Copesco HDRP, Albertino GS, Lima FR
… +2 more, Tedesco AC, Frade MAC
An Bras Dermatol
· 2026 Jul · PMID 42398233
·
Publisher ↗
BACKGROUND: Androgenetic Alopecia (AGA) is the most prevalent hair disorder. Conventional topical minoxidil is limited by suboptimal follicular penetration, local adverse effects, and poor adherence; nanocarrier-based "n...BACKGROUND: Androgenetic Alopecia (AGA) is the most prevalent hair disorder. Conventional topical minoxidil is limited by suboptimal follicular penetration, local adverse effects, and poor adherence; nanocarrier-based "nanominoxidil" systems may optimize delivery, but their clinical value remains uncertain. OBJECTIVE: To synthesize experimental and clinical evidence on nanocarrier-based topical minoxidil for AGA. METHODS: We systematically searched databases (2015-2024) for in vitro, ex-vivo, in vivo, and human studies evaluating nanocarriers < 1000 nm loaded with minoxidil versus conventional minoxidil, placebo, or no treatment. Primary outcomes were follicular and cutaneous penetration or retention; secondary outcomes included hair length, density and/or coverage, biomarker modulation, adverse events, and formulation stability. Risk of bias was assessed with SYRCLE and OHAT. RESULTS: Of 410 records, 20 studies met eligibility criteria, predominantly preclinical, and one evaluated cutaneous tolerability in healthy volunteers. Across platforms (lipid, polymeric, hybrid and deformable systems, nanoemulsions), nanominoxidil consistently increased follicular deposition and cutaneous retention (≈2- to > 7-fold vs conventional solutions) and improved hair growth surrogates and angiogenic or stem-cell markers. Local tolerability was generally acceptable and systemic exposure was negligible when reported. STUDY LIMITATIONS: Evidence is preclinical, with a single non-therapeutic human study; heterogeneity across models, comparators, doses, follow-up, and outcomes, and frequent lack of randomization, blinding, and standardized safety reporting, precluded meta-analysis and limited internal validity and generalizability. CONCLUSIONS: Nanotechnology-based minoxidil formulations enhance follicular targeting and hair-growth surrogate outcomes in experimental models and appear locally safe, but randomized trials in patients with AGA are required before nanominoxidil can be recommended for routine clinical use.
Martinelli Salathiel AS, Secamilli EN, Maciel MG
… +3 more, Serrano JYM, da Costa França AFE, Magalhães RF
An Bras Dermatol
· 2026 Jul · PMID 42398232
·
Publisher ↗
BACKGROUND: Pediatric psoriasis may result in significant cumulative life course impairment, and there is comparatively less evidence available than for adult psoriasis. OBJECTIVE: The aim of this study is to provide an...BACKGROUND: Pediatric psoriasis may result in significant cumulative life course impairment, and there is comparatively less evidence available than for adult psoriasis. OBJECTIVE: The aim of this study is to provide an update on the management of pediatric psoriasis, integrating recent immunogenetic and therapeutic advances. It highlights challenges, including clinical heterogeneity, complex differential diagnosis, and limited treatment options, especially in Brazil. METHODS: A narrative review was conducted, including studies published in English, Portuguese, and Spanish between 2009 and 2025, retrieved from the United States National Library of Medicine (PubMed), Cochrane Library, and Scientific Electronic Library Online (SciELO). The following descriptors were used: "psoriasis", "child health", "pediatrics", "therapeutics", "comorbidity", and "T-lymphocyte antigen differentiation". RESULTS: Pediatric psoriasis most commonly presents as chronic plaque. Differential diagnoses are broad and include atopic dermatitis and autoimmune diseases. Data about comorbidities, particularly cardiovascular risk, are controversial. Although severe cases are less frequent, they are associated with a substantial impact on quality of life. Conventional therapies include topical corticosteroids, phototherapy, and non-targeted systemic agents such as acitretin, methotrexate, and cyclosporine. Biologic therapies have been approved for pediatric use and demonstrate safety profiles and superior efficacy compared to conventional treatments. STUDY LIMITATIONS: Scarcity of pediatric psoriasis guidelines. CONCLUSIONS: Despite advances in understanding adult psoriasis, evidence in pediatric populations remains limited, especially in Brazil. Expanding knowledge in pediatric psoriasis is essential to improve diagnosis, optimize treatment strategies, and increase access to innovative therapies, thereby reducing inflammatory burden and cumulative life course impairment.
An Bras Dermatol
· 2026 Jul · PMID 42398231
·
Publisher ↗
BACKGROUND: Androgenetic Alopecia (AGA) and Seborrheic Dermatitis (SD) are scalp conditions that may show histopathological features overlapping with Fibrosing Alopecia in a Pattern Distribution (FAPD), potentially leadi...BACKGROUND: Androgenetic Alopecia (AGA) and Seborrheic Dermatitis (SD) are scalp conditions that may show histopathological features overlapping with Fibrosing Alopecia in a Pattern Distribution (FAPD), potentially leading to diagnostic confusion between non-scarring and scarring alopecias. OBJECTIVE: To identify histopathological features that distinguish AGA from SD and to evaluate findings overlapping with those described in FAPD, focusing on perifollicular fibrosis and inflammation. METHODS: Transverse scalp biopsy sections from 56 Caucasian male patients (21 AGA, 35 SD) were blindly evaluated. Quantitative follicular parameters and qualitative epidermal, follicular, inflammatory, and adnexal features were assessed and statistically compared. RESULTS: AGA showed higher vellus follicle counts (p = 0.029) and lower terminal follicle and anagen hair counts (p = 0.002; p = 0.045), confirming follicular miniaturization. Perifollicular fibrosis (infundibular and/or isthmic) was frequent in both conditions, limiting its specificity for scarring alopecias. Mild basal vacuolization (14.3%; p = 0.048) and eccrine duct dilatation (23.8%; p = 0.006) occurred exclusively in AGA, whereas polytrichia was observed only in SD (17.1%; p = 0.050). Perifollicular inflammation was common and non-specific in both groups, occasionally mimicking lichenoid patterns. Demodex spp. was more prevalent in AGA (p = 0.007). Necrotic keratinocytes were rare, with no significant differences. STUDY LIMITATIONS: The study included only male patients and had a limited sample size, a cross-sectional design, and no FAPD comparison. Nonetheless, substantial histopathological overlap exists between AGA, SD, and features attributed to FAPD, particularly perifollicular fibrosis and inflammation. Careful clinicopathological correlation is essential to avoid misclassification, with prognostic and therapeutic implications.
An Bras Dermatol
· 2026 Jun · PMID 42364363
·
Full text
BACKGROUND: Human skin, the body's largest organ, hosts a diverse ecosystem of bacteria, fungi, viruses, and mites collectively known as the skin microbiome. This microbiome supports cutaneous homeostasis through barrier...BACKGROUND: Human skin, the body's largest organ, hosts a diverse ecosystem of bacteria, fungi, viruses, and mites collectively known as the skin microbiome. This microbiome supports cutaneous homeostasis through barrier defense, immune education, and metabolic functions. OBJECTIVE: To narratively review the historical evolution of skin microbiome research, synthesize current knowledge on its composition, biogeography, and functional roles in health and disease, and highlight emerging microbiome-based therapeutic strategies in dermatology. METHODS: This review integrates seminal historical works with contemporary evidence from culture-independent sequencing and multi-omic investigations of the skin microbiome, identified through a selective search of recent dermatology and microbiome literature. RESULTS: Modern molecular and multi-omic approaches have revealed microbial diversity across sebaceous, moist, and dry skin niches and clarified key functions of the skin microbiome, including colonization resistance, immune modulation, metabolite production, and participation in the gut-skin axis. Dysbiosis of these communities is linked to inflammatory conditions such as atopic dermatitis, acne vulgaris, psoriasis, and chronic wounds. A growing body of work supports microbiome-targeted interventions, including probiotics, prebiotics, postbiotics, and microbiome engineering, as promising personalized strategies. STUDY LIMITATIONS: As a narrative review, this work may be subject to selection bias and does not provide a quantitative synthesis of all available studies on the skin microbiome. CONCLUSIONS: By integrating historical context with mechanistic insights from modern microbiome research, this review underscores the skin microbiome as a central ecological determinant of cutaneous health and disease and provides a framework for translating microbiome science into clinical applications and precision dermatology.
An Bras Dermatol
· 2026 Jun · PMID 42364360
·
Full text
BACKGROUND: People with albinism, a genetic condition characterized by reduced melanin production, have an increased risk of developing skin cancer due to their diminished photoprotection. The global prevalence of albini...BACKGROUND: People with albinism, a genetic condition characterized by reduced melanin production, have an increased risk of developing skin cancer due to their diminished photoprotection. The global prevalence of albinism is estimated at 1 in 17,000 individuals, but it varies significantly by region, being more common in certain parts of Africa. Despite this heightened vulnerability, data on the prevalence of skin cancer and its subtypes in this population remain limited. OBJECTIVE: This study aimed to determine the prevalence of Skin Cancer (SC) and Actinic Keratosis (AK) among patients with albinism. METHODS: A systematic search of PubMed, Embase, Web of Science, and Cochrane databases was conducted, only including cross-sectional and cohort studies. The review adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Statistical analyses were performed using R software, and heterogeneity was assessed via the I statistic. RESULTS: Among 1,747 individuals with albinism from 12 studies, the pooled prevalence of actinic keratosis (AK) was 38% (95% CI 17.7-60.3; I = 99%), and that of skin cancer (SC) was 19% (95% CI 13.5-24.4; I = 89%). Within the SC group, squamous cell carcinoma (SCC) accounted for 55.4% (95% CI 36.2-73.8; I = 94%), basal cell carcinoma (BCC) for 33.7% (95% CI 19.6-49.2; I = 91%), and malignant melanoma (MM) for 0% (95% CI 0.00-0.56; I = 0%). CONCLUSION: This study demonstrates a high global prevalence of actinic keratosis (AC) and skin cancer (SC) among individuals with albinism, reinforcing the need for targeted surveillance, preventive strategies, and treatments tailored to this high-risk population. Overall, heterogeneity remained high across outcomes despite the exclusion of individual studies. STUDY LIMITATIONS: The results show persistent heterogeneity driven by differences in study design, diagnostic criteria, and the predominance of cross-sectional data. Future research should aim to address these gaps by employing longitudinal designs, standardizing diagnostic criteria, and including detailed patient-level data.
Sabas-Ortega K, García-González S, Ara-Martín M
… +7 more, Morales-Moya AL, de la Fuente Meira S, Bularca E, Villagrasa-Boli P, Martinez-Lostao L, Rivera-Fuertes I, Prieto-Torres L
An Bras Dermatol
· 2026 Jun · PMID 42330721
·
Full text