The Journal of dermatological treatment最新文献

Background: Facial aging is characterized by midface volume loss from structural and dermal atrophy.

Objectives: To evaluate the efficacy and safety of a hyaluronic acid-polynucleotide (HA-PN) hybrid filler for temporary restoration of anteromedial cheek volume.

Methods: In this single-center, open-label trial, 15 adults with moderate-to-severe anteromedial cheek volume loss (Mid-Face Volume Deficit Scale [MFVDS] score ≥ 3) received up to 1 mL HA-PN hybrid filler per side. Evaluations at baseline and weeks 4, 12, and 24 comprised blinded photographic MFVDS rating (primary endpoint: ≥1-grade improvement at week 4), GAIS (Global Aesthetic Improvement Scale) score, participant satisfaction, transepidermal water loss, skin hydration, elasticity, and adverse events.

Results: All participants completed the study without serious adverse events. MFVDS scores improved significantly at week 4 and remained improved through weeks 12 and 24. GAIS and satisfaction scores paralleled these gains. Transepidermal water loss decreased and hydration increased over time, and Cutometer parameters (R2 R5 R7) showed progressive improvements in elasticity, indicating enhanced skin quality along with midface volumization.

Conclusions: The HA-PN hybrid filler demonstrated improvements in midface volume restoration with concurrent improvements in skin barrier function, hydration, and elasticity, and was well tolerated over 24 weeks within the constraints of the study design.

Background: Moderate-to-severe atopic dermatitis (AD) often relapses after dupilumab discontinuation. This study compared proactive intermittent tacrolimus versus on-demand therapy for post-discontinuation maintenance.

Methods: This was a real-world, mixed retrospective-prospective observational study conducted at a single dermatology center. Patients who discontinued dupilumab were identified through retrospective chart review, and a subset was followed prospectively. Based on observed post-discontinuation topical management patterns, patients were classified into a proactive maintenance group or a reactive, as-needed treatment group. Patients were followed for 24 weeks, with extended follow-up to 52 weeks for exploratory analyses. The primary outcome was time to first flare.

Results: Median follow-up was 28 weeks. Proactive maintenance prolonged flare-free survival (HR 0.62, 95% CI 0.45-0.86, p = 0.004), reduced flare rate (IRR 0.68, 95% CI 0.52-0.88, p = 0.003), and lowered steroid use (mean difference -18.4 g, p < 0.001). PROs improved more (POEM β -2.1; DLQI β -1.8). Local reactions were comparable (8.3 vs. 7.9%); no serious adverse events occurred.

Conclusion: Proactive intermittent tacrolimus after dupilumab reduces flare risk and steroid burden, improving outcomes, and is a feasible maintenance strategy.

Background: This multicenter study aimed to evaluate treatment adherence and satisfaction among patients with acne vulgaris.

Methods: A total of 2,349 patients from 18 dermatology centers across Türkiye completed structured questionnaires.

Results: The participants were predominantly female (79.4%) with a mean age of 21.6 years. Overall, 48% reported consistent adherence to therapy, with significantly lower adherence among males (p < 0.001). The most frequent reasons for nonadherence were forgetfulness (28.7%), dislike of the treatment (26.4%), and reluctance to maintain long-term therapy (21.5%). Treatment adherence was positively associated with higher educational levels (p = 0.006) and greater acne severity (p < 0.001). Logistic regression revealed that systemic oral therapy (OR = 4.37, 95% CI: 3.147-6.086; p < 0.001) and oral isotretinoin (OR = 4.81, 95% CI: 3.379-6.869; p < 0.001) significantly increased adherence compared to topical therapy. Oral treatment was also independently associated with greater satisfaction (OR = 2.33, 95% CI: 1.767-3.095; p < 0.001). Moreover, mild acne severity (OR = 1.67, 95% CI: 1.216-2.297; p = 0.002) and older age (per year; OR = 1.05, 95% CI: 1.020-1.088; p = 0.001) predicted higher satisfaction.

Conclusion: Systemic therapies-particularly oral isotretinoin-were associated with improved adherence and satisfaction.

Background: Oral finasteride 1 milligram (1 mg) daily-which is a 5-alpha reductase inhibitor (5-ARI) approved by the Food and Drug Administration (FDA) for androgenetic alopecia-is linked to sexual adverse events (AEs). However, it remains unclear whether this link is causal or merely correlational.

Methods: In FAERS, AEs are described by preferred terms (pts) of the Medical Dictionary for Regulatory Activities system; we investigated 8 AEs, including erectile dysfunction (pt = 10,061,461). We determined if signals could be detected with finasteride 1 mg-and 0.5 mg of dutasteride (a more potent 5-ARI)-in FAERS, for sexual AEs related to the post-finasteride syndrome (PFS): for the two, we identified the yearly number of cases (i.e. reports with sexual AEs) from 2006 to 2024. For each AE, we conducted a disproportionality analysis where reporting odds ratios (RORs) were estimated-along with p-values and 95% confidence intervals (CIs).

Results: There were more reports with finasteride 1 mg than with dutasteride 0.5 mg; for both, more reporting was observed as of 2012, the year the PFS foundation formally propagated PFS awareness.

Conclusions: Our findings support that the disproportionately higher reporting of sexual AEs with finasteride 1 mg than with dutasteride 0.5 mg-even more so after 2012-could be attributed to the nocebo effect.

Purpose: Biologic-refractory psoriasis has emerged as an area of unmet need in a landscape of generally well-controlled disease. The study aimed to establish a predictive model grounded in the clinical features and laboratory parameters to assess the risk of biologic-refractory patient (BRP) prior to initiating biologic therapy.

Materials and methods: Biologic-naïve psoriasis patients who initiated their first biologic at the Department of Dermatology of Xiangya Hospital were included and randomized into training and validation sets in a 6:4 ratio. Logistic regression and lasso analysis were performed to screen the risk variables for BRP status.

Results: Seven hundred and forty-two psoriatic patients comprising 40 BRPs were included. Body mass index, nonalcoholic fatty liver disease, psoriasis area and severity index, direct bilirubin level, indirect bilirubin level, and erythrocyte sedimentation rate level were identified as predictive factors of BRP. Nomogram models incorporating these factors demonstrated excellent discrimination capabilities with areas under the curve of 0.915 (95%CI, 0.846-0.916) in the training cohort and 0.933 (95%CI, 0.884-0.934) in the validation cohort. Calibration curves indicated good calibration for both cohorts, and decision curve analysis (DCA) revealed the excellent clinical utility of the predictive model.

Conclusions: We developed the nomogram that integrated clinical features and laboratory parameters, providing a convenient and efficient method for predicting BRP risk.

Background: Plantar warts (verrucae plantaris), caused by human papillomavirus, are common and often resistant to standard therapies, which can be painful and damaging. Novel, noninvasive options are needed.

Objective: To evaluate the safety and preliminary efficacy of a topical nitric oxide-releasing solution (NORS) as a self-administered therapy for plantar warts.

Methods: In this Phase 2a, multicenter, randomized, double-blind, placebo-controlled trial, 20 participants with ≥3 plantar warts were randomized (1:1:1) to NORS 1X (41.1 PPM·min), NORS 3X (121.9 PPM·min), or placebo. Participants completed 15-minute footbaths three times weekly for 3 weeks, followed by 2 weeks of observation. The primary endpoint was complete wart clearance at Day 35; secondary endpoints included ≥70% wart area reduction, pain change, and Physician Wart Assessment (PWA) grading.

Results: NORS was well tolerated with no serious adverse events; mild, transient irritation occurred in 85% of participants. Complete clearance was achieved in 6% (NORS 1X), 8% (NORS 3X), and 0% (placebo). A ≥ 70% wart area reduction occurred in 21%, 16%, and 12%, respectively. Pain improvement and a 50% reduction in severe warts (PWA grade 3) were observed only with NORS 3X.

Conclusion: NORS demonstrated favorable safety and early clinical activity, warranting larger, longer-term efficacy trials.

Trial registration: ClinicalTrials.gov Identifier NCT05877313.

Background: Facial photoaging involves structural and functional deterioration across multiple skin layers. Single-modality treatments rarely address pigmentary, vascular, and dermal matrix changes concurrently. Intense pulsed light (IPL) is widely used for the treatment of dyschromia and vascular lesions. Mesotherapy incorporating non-crosslinked sodium hyaluronate (NCSH), tranexamic acid (TXA), and vitamin C (VC) has been introduced to improve skin hydration and related dermal parameters. The present study assessed the efficacy and safety of combining these modalities for facial rejuvenation.

Methods: Eighty-four patients underwent three sessions of IPL with mesotherapy. Standardized VISIA imaging was conducted before each treatment (T0, T1, T2) and at 1-2 months (T3) and 3-6 months (T4) post-treatment. Efficacy was assessed using the Modified Fitzpatrick Wrinkle Scale (MFWS) and Global Aesthetic Improvement Scale (GAIS); adverse events and satisfaction were recorded.

Results: All six VISIA parameters and MFWS scores improved significantly (p $<$0.001), peaking at T3 with mild non-significant rebound at T4. GAIS and satisfaction assessments confirmed consistent aesthetic improvement. No severe adverse events occurred; transient burning, papular reactions, and erythema were most common. The overall satisfaction rate was 82.15%.

Conclusions: IPL combined with NCSH/TXA/VC mesotherapy provided safe, effective, and well-tolerated improvement in facial photoaging, representing a promising multimodal rejuvenation approach.