BACKGROUND: Advances in biotechnology have enabled highly effective, site-specific topical therapies for skin disease. Particle-based delivery systems can be engineered with tailored physicochemical properties and surfac...BACKGROUND: Advances in biotechnology have enabled highly effective, site-specific topical therapies for skin disease. Particle-based delivery systems can be engineered with tailored physicochemical properties and surface modifications to optimize controlled drug release and skin targeting, potentially improving acne treatment outcomes. OBJECTIVE: To evaluate the effectiveness and tolerability of a retinol plus site-specific salicylic acid-targeted bio-delivery system in 40 Fitzpatrick skin type I-VI patients with moderate-to-severe acne over 12 weeks. RESULTS: Significant improvements were observed across multiple efficacy measures, including expert grading, microbiome analysis, visual imaging, and patient self-assessments. Investigator grading demonstrated a 27.8% reduction in inflamed pustules at 2 weeks and a 68.6% reduction at 12 weeks. Acne nodules improved by 61.1% at 2 weeks, with a 92.2% reduction by week 12. Post-inflammatory hyperpigmentation improved significantly beginning at week 2, with an overall 32.3% improvement at week 12. Microbiome analysis showed a 52% reduction in Cutibacterium acnes levels by week 12. Expert grading revealed no erythema by week 12 and no edema throughout the study period. Patients also reported no significant itching, burning, tingling, or stinging sensations during treatment. CONCLUSION: Combination therapy with site-specific acne medication and retinol produced significant clinical improvement in acne and post-inflammatory hyperpigmentation while demonstrating excellent tolerability over 12 weeks.  .
Hair loss is a widespread condition with a potentially severe psychological burden, especially among women. The chance of suffering from female alopecia increases with menopause, and topical treatments beyond minoxidil a...Hair loss is a widespread condition with a potentially severe psychological burden, especially among women. The chance of suffering from female alopecia increases with menopause, and topical treatments beyond minoxidil are scarce. Over the past several years, new combinations of natural ingredients and patented mixtures have shown promising results to improve hair shedding, thus helping recover self-esteem and confidence. In this work, results of a prospective, open-label clinical trial conducted in women of predominantly menopausal age provides evidence that the dual cosmetic serum system developed by KilgourMD displays statistically significant and clinically meaningful effects on female hair loss, measured through an objective combing test, modified hair wash test, and clinical expert evaluation, after an application period of 4 months.
BACKGROUND: Mineral sunscreens are increasingly favorable among consumers. However, mineral sunscreens typically cause a white cast that can impact consumer selection and application. OBJECTIVE: This study measured the w...BACKGROUND: Mineral sunscreens are increasingly favorable among consumers. However, mineral sunscreens typically cause a white cast that can impact consumer selection and application. OBJECTIVE: This study measured the whitening effect of mineral sunscreens across diverse skin tones and evaluated its relationship with consumer perception, application behavior, and the product's efficacy in terms of ultraviolet A protection factor (UVAPF) and sun protection factor (SPF). METHODS: Five mineral sunscreens with differing whiteness and one chemical sunscreen were applied at 2 mg/cm2 on the forearm. Two of the 6 sunscreens were randomly assigned for uncontrolled application on the lower legs, and the participants' preferred product of the pair was then applied to the face at his/her discretion. Imaging and Hybrid Diffuse Reflectance Spectroscopy (HDRS) of the arm and face determined UVAPF and SPF. RESULTS: Controlled application with all mineral sunscreens led to significant whitening, which was 3 times more pronounced on darker skin tones. Uncontrolled sunscreen application showed a significant reduction in the amount applied, whitening, and sunscreen efficacy. Participants had reduced preference for more whitening sunscreens and selected sunscreens in product pairings that resulted in less whitening. CONCLUSION: Patients may avoid sunscreens with negative whitening aesthetics or compensate with reduced application, compromising their ability to achieve appropriate sun protection, especially in darker skin tones.  .
BACKGROUND: Aesthetic patients are increasingly aware of the contrast between rejuvenated facial skin and untreated aging skin of the décolletage, and frequently request cosmetic enhancement of this area. Poly-L-l...BACKGROUND: Aesthetic patients are increasingly aware of the contrast between rejuvenated facial skin and untreated aging skin of the décolletage, and frequently request cosmetic enhancement of this area. Poly-L-lactic acid (Sculptra®, Galderma; PLLA-SCA) is a regenerative biostimulator that stimulates collagen and elastin production to help regenerate the skin’s inner structure. OBJECTIVE: This 9-month, open-label study investigated the effectiveness and safety of correcting décolletage wrinkles with PLLA-SCA using 2 reconstitution volumes. METHOD: Women with moderate/severe wrinkles on the Galderma Décolletage Scale (GDS) were randomized 1:1 to receive PLLA-SCA reconstituted with 8 mL or 17 mL sterile water for injection, plus 1 mL 2% lidocaine (up to 4 treatments, 1 month apart). Assessments included GDS, Global Aesthetic Improvement Scale (GAIS), subject satisfaction, skin quality, and adverse events (AEs). RESULTS: Of 30 randomized subjects, the majority (8 mL: 93.8%; 17 mL: 78.6%) showed a ≥1-point improvement on investigator-assessed GDS at month 9 (primary endpoint), with ≥93% improved also at month 6. GAIS improvement was also great (>90% of subjects) across both groups at months 6 and 9. In both groups, >90% of subjects reported satisfaction with the appearance of their wrinkles by month 3, and this satisfaction was sustained throughout the study. The majority (>80%) of subjects were satisfied with the texture, smoothness, and radiance of their skin at months 6 and 9. One AE was judged as treatment-related; no AEs were serious or led to discontinuation. CONCLUSION: Treatment of the décolletage area with PLLA-SCA was effective and well tolerated with both reconstitution volumes, with high subject satisfaction.
BACKGROUND: Acne is the most prevalent skin disease globally, with a significant burden and limited therapeutic innovation. Although it has a multifactorial etiology, Cutibacterium acnes (C acnes) overgrowth is a key fac...BACKGROUND: Acne is the most prevalent skin disease globally, with a significant burden and limited therapeutic innovation. Although it has a multifactorial etiology, Cutibacterium acnes (C acnes) overgrowth is a key factor in driving inflammation in acne. Bacteriophages are a novel mechanism that can specifically target C acnes and are found in greater abundance on healthy skin compared to acne-prone skin. OBJECTIVES: To study the safety and efficacy of phages and salicylic acid (SA) in acne, and to analyze their mode of action and effect on microbiome diversity. METHODS: A randomized double-blind placebo-controlled study was conducted on 90 participants for 8 weeks. Males and females 12 to 35 years old with mild to moderate acne were enrolled in placebo, phage, and phage + SA arms. Clinic visits at baseline, week 4, and week 8 collected safety data, VISIA imaging, lesion counts, IGA scores, and microbiome samples. RESULTS: Phage treatment demonstrated an excellent safety profile. Participants in both phage and phage + SA arms showed significant improvement (P<0.05) over baseline at 8 weeks. Phage application resulted in a statistically significant (P<0.05) decrease of C acnes on the skin compared to placebo. Notably, phage use over 8 weeks significantly increased microbiome diversity, a marker of long-term skin health. CONCLUSION: This study shows the potential of bacteriophages to be a highly promising modality with a unique mode of action for the treatment of acne. Beyond short-term lesion improvement, phage-induced enhancement of microbiome diversity suggests potential for durable, long-term skin health benefits.  .
BACKGROUND: Clascoterone cream 1% is a topical androgen receptor inhibitor approved for the treatment of acne vulgaris in patients ≥12 years of age. The American Academy of Dermatology recommends topical combination t...BACKGROUND: Clascoterone cream 1% is a topical androgen receptor inhibitor approved for the treatment of acne vulgaris in patients ≥12 years of age. The American Academy of Dermatology recommends topical combination therapy using medications that target different mechanisms of acne pathogenesis. This 20-week, open-label, pilot study (NCT06336603) evaluated the efficacy and safety of clascoterone cream 1% combined with adapalene gel 0.3% in patients with acne. METHODS: Patients aged ≥12 years with moderate-to-severe acne applied clascoterone cream 1% twice daily and adapalene gel 0.3% once daily for 16 weeks. Efficacy assessments included Investigator's Global Assessment (IGA) score; inflammatory, noninflammatory, and total lesion counts; and Dermatology Life Quality Index (DLQI) through week 16. Tolerability and safety were assessed from local skin reactions and adverse events through week 20. RESULTS: Twenty patients were enrolled; 17 completed the study (female, 53%; mean [standard deviation (SD)] age, 22 [10] years). At week 16, 65% of patients achieved an IGA score of clear (0) or almost clear (1). From baseline to week 16, there were significant reductions in lesion counts (mean [SD] percent reduction: inflammatory, 90.5 [10.1]; noninflammatory, 84.8 [13.5]; total, 87.3 [11.4]; all P<0.001) and DLQI score (mean [SD] reduction, 3.7 [6.2]; P=0.02). Treatment was well tolerated, with most local skin reactions reported as absent or trace, and no adverse events reported. CONCLUSIONS: This open-label pilot study shows promising results for combination treatment with clascoterone cream 1% and adapalene gel 0.3% for the treatment of patients with acne.  .
BACKGROUND: As the largest online rosacea forum, r/Rosacea, a subreddit hosted on Reddit, provides a unique opportunity to better understand the concerns of rosacea patients. METHODS: Using Python software and artificial...BACKGROUND: As the largest online rosacea forum, r/Rosacea, a subreddit hosted on Reddit, provides a unique opportunity to better understand the concerns of rosacea patients. METHODS: Using Python software and artificial intelligence models, a total of 1,000 posts from the r/Rosacea subreddit were analyzed for emotional tone, post category, and mentions of signs and symptoms, as well as medications. RESULTS: The majority of posts were classified as seeking advice (n = 631), and posts categorized as patient stories received the highest median upvotes (P<0.001). Rosacea patients were found to be most concerned with external appearance, with redness (45.2%) and pustules (24.2%) being the most discussed signs in advice-seeking posts. Posts referencing burning exhibited strong negative emotional tones of anger and disgust. Ivermectin (12.7%) and azelaic acid (10.9%) were the most discussed medications in advice-seeking posts, and ivermectin received significantly lower median upvotes (P=0.0067). CONCLUSION: The insights of this cross-sectional analysis aid in achieving a deeper understanding of the rosacea patient perspective. Additional emotional analysis of the posts highlights the need for greater focus on the psychological burden of the disease. The frequency and popularity of rosacea medications reveal potential gaps in patient education and raises concerns regarding treatment adherence to medications, including ivermectin. It is imperative to increase rosacea patient access to quality-assured educational resources and to limit the potential spread of misinformation on r/Rosacea.  .
BACKGROUND: Clascoterone cream 1% is a topical androgen receptor inhibitor approved to treat acne vulgaris in patients ≥12 years of age. The American Academy of Dermatology recommends combining topical therapies that...BACKGROUND: Clascoterone cream 1% is a topical androgen receptor inhibitor approved to treat acne vulgaris in patients ≥12 years of age. The American Academy of Dermatology recommends combining topical therapies that target different mechanisms of acne pathogenesis as first-line treatment for acne. This 16-week, open-label pilot study evaluated the efficacy and safety of clascoterone cream 1% combined with clindamycin 1.2%/benzoyl peroxide 5% gel in patients with acne. METHODS: Patients aged ≥12 years with moderate acne applied clascoterone cream 1% twice daily and clindamycin 1.2%/benzoyl peroxide 5% gel once daily for 12 weeks. Assessments included Investigator's Global Assessment (IGA) score; inflammatory, noninflammatory, and total lesion counts; Dermatology Life Quality Index (DLQI) score; tolerability (through local skin reactions); and safety (through adverse events) through week 16. RESULTS: Nine patients were enrolled in the study (female, 56%; White, 56%; mean [standard deviation (SD)] age, 33 [17] years). At week 16, all patients had an IGA score of clear (0) or almost clear (1); from baseline to week 16, there were significant decreases in lesion counts (mean [SD] percent reduction; inflammatory: 96.4 [6.0], P=0.007; noninflammatory: 86.1 [15.3], P=0.009; total: 92.0 [8.2], P=0.008) and DLQI scores (mean [SD] reduction, 3.1 [2.1], P=0.014). The treatment was well tolerated with no adverse events reported through week 16. CONCLUSIONS: Based on data from 9 patients, combination treatment with clascoterone cream 1% and clindamycin 1.2%/benzoyl peroxide 5% gel is safe and effective to treat patients with acne.  .
INTRODUCTION: Generalized bullous fixed drug eruption (GBFDE) is a potentially life-threatening condition, typically triggered by a range of medications. Its incidence in the pediatric population is exceedingly low. CASE...INTRODUCTION: Generalized bullous fixed drug eruption (GBFDE) is a potentially life-threatening condition, typically triggered by a range of medications. Its incidence in the pediatric population is exceedingly low. CASE SUMMARY: We present a 14-year-old boy with a complex medical history, including Becker muscular dystrophy and epilepsy, who experienced recurrent episodes of GBFDE over the past 2 years. The episodes culminated in a severe presentation resembling Stevens-Johnson syndrome. Detailed evaluation identified ibuprofen as the culprit drug. The patient was treated with prednisone, commencing at a dose of 0.5 mg/kg and tapered over a 2-week period, which resulted in a significant regression of lesions. CONCLUSION: In cases with multiple potential drug triggers, it is essential to identify common drug classes associated with GBFDE and monitor the onset of symptoms post-ingestion. Our findings support the effective and safe use of prednisone, highlighting a generally positive prognosis for pediatric patients with this condition.  .
BACKGROUND: Cutaneous squamous cell carcinoma (cSCC) is the second most prevalent skin cancer, and its incidence has been rising. Certain patients with high-risk cSCC may benefit from adjuvant radiation therapy (ART). Th...BACKGROUND: Cutaneous squamous cell carcinoma (cSCC) is the second most prevalent skin cancer, and its incidence has been rising. Certain patients with high-risk cSCC may benefit from adjuvant radiation therapy (ART). This systematic review aims to analyze existing data on factors of cSCC that predict benefit from ART and explore approaches to optimize patient outcomes. METHODS: A systematic review was performed. The terms "cutaneous squamous cell carcinoma," "adjuvant radiation therapy," "clinical recommendations," and "predicting benefit," along with Boolean terms "AND" and "OR" were used to search PubMed, Scopus, Embase, and Google Scholar. Original articles published before April 2025 were screened for relevance. RESULTS: Although it is well established that adjuvant radiation therapy (ART) provides significant benefit when directed to the appropriate high-risk patients, there are limited studies reporting clinicopathologic factors that can reliably inform which patients are most likely to benefit from ART. As such, decisions for ART usage based on clinicopathologic factors are variable. The 40-GEP test has been shown to accurately identify which patients would benefit most from ART (Class 2B), and to aid in determining which patients can consider deferring ART (Class 1). The Class 2B result is the only high-risk factor that has been demonstrated to predict benefit from ART. CONCLUSION: Relying exclusively on clinicopathologic factors has limitations, contributing to inconsistent use of ART in clinical settings. This systematic review highlights that the 40-GEP test improves risk stratification in cSCC and aids in making more precise ART decisions, including determining which patients may safely defer treatment.
BACKGROUND: Many treatments have been proposed for the treatment of acne vulgaris and acne scarring; however, few data exist regarding the efficacy of botulinum toxin A as a treatment option. OBJECTIVE: To compile all av...BACKGROUND: Many treatments have been proposed for the treatment of acne vulgaris and acne scarring; however, few data exist regarding the efficacy of botulinum toxin A as a treatment option. OBJECTIVE: To compile all available data on the efficacy and safety of botulinum toxin A as a treatment for acne vulgaris and acne scarring. METHODS: A systematic review of PubMed/MEDLINE, Excerpta Medica Database (EMBASE), Scopus, CINAHL, and the Cochrane CENTRAL Register of Controlled Trials, and Google Scholar databases identified all cases of acne vulgaris and acne scarring treated with botulinum toxin. RESULTS: Four hundred thirty-six patients (218 with acne vulgaris and 218 patients with acne scarring) from 14 manuscripts were included in this review. Results showed overall improvement for up to 3-6 months in the majority of patients based on sebometer readings, fine pore count, and patient satisfaction scores. Acne scarring improved in patients treated with botulinum toxin as a single therapy, as well as in combination with other therapies, with consistently high patient satisfaction scores. CONCLUSIONS: Patients experienced a significant reduction in sebum production, number of acne lesions, and improvement in the appearance of acne scars, indicating a role for botulinum toxin A in the treatment of acne and acne scarring.
Hand, foot, and mouth disease (HFMD) is a common viral illness that predominantly affects young children, with approximately 95% of cases occurring in individuals under the age of 5. While typically self-limiting, a subs...Hand, foot, and mouth disease (HFMD) is a common viral illness that predominantly affects young children, with approximately 95% of cases occurring in individuals under the age of 5. While typically self-limiting, a subset of cases may present with more severe cardiopulmonary and neurological sequelae, such as myocarditis, pneumonia, meningitis, and encephalitis. Management is primarily supportive, as no standard antiviral therapy currently exists. However, previous case reports have suggested that acyclovir may offer therapeutic benefits. We present a case of a healthy 39-year-old female who experienced dramatic symptomatic improvement within 10 hours and complete resolution within 48 hours following off-label valacyclovir use. This case raises the possibility of valacyclovir use in adults with HFMD and highlights the need for further research to validate its role.