period. At week 16, the mean EASI was 4.6 (0.8-13.1), EASI-75 reached 75% and EASI-90 38% of the patients. Within the initial 16 weeks of dupilumab treatment, 50% of patients experienced at least one adverse event, none of which were deemed severe. Conjunctivitis was among the most common adverse events (8.3%). In conclusion, dupilumab exhibited favorable tolerability, efficacy, and safety in children diagnosed with atopic dermatitis who were below the age of 6.

Purpose:  Psoriasis is a chronic, immune-mediated inflammatory skin condition marked by erythematous, scaly plaques. This retrospective observational study evaluated the long-term efficacy and safety of bimekizumab, a dual IL-17A and IL-17F inhibitor, in treating moderate to severe plaque psoriasis in 56 patients across two dermatology clinics in Italy.

Materials and methods:  Adult participants with a baseline Psoriasis Area and Severity Index (PASI) >10, or <10 with sensitive area involvement, were followed for 16 to 52 weeks. Clinical outcomes were measured by PASI 75, 90, and 100 responses and Dermatology Life Quality Index (DLQI) scores at 4, 16, 36, and 52 weeks.

Results:  At week 16, 97.5% of patients achieved PASI 75, 76.7% reached PASI 90, and 66% attained PASI 100. By week 52, 91.5% achieved PASI 90 and 85.1% reached PASI 100, with 95.7% reporting a Dermatology Life Quality Index (DLQI) score of 0 or 1, indicating minimal impact on daily life. The study found similar efficacy across bio-naïve and bio-experienced groups, and between normal-weight and obese patients, without statistically significant differences. The safety profile was consistent with previous trials, with oral candidiasis as the most frequent adverse event (21%).

Conclusions:  These findings support the efficacy and tolerability of bimekizumab for long-term psoriasis management.

Purpose: Pyoderma gangrenosum (PG) is a rare, neutrophilic dermatosis characterized by rapidly developing, painful ulcers. This study explores the potential of spesolimab, an anti-IL-36R antibody, as a therapeutic option for refractory PG.

Materials and methods: We report a case of a 48-year-old male with refractory PG who failed to respond to etanercept and adalimumab. Upon admission, the patient presented with extensive, painful ulcerations on the trunk and extremities. He was started on oral methylprednisolone (32 mg/day) and minocycline (50 mg twice daily). After a week, minimal improvement was observed. After reviewing the screening results and discussing treatment options, the patient received two doses of spesolimab (900 mg intravenously) administered two weeks apart.

Results: Marked clinical improvement was observed after spesolimab initiation. Complete ulcer healing was achieved within six weeks of starting spesolimab, with no adverse effects reported.

Conclusions: This case demonstrates the potential efficacy of spesolimab for treating refractory PG, particularly in patients unresponsive to TNF-α inhibitors. Despite the added complexity of the patient's underlying HBV infection and elevated M-protein, no HBV reactivation or other hematologic complications occurred. Further studies are needed to validate its role in managing PG and other neutrophilic dermatoses.

Background: Primary axillary hyperhidrosis has limited noninvasive and effective treatment, and we present the use of sofpironium bromide as a promising treatment option. We aimed to assess the efficacy and safety of sofpironium in patients with primary hyperhidrosis.

Methods: We systematically searched the databases for Studies that assessed sofpironium bromide in patients with primary axillary hyperhidrosis. Methodological quality was determined using the Cochrane Risk of Bias Assessment tool and Newcastle-Ottowa scale.

Results: Five studies were included (752 patients). They used 5% sofpironium, except for one study that used 5%, 10%, and 15% sofpironium. Studies have shown a significant difference in the incidence of patients with an HDSS score of 1 or 2 ranging from 53.9% to 86.7% and reported a greater reduction in the mean change in the DLQI score in the sofpironium group. They also noted a more significant reduction in the total gravimetric weight of sweat in the sofpironium group. A 1.5 point or greater improvement in HDSM-Ax score ranged from 48.2% to 69.1%. Serious adverse events were not observed in the intervention group.

Conclusion: Sofpironium gel provides notable improvements in symptom severity, sweat reduction, and quality of life, with mostly mild localized adverse events.Hyperhidrosis is relatively common, affecting 4.8% of the US population and negatively affects physical, social, and psychological well-being.Sofpironium bromide is recently approved by the FDA for the treatment of primary axillary hyperhidrosisSofpironium bromide showed promising results in terms of safety and efficacy for treating hyperhidrosisWe systematically assessed the use of sofpironium gel reported in five studies (752 patients)Sofpironium gel provides notable improvements in symptom severity, sweat reduction and quality of life, with mostly mild localized adverse events.