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: T...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). ≥ 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.
OBJECTIVES: Effective management of moderate to severe Chronic Hand Eczema (CHE) requires improved understanding of its etiological subtypes, signs and symptoms, and comorbidities. The objective of this study was to inve...OBJECTIVES: Effective management of moderate to severe Chronic Hand Eczema (CHE) requires improved understanding of its etiological subtypes, signs and symptoms, and comorbidities. The objective of this study was to investigate the clinical characteristics of patients with moderate to severe CHE. METHODS: This was a multinational retrospective online chart review in Canada, France, Germany, Italy, Spain, and the UK. Physicians were asked to identify eligible patients from medical records to provide retrospective data over the past 12 months for up to 10 adult patients treated with topical corticosteroids (TCS) or for whom TCS were contraindicated. RESULTS: A total of 292 physicians completed forms for 1939 patients (56.8% with moderate and 43.2% with severe CHE). The most frequent etiological subtypes were irritant contact dermatitis (40.1%), atopic dermatitis (33.1%) and allergic contact dermatitis (27.5%). Palms (56.6%), fingertips (41.6%) and backs of hands (40.8%) were the most affected areas. Erythema and pruritus were the most frequent signs and symptoms. A history of atopic dermatitis was reported for 43.8% of patients. CONCLUSIONS: In conclusion, patients with moderate to severe CHE present with multiple etiological subtypes and a range of signs and symptoms. Many patients had no atopic condition besides CHE, and no history of atopic dermatitis, indicating that CHE is not simply atopic dermatitis of the hands.
OBJECTIVES: The potential utility of a novel microwave device for the treatment of a variety of superficial dermatologic indications is reviewed. MATERIALS AND METHODS: The Swift microwave system applies low-dose microwa...OBJECTIVES: The potential utility of a novel microwave device for the treatment of a variety of superficial dermatologic indications is reviewed. MATERIALS AND METHODS: The Swift microwave system applies low-dose microwave energy (8 GHz) noninvasively using a precision applicator to directly target lesional tissue, while modulating power setting and application time to maintain patient comfort during heat application. The device has been approved for general dermatology use, with some models labeled more-specifically for HPV-associated lesions and actinic keratosis. New case treatment data and published case reports were reviewed for viral skin infection, fungal nail infection, nodular cystic acne, neoplastic skin lesions, hidradenitis suppurativa (HS), and intractable plantar keratosis (IPK). RESULTS: Case reports demonstrate preliminary efficacy of microwave hyperthermia in viral skin infection, fungal nail infection, nodular cystic acne, and neoplastic skin lesions, with few reported adverse events. Microwaves additionally provided good pain control for the reviewed cases of HS and IPK. CONCLUSIONS: The data support a possible role for the microwave device in the studied indications. Microwave treatment may be more tolerable for patients than cryotherapy or laser comparators. More systematic investigation of microwave hyperthermia is warranted to better define optimum dosing regimens and efficacy, as well as a wider safety profile.
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...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 ( 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.
PURPOSE: Emerging evidence suggests rosacea as a recognizable adverse event during dupilumab therapy. This study aimed to investigate the potential association between dupilumab and rosacea using pharmacovigilance data a...PURPOSE: Emerging evidence suggests rosacea as a recognizable adverse event during dupilumab therapy. This study aimed to investigate the potential association between dupilumab and rosacea using pharmacovigilance data and to characterize the clinical features of dupilumab-associated rosacea (DAR) through a review of reported cases. MATERIALS AND METHODS: We utilized the FDA Adverse Event Reporting System (FAERS) database (2017-2024) to identify disproportionality signals using four methods: Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Information Component (IC), and Empirical Bayesian Geometric Mean (EBGM). To contextualize these findings, we performed a focused narrative review of 8 publications comprising 10 DAR cases with extractable individual data. RESULTS: A significant disproportionality signal was identified across all four methods (ROR 3.873; PRR 3.872; IC 1.865 with IC025 1.653; EBGM 3.642), with reports predominantly in adults and females. In the case review, a consistent phenotype emerged: papulopustules on persistent centrofacial erythema with frequent burning; facial predominance with occasional extension to neck, scalp, or upper trunk; frequent Demodex detection by scraping, KOH, or in vivo imaging; and occasional granulomatous histology. Onset ranged from approximately 2 weeks to 21 months, including one post-discontinuation case. Most patients improved with rosacea-directed therapy (topical ivermectin or metronidazole; anti-inflammatory-dose doxycycline). However, dechallenge or rechallenge patterns and the need for dose-interval extension, temporary interruption, or switching biologic (e.g., lebrikizumab, upadacitinib) in a subset support a drug-related pattern at the reporting level. CONCLUSIONS: DAR represents a distinct clinical entity from dupilumab-associated head and neck dermatitis, which is eczematous and typically responds to antifungals or calcineurin inhibitors. While disproportionality signals indicate association rather than incidence or causality and are subject to reporting bias, clinicians should be aware of this potential adverse event to ensure appropriate management.
BACKGROUND: The management of psoriasis presents challenges, prompting many patients to seek alternative treatments. Cannabidiol (CBD) has demonstrated potential antioxidant and anti-inflammatory properties which may off...BACKGROUND: The management of psoriasis presents challenges, prompting many patients to seek alternative treatments. Cannabidiol (CBD) has demonstrated potential antioxidant and anti-inflammatory properties which may offer therapeutic benefits for skin conditions. OBJECTIVE: To evaluate the efficacy and safety of cannabidiol oil compared to placebo in chronic plaque psoriasis patients. METHODS: The randomized, double-blind, placebo-controlled trial enrolled 28 participants, who were administered either oral CBD oil 60 mg/day or placebo. The primary outcome was the Psoriasis Area and Severity Index (PASI) score. Secondary outcomes encompassed disease severity, quality of life, and sleep parameters. Safety was monitored through adverse events and laboratory assessments. RESULTS: The CBD group did not demonstrate a significant improvement in PASI scores. However, there was a notable reduction in itch scores by Week 8, and sleep onset latency decreased by Week 6, although this effect was not sustained. Adverse events were mild to moderate in nature and similar across both groups. LIMITATIONS: The study duration may not fully capture the long-term effects, and the race and disease severity may limit the generalizability of the findings. A larger sample size is suggested for future studies. CONCLUSION: Cannabidiol oil was well-tolerated; however, it did not result in a significant reduction in psoriasis severity. Temporary improvements in itch relief and sleep onset indicate that further research with higher doses and extended durations is warranted.
OBJECTIVES: To assess the efficacy and safety of topical compound flumethasone pivalate-salicylic acid cream for verrucous epidermal nevus (VEN), a benign keratinocytic hamartoma with limited current treatment options. M...OBJECTIVES: To assess the efficacy and safety of topical compound flumethasone pivalate-salicylic acid cream for verrucous epidermal nevus (VEN), a benign keratinocytic hamartoma with limited current treatment options. METHODS: A 25-year-old male with 20-year VEN (right buttock/lower limb plaques) was treated with the compound cream (0.2 mg flumethasone pivalate + 30 mg salicylic acid/gram) twice daily for over 2 months, followed by 14-week follow-up. RESULTS: Lesions showed progressive thinning, significantly reduced hyperpigmentation, and no adverse events. The Dermatology Life Quality Index score improved from 13 to 3, with no recurrence at follow-up. CONCLUSIONS: Topical compound flumethasone pivalate-salicylic acid cream is effective and safe for VEN, potentially inhibiting abnormal keratinocyte proliferation, serving as a practical topical option.
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 labor...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: Rosacea is a common chronic inflammatory skin disease. Mast cells are implicated in the pathogenesis of rosacea. However, the therapeutic potential of tranilast, a mast cell membrane stabilizer, remains unexp...BACKGROUND: Rosacea is a common chronic inflammatory skin disease. Mast cells are implicated in the pathogenesis of rosacea. However, the therapeutic potential of tranilast, a mast cell membrane stabilizer, remains unexplored. This study aims to evaluate the efficacy and safety of tranilast monotherapy and in combination with minocycline in patients with moderate-to-severe rosacea. METHODS: This study has been registered on ClinicalTrials.gov (Registration No. NCT06307223). All enrolled patients with rosacea were randomly assigned to receive tranilast, minocycline, or a combination of both. Tranilast (0.1 g, three times daily) and minocycline (50 mg, once daily) were administered for 12 weeks, with follow-up every two weeks. RESULTS: Forty-five patients completed the study. At week 12, the combination group showed a significantly higher IGA success rate (93.33%) compared to the tranilast (53.33%) and minocycline (46.67%) groups ( < 0.05). The secondary endpoints, such as CEA success rate, erythema index, and erythema score, also favored the combination group over minocycline group ( = 0.021, 0.030, and 0.024, respectively). CONCLUSION: In our study, patients with moderate to severe rosacea treated with tranilast showed a favorable clinical response and experienced no serious adverse events. The combination therapy yielded better outcomes than minocycline monotherapy, especially in improving facial erythema.
OBJECTIVE: To assess the real-world efficacy and safety of tildrakizumab in Chinese patients with psoriasis stratified by age, age of psoriasis onset and MetS status. METHODS: This two-center retrospective cohort study e...OBJECTIVE: To assess the real-world efficacy and safety of tildrakizumab in Chinese patients with psoriasis stratified by age, age of psoriasis onset and MetS status. METHODS: This two-center retrospective cohort study evaluated tildrakizumab's efficacy and safety over 28 weeks in 80 Chinese adults with moderate-to-severe plaque psoriasis, with subgroup analyses by age and age of psoriasis onset and metabolic syndrome (MetS). RESULTS: Mean PASI scores showed progressive improvement, declining from 9.3 ± 5.1 at baseline to 1.0 ± 1.4 at week 28 ( < 0.001). A high proportion of patients responded by week 16 (78.4% achieving PASI ≤ 3; 48.6% PASI ≤ 1), with further improvement at week 28 (88.6% and 62.0%, respectively). Dermatology Life Quality Index (DLQI) scores paralleled clinical gains, decreasing from 7.7 ± 4.6 to 0.9 ± 1.8 ( < 0.001), reflecting an 88.3% reduction in quality-of-life impairment. Geriatric patients showed superior PASI 100 responses (81.8% vs 38.6%, < 0.001) while late-onset patients also represented higher PASI 90 responses (81.5% vs 55.8%, = 0.027) at week 28. The MetS status did not affect therapeutic response (PASI 100 response: 52.6% vs 45.5%, = 0.622) at week 28. Safety monitoring identified 4 (5.0%) treatment-emergent adverse events, with no treatment discontinuation for psoriasis exacerbation. CONCLUSION: Tildrakizumab demonstrated sustained efficacy in real-world management of moderate-to-severe psoriasis and supported broad applicability across diverse psoriasis subtypes.
BACKGROUND: An increasing number of psoriatic patients are experiencing secondary failure with interleukin (IL)-17A inhibitors, highlighting the urgency to identify effective switching strategies. We evaluated the effect...BACKGROUND: An increasing number of psoriatic patients are experiencing secondary failure with interleukin (IL)-17A inhibitors, highlighting the urgency to identify effective switching strategies. We evaluated the effectiveness and treatment patterns of intraclass versus interclass switching therapies in psoriasis patients experiencing secondary failure to IL-17A inhibitors over a 28-week period. METHODS: This single-center, retrospective analysis included psoriatic patients who experienced secondary failure to either ixekizumab or secukinumab and subsequently switched to another IL-17A inhibitor (ixekizumab or secukinumab; intraclass switching group) or to an IL-23 inhibitor (guselkumab; interclass switching group). RESULTS: 80 patients were enrolled, including 47 in the intraclass switching group and 33 in the interclass switching group. The mean psoriasis area and severity index and dermatology life quality index were lower in the intraclass switching group compared to the interclass switching group at each time point over 28 weeks ( < .05). The discontinuation rate was higher in the interclass switching group (24.1%) compared to the intraclass switching group (2.7%; < .05). Previous exposure to ≥2 biologics working on different pathways was identified as a risk factor for treatment failure in the interclass switching group. CONCLUSION: An intraclass switch following IL-17A inhibitors failure yielded better treatment outcomes than a switch to guselkumab.
OBJECTIVE: This retrospective cohort study evaluated the clinical effectiveness of platelet-rich fibrin (PRF) versus conventional therapy in chronic wound management. METHODS: Electronic health records from a single inst...OBJECTIVE: This retrospective cohort study evaluated the clinical effectiveness of platelet-rich fibrin (PRF) versus conventional therapy in chronic wound management. METHODS: Electronic health records from a single institution (2010-2020) were analyzed. Included patients were adults (≥18 years) diagnosed with a chronic wound and treated with either PRF or conventional therapy. RESULTS: Wound healing was faster in the PRF group (36.2 ± 9.3 days vs. 60.4 ± 11.4 days, < .001). Multivariate Cox regression identified PRF as an independent factor for accelerated healing (HR = 0.61, 95% CI: 0.52-0.72, = .001). Wound closure (89.8% vs. 70.6%, < .001) and complete re-epithelialization (90.3% vs. 69.6%, < .001) were higher in the PRF group. Wound recurrence (10.1% vs. 25.1%, = .029) and scar formation (12.4% vs. 28.7%, = .008) were lower in the PRF group. The incidence of adverse events was similar between groups (8.7% vs. 10.4%, = .582). CONCLUSION: PRF therapy accelerates chronic wound healing, improves healing quality by reducing recurrence and scarring, and demonstrates a safety profile comparable to conventional care.
OBJECTIVES: Plaque psoriasis is a common immune-mediated disease associated with various comorbidities, including cardiovascular disease, diabetes, psoriatic arthritis, liver disease, and mood disorders. Biologic and sma...OBJECTIVES: Plaque psoriasis is a common immune-mediated disease associated with various comorbidities, including cardiovascular disease, diabetes, psoriatic arthritis, liver disease, and mood disorders. Biologic and small-molecule therapies are efficacious and well tolerated in adults with moderate to severe plaque psoriasis. However, dermatologists may be uncertain about appropriate laboratory monitoring in patients treated with these therapies, especially those with comorbidities. METHODS: This review summarizes prescribing information and provides expert recommendations based on real-world experience in the monitoring of concerning laboratory values in patients with psoriasis. RESULTS: Individualized monitoring is essential for maximizing the benefits and minimizing the risks associated with biologic and small-molecule therapies. The recommendations provided in this review focus on laboratory monitoring associated with biologic and small-molecule therapies; additional laboratory monitoring may be necessary for other therapeutic classes. Laboratory monitoring of comorbid conditions is based on individual patient clinical characteristics and occurs at the discretion of the treating physician; general laboratory monitoring guidelines for some of the most common comorbid conditions in patients with psoriasis are included. CONCLUSIONS: Patients with psoriasis can be successfully monitored in clinical practice through ongoing collaboration among dermatologists, primary care physicians, and/or other specialists.
Psoriasis is a chronic disease. Its management is based on disease severity, clinical implications, and patients' quality of life. Biological agents are available in Kuwait for the treatment of moderate-to-severe chronic...Psoriasis is a chronic disease. Its management is based on disease severity, clinical implications, and patients' quality of life. Biological agents are available in Kuwait for the treatment of moderate-to-severe chronic psoriasis and are frequently used. The Kuwait Society of Dermatologists decided to develop consensus statements and recommendations for the use of biologics in moderate-to-severe plaque psoriasis in Kuwait. This paper reports these consensus statements. An advisory board composed of psoriasis experts was formed, and a robust literature review was conducted. After several deliberations, experts proposed a few statements for further deliberations and refinement. The finalized consensus statements were put to a vote by the experts. The maximum rating was 10, and an average rating above 8 was considered to meet the << acceptance criteria>> for the proposed statement and recommendations. A total of seventeen consensus statements were formulated. They were grouped under eight specific domains. The average rating for the consensus statements ranged from 8.9 to 9.8, and all statements were accepted. The consensus statements aim to systematically and holistically treat patients with plaque psoriasis in Kuwait using biologics while caring for their overall health, comorbidities, and mental health. These consensus statements are developed after rigorous deliberation, a review of international guidelines, and the clinical practice followed in Kuwait to guide the systematic and standardised use of biologics for plaque psoriasis.
BACKGROUND: Androgenetic alopecia (AGA) is a common, age-related, androgen-dependent condition. Dihydrotestosterone and androgen receptors play key roles in its pathogenesis. METHODS: This multicenter, randomized, double...BACKGROUND: Androgenetic alopecia (AGA) is a common, age-related, androgen-dependent condition. Dihydrotestosterone and androgen receptors play key roles in its pathogenesis. METHODS: This multicenter, randomized, double-blind, placebo-controlled Phase II trial evaluated the efficacy and safety of topical GT20029 in Chinese adult males with AGA. From April 2023 to April 2024, 180 eligible subjects (Hamilton-Norwood IIIv-V) were randomized equally into six groups receiving GT20029 (0.5% or 1.0%) or placebo, either once daily (QD) or twice weekly (BIW) for 12 weeks. The primary endpoint was the change in target area non-vellus hair count (TAHC) at Week 12; secondary endpoints included TAHC at Week 6, hair width (TAHW), and terminal/vellus hair ratio. Safety was assessed adverse events (AEs). RESULTS: All four GT20029-treated groups showed significant increases in TAHC at Week 12 ( < 0.001), with 0.5% QD and 1.0% BIW groups showing significant improvement over their respective placebo groups ( = 0.032 and = 0.023). TAHW also improved significantly in the 1.0% BIW group vs placebo ( = 0.011). TEAE incidence was similar across all groups and mostly mild. CONCLUSION: Topical GT20029 demonstrated significant efficacy in hair regrowth with good tolerability. Further studies are warranted to confirm its therapeutic potential in AGA.
Carvalho AVE, Galimany L, Leite L
… +13 more, Merino-Senekowitsch N, Armijo D, Barboza da Silva J, de la Cruz C, Hidalgo-Matlock B, Romiti R, van de Kerkhof P, Velásquez-Lopera MM, Echeverría CM, Contreras CR, Maskin M, Rivas E, Valenzuela F
OBJECTIVE: This study evaluated psoriasis treatment teaching in dermatology residency programs across Latin America (LATAM). METHODS: A Spanish/Portuguese survey was distributed to directors of dermatology departments/tr...OBJECTIVE: This study evaluated psoriasis treatment teaching in dermatology residency programs across Latin America (LATAM). METHODS: A Spanish/Portuguese survey was distributed to directors of dermatology departments/training programs and their residents in several LATAM countries between November 29, 2022, and March 31, 2023. RESULTS: A total of 108 individuals responded (59 directors and 49 residents) from eight countries: Argentina (2.8%), Brazil (41.7%), Chile (25.0%), Colombia (7.4%), Guatemala (1.9%), Mexico (1.9%), Paraguay (4.6%), and Peru (14.8%). Most directors reported that residents received training in complex medical dermatology (89.8%), immunodermatology (66.1%), and phototherapy (78%). Most residents reported familiarity with national guidelines (81.6%) and adherence to local guidelines (85.7%). In Brazil, 91% of programs had at least seven faculty members, 97% required national specialization exams, and 91% treated more than 31 psoriasis patients per week, compared with 48%, 36%, and 67% in other LATAM countries, respectively. Additionally, 47% of centers in Brazil reported that at least 26% of psoriasis patients received biological therapy, compared with only 8% in other LATAM countries. CONCLUSION: Dermatology residents in LATAM are trained in complex dermatology, immunodermatology, and phototherapy and national psoriasis guidelines. Variation exists in patient volume and biologics use. A focus on improving residents' psoriasis training throughout LATAM is needed.
PURPOSE: Melasma, a prevalent acquired hypermelanosis, significantly impacts psychological well-being. It presents as irregular, bilateral patches of brown or gray skin discoloration and currently lacks a curative treatm...PURPOSE: Melasma, a prevalent acquired hypermelanosis, significantly impacts psychological well-being. It presents as irregular, bilateral patches of brown or gray skin discoloration and currently lacks a curative treatment. Management focuses on controlling disease progression and preventing further hyperpigmentation through photoprotection, topical and oral medications, and dermatological procedures such as chemical peels, lasers, and microneedling. MATERIALS AND METHODS: This review draws upon extensive literature from PubMed and Google Scholar to critically evaluate and compare the safety and efficacy of topical treatments for melasma, highlighting both established and emerging agents. The Melasma Area and Severity Index (MASI) was used as the primary outcome measure to assess treatment effectiveness. RESULTS: Among chemical agents, thiamidol demonstrated comparable efficacy to hydroquinone with a better tolerability profile in multiple randomized studies. Tranexamic acid and metformin showed similar MASI score improvements to triple-combination therapy with fewer adverse effects. Natural agents such as niacinamide, kojic acid, and ascorbic acid also demonstrated meaningful pigment reduction with superior safety profiles, supporting their potential role in maintenance therapy. Hydroquinone remains the gold-standard topical treatment despite its known side effects. CONCLUSIONS: Several alternative topical agents show promise and warrant further rigorous, large-scale clinical trials to establish their long-term safety and efficacy.
Psoriasis involving the genital region (GenPsO) is associated with impaired quality of life (QoL), including sexual burden and avoidance of sexual intercourse. There is limited data on the effectiveness of risankizumab i...Psoriasis involving the genital region (GenPsO) is associated with impaired quality of life (QoL), including sexual burden and avoidance of sexual intercourse. There is limited data on the effectiveness of risankizumab in GenPsO on patients' QoL and sexual impairment. GPS-Best, a nested cohort non-interventional study within the German Psoriasis registry PsoBest, aims to evaluate the effectiveness of risankizumab in GenPsO and its impact on QoL and sexual impairment. This interim analysis involves 52 patients who completed week 16 of the 52-week GPS-Best study. Patient questionnaires, including the Genital Psoriasis Symptoms Scale (GPSS) and Genital Psoriasis Sexual Impact Scale (GPSIS), were evaluated in patients with plaque psoriasis and a static physician's global assessment of genitalia ≥ 3 at baseline. The results demonstrated a significant reduction in the GPSS total score from a median [IQR] of 42.0 [36.0-57.0] at baseline to 3.0 [0-9.0] at week 16 ( < 0.001). In the GPSIS avoidance and impact subscale, more patients reported 'never' avoiding sexual activity at week 16 compared to baseline (46.8% vs. 10.5%) and 78.9% reported 'no or very low' impact compared to 18.5% at baseline, respectively. These findings indicate risankizumab significantly reduces patient-reported GenPsO symptoms over a 16-week period and increases sexual QoL.