Atopic dermatitis (AD), a chronic inflammatory skin disease, is typically treated with topical corticosteroids in patients with mild to moderate disease, creating an ongoing need for nonsteroidal therapies. As part of a...Atopic dermatitis (AD), a chronic inflammatory skin disease, is typically treated with topical corticosteroids in patients with mild to moderate disease, creating an ongoing need for nonsteroidal therapies. As part of a phase 2, randomized, dose-ranging study of ruxolitinib (Janus kinase [JAK]1/JAK2 inhibitor) cream, twice-daily 1.5% ruxolitinib cream was compared with twice-daily 0.1% triamcinolone cream (midpotency topical corticosteroid) in adults with mild to moderate AD for ≥2 years. Triamcinolone cream was only used for 4 continuous weeks of the 8-week vehicle-controlled period for safety considerations; thus, data here are reported up to week 4 in the study. At week 4, substantially more patients who applied 1.5% ruxolitinib cream vs 0.1% triamcinolone cream achieved ≥75% or ≥90% improvement from baseline in the Eczema Area and Severity Index (56.0% vs 47.1% and 26.0% vs 13.7%, respectively) and Investigator’s Global Assessment Score of 0/1 with ≥2-grade improvement from baseline (38.0% vs 25.5%). Significantly more patients achieved ≥2-point improvement in itch numerical rating scale (NRS) on day 2 with 1.5% ruxolitinib cream vs 0.1% triamcinolone cream (42.5% vs 20.5% [P=0.0412]), and significantly more patients achieved ≥4-point improvement in itch NRS at week 4 (62.5% vs 32.3% [P=0.0128]). Ruxolitinib cream was well tolerated, with no clinically significant application site reactions. Treatment-emergent adverse events were mild/moderate in severity; nasopharyngitis and headache were most common (n=2 [4.0%] each). In summary, ruxolitinib cream is a well-tolerated nonsteroidal therapy with efficacy at least as good as a midpotency topical corticosteroid while avoiding the potential concerns of long-term corticosteroid use.
Skin rejuvenation treatments, including chemical peels and biostimulatory therapies, aim to improve facial aging concerns. However, these treatments have limitations, including efficacy, safety, postinflammatory hyperpig...Skin rejuvenation treatments, including chemical peels and biostimulatory therapies, aim to improve facial aging concerns. However, these treatments have limitations, including efficacy, safety, postinflammatory hyperpigmentation in dark skin types, and downtime. An Antioxidant Biostimulating Treatment (ABT) is an innovative approach that integrates the principles of chemical peels and biostimulatory therapies to deliver superior benefits with traditional invasive and non-invasive therapies, while reducing the risk of adverse events. ABT utilizes a multi-acid delivery system to create controlled epidermal fissures, facilitating the safe delivery of phytocompound antioxidant acids into the dermis for skin rejuvenation. The safety and efficacy of the ABT were assessed in patients with Fitzpatrick Skin Types (FST) V-VI with mild to moderate global facial radiance, skin smoothness, and overall appearance. The ABT improved overall appearance, radiance, and skin smoothness after three sessions spaced 4 weeks apart. The ABT was well tolerated with no incidence of postinflammatory hyperpigmentation or other adverse events. The ABT addresses the critical need in offering patients safe, non-invasive, and comprehensive skin rejuvenation treatment options with demonstrated efficacy in all skin tones.
The major dermatologic adverse effect of nail polish that has been reported is an allergic contact dermatitis. This can within the ungual and periungual region, but it can also be diffuse and spread along the face, chest...The major dermatologic adverse effect of nail polish that has been reported is an allergic contact dermatitis. This can within the ungual and periungual region, but it can also be diffuse and spread along the face, chest, trunk, and arms. The purpose of this paper is to explore the dermatologic impacts, especially allergic contact dermatitis, secondary to nail product use. This paper aims to increase awareness of possible dermatologic risks of nail product use and encourage consumer safety.1 J Drugs Dermatol. 2025;24(10): doi:10.36849/JDD.9039.
BACKGROUND: Central centrifugal cicatricial alopecia (CCCA) is a scarring alopecia primarily affecting Black women. To date, there are no standardized treatment regimens or approved medications for the treatment of CCCA....BACKGROUND: Central centrifugal cicatricial alopecia (CCCA) is a scarring alopecia primarily affecting Black women. To date, there are no standardized treatment regimens or approved medications for the treatment of CCCA. This single-center, open-label, clinical study investigated the efficacy of apremilast in the treatment of mild to moderate vertex-predominant CCCA. METHODS: 20 adult female patients of African ancestry with mild to moderate vertex-predominant CCCA were treated in an open-label fashion with apremilast 30 mg orally twice daily for 24 weeks. RESULTS: 15 of 20 patients completed the study. At week 24, mean change in the physician global assessment of improvement (primary endpoint), investigator global severity score, and central hair loss grade was 0.235 (P=0.04), -0.31 (P=0.01), and -0.46 (P=0.08), respectively. Mean improvements were also seen in patient reported outcomes at week 24 including the patient global assessment of improvement 1.31 (P=0.01), visual analog of hair loss severity 1.85 (P=0.05), numerical rating scales for pruritus -2.31 (P=0.00), burning -0.46 (P=0.36), and pain -0.15 (P=0.61), as well as the dermatology life quality index -2.42 (P=0.09). LIMITATIONS: The sample size was small and underpowered to detect statistically significant changes in most secondary endpoints. Additionally, the COVID-19 pandemic interfered with the conduct of the study protocols. CONCLUSION: Apremilast was safe and moderately efficacious for the treatment of CCCA, with patients showing statistically significant improvements in several investigator and patient-reported outcomes. Larger, placebo-controlled studies investigating therapies for CCCA are warranted. Adverse events (AEs) were consistent with the known safety profile of apremilast and may limit the use of this medication in some patients.
Contour Tunable Resurfacing Laser (TRL™) is an erbium: yttrium aluminum garnet (YAG) fully ablative laser commonly used to treat the delicate lower eyelid skin for undereye rejuvenation. Post-treatment patients exp...Contour Tunable Resurfacing Laser (TRL™) is an erbium: yttrium aluminum garnet (YAG) fully ablative laser commonly used to treat the delicate lower eyelid skin for undereye rejuvenation. Post-treatment patients experience discomfort and extensive downtime. This pilot study incorporated an innovative post-procedure treatment that addresses patient concerns to skin rejuvenation procedures to improve patient relief and recovery, while improving patient retention. The evaluated neurocosmetic Post Procedure Cream (PPC) was safe and tolerable for the thin delicate lower eyelid skin. Following Contour TRL™ under-eye rejuvenation, the PPC ameliorated discomfort by reducing erythema, edema, stinging, and itch post-treatment, while enhancing recovery. Tested alongside the commonly used anhydrous topical, the PPC reduced erythema in the treatment area better than the comparator after 3 days and restored skin tone evenness to pre-procedure condition as early as 7 days post-procedure and maintained skin health for 31 days. The PPC offers physicians a topical solution for post-laser rejuvenation, addressing an unmet need by reducing patient discomfort and enhancing skin recovery.
BACKGROUND: Soft-tissue filler injection-related vascular complications (IRVC) can lead to tissue necrosis, vision loss, and stroke. Hyaluronidase-based injections are the mainstay of treatment, though other options incl...BACKGROUND: Soft-tissue filler injection-related vascular complications (IRVC) can lead to tissue necrosis, vision loss, and stroke. Hyaluronidase-based injections are the mainstay of treatment, though other options include heat, massage, nitroglycerin, and anticoagulants. Given the narrow therapeutic window and limited early warning signs, we propose training residents to implement a standardized soft-tissue filler vascular complication (SFVC) management protocol. OBJECTIVE: This study aims to address gaps in procedural knowledge by providing residents with a lecture series followed by a hands-on cadaveric practice session. METHODS AND MATERIALS: An SFVC management protocol was developed based upon a literature review and expert opinion. Didactic instruction and practice sessions with cadavers were conducted with residents at an academic dermatology program. All resident trainees took a survey assessing their knowledge and satisfaction with the quality of training. RESULTS: Thirteen residents were included in this study. Overall, the aggregate confidence score for recognizing vascular events, acute management of filler complications, and performance of procedures after hands-on simulation on cadavers significantly increased between pre- and post-surveys (P<0.001). CONCLUSION: Our intervention successfully demonstrated increased confidence among residents regarding the key components of SFVC, namely, in recognizing the signs and symptoms, managing an acute event, and finally, in performing advanced procedures for SFVC.
BACKGROUND: Hidradenitis suppurativa is a chronic inflammatory skin condition frequently associated with type 2 diabetes mellitus and obesity. Glucagon-like peptide-1 receptor agonists have emerged as promising agents fo...BACKGROUND: Hidradenitis suppurativa is a chronic inflammatory skin condition frequently associated with type 2 diabetes mellitus and obesity. Glucagon-like peptide-1 receptor agonists have emerged as promising agents for managing type 2 diabetes mellitus due to their potent effects on glycemic control and weight reduction. Recent evidence suggests that glucagon-like peptide-1 receptor agonists may also possess anti-inflammatory properties, potentially making them effective in treating inflammatory conditions, such as hidradenitis suppurativa. OBJECTIVE: To determine if glucagon-like peptide-1 receptor agonists reduce surgeries and hospitalizations in patients with hidradenitis suppurativa. METHODS: We utilized the TriNetX platform to evaluate the rate of surgical abscess repairs performed and hospitalizations in a propensity score-matched cohort of patients with hidradenitis suppurativa who were prescribed glucagon-like peptide-1 receptor agonists. RESULTS: Our analysis revealed that patients prescribed glucagon-like peptide-1 receptor agonists had significantly lower rates of surgeries with a HR of 0.35 (95% CI: 0.25, 0.50) and hospitalizations with a HR of 0.87 (95% CI: 0.82, 0.92) compared to a control cohort of patients who did not receive glucagon-like peptide-1 receptor agonists. CONCLUSIONS: Glucagon-like peptide-1 receptor agonists reduce surgeries and hospitalizations in hidradenitis suppurativa, demonstrating their potential therapeutic value in dermatology patient care.
BACKGROUND: Energy-based devices are commonly used to improve the appearance of aging skin. Treatments can involve long recovery times, marked by pain, erythema, edema, and purpura, which is often a limiting factor in a...BACKGROUND: Energy-based devices are commonly used to improve the appearance of aging skin. Treatments can involve long recovery times, marked by pain, erythema, edema, and purpura, which is often a limiting factor in a patient’s willingness to undergo a procedure. OBJECTIVE: This study evaluated the safety and effectiveness of an Angiopoietin-1 derived QHREDGS peptide (Q-peptide) hydrogel and ointment, in comparison to a peptide-free control, in enhancing healing and patient satisfaction after radiofrequency microneedling (RFMN) treatment. METHODS: In this Institutional Review Board-approved, randomized, double-blind, split-face study, 8 subjects underwent RFMN. Post-procedure, they applied Q-peptide regimen to one side of their face and a peptide-free control to the other. Post-treatment recovery and skin quality were assessed at 2 ± 1 and 7 ± 1 days post-procedure. Adverse events were monitored. RESULTS: The Q-peptide regimen was preferred by both clinicians (6-fold) and subjects (5-fold) compared with the control at the first follow-up visit (2 ± 1 days). Subjects were 5-fold more likely to report better-looking skin and 5-fold more likely to report better-feeling skin on the Q-peptide side of the face. Image analysis demonstrated 2-fold decreased presence of edema, erythema, and purpura at 2 ± 1 days post-procedure. Improved skin quality and more rapid recovery were noted with the Q-peptide. By 7 ± 1 days, patients strongly favored Q-peptide, endorsing its continued use and recommending it to others. No adverse events were reported. CONCLUSION: The Q-peptide regimen was effective and well-tolerated following RFMN treatment, highlighting its potential for skin regeneration and dermatological post-procedure use.
BACKGROUND: Hyaluronic acid (HA) is a key component naturally present in the skin and is commonly used in skincare formulations and dermal fillers. Recently, there has been growing interest in oral HA supplementation for...BACKGROUND: Hyaluronic acid (HA) is a key component naturally present in the skin and is commonly used in skincare formulations and dermal fillers. Recently, there has been growing interest in oral HA supplementation for maintaining skin health and preventing aging due to its potential systemic benefits. OBJECTIVE: This study aims to provide a comprehensive analysis of the efficacy of oral HA supplementation on various skin parameters, including hydration, elasticity, firmness, wrinkle reduction, and transepidermal water loss. METHOD: Electronic databases (PubMed and Google Scholar) were searched for relevant articles. A total of 7 randomized controlled trials (RCTs) on the use of oral HA as a supplement were identified. A meta-analysis was performed to compare the standardized mean differences between the treatment (HA) and control (placebo) groups. RESULTS: The meta-analysis revealed statistically significant improvements in skin hydration, elasticity, and wrinkle depth following oral HA supplementation. Although the effects of oral HA on skin firmness, wrinkle volume, and transepidermal water loss were not statistically significant, a general trend of improvement was observed in these parameters. CONCLUSION: The findings of this analysis align with existing literature, underscoring the potential of oral HA supplementation as a valuable component in anti-aging and skincare regimens. However, the study's limited sample size and heterogeneity among included studies call for larger, more robust trials to confirm these findings and further explore the effects of oral HA on skin health.
BACKGROUND: Hair transplantation is a widely used treatment for androgenetic alopecia (AGA) and other hair loss conditions, with increasing demand from women in recent years. AIM: Explore differences in hair loss pattern...BACKGROUND: Hair transplantation is a widely used treatment for androgenetic alopecia (AGA) and other hair loss conditions, with increasing demand from women in recent years. AIM: Explore differences in hair loss patterns, surgical techniques, and psychosocial impacts between sexes that allow for a more tailored approach to optimize outcomes. METHODS: A PubMed review of 1,443 publications was conducted using the keywords “female,” “women,” and “hair transplantation.” Twenty-four studies focusing on hair transplantation in women were analyzed. RESULTS: Hair loss has a profound psychosocial impact on both genders, but women often face greater societal stigma. Women often present later than men for transplantation, with diffuse thinning across the vertex and temples compared to men who typically present with localized frontotemporal and crown recession. Women should be evaluated for systemic contributors and the presence of scarring or traction alopecia. Women favor follicular unit transplantation (FUT) due to donor area preservation and compatibility with long hairstyles, whereas men may be treated with FUT or follicular unit extraction (FUE). CONCLUSION: Hair transplantation in women requires a tailored approach focusing on diffuse density restoration, donor area preservation, and adjunct medical management. Advances in techniques and adjunctive therapies are transforming the field, providing effective, patient-centered solutions for hair loss.
BACKGROUND: Alopecia universalis (AU) is the most severe form of alopecia areata (AA), characterized by complete scalp and body hair loss. While post-COVID-19 hair loss is often attributed to telogen effluvium (TE), emer...BACKGROUND: Alopecia universalis (AU) is the most severe form of alopecia areata (AA), characterized by complete scalp and body hair loss. While post-COVID-19 hair loss is often attributed to telogen effluvium (TE), emerging evidence suggests that COVID-19 may also trigger AU through immune dysregulation, particularly via interferon-gamma (IFN-γ)-mediated inflammation. The chronic and relapsing nature of AU raises challenges in long-term disease management, particularly regarding treatment duration and relapse prevention. CASE PRESENTATION: We present a 79-year-old woman with no personal or family history of hair loss who developed sudden-onset AU one month after recovering from COVID-19. Initial treatment with topical and intralesional corticosteroids failed, prompting systemic therapy initiation. Over 10 months of treatment, she achieved significant hair regrowth. However, 3 months after discontinuation, hair loss recurred, reinforcing the relapsing nature of post-COVID-19 AU. CONCLUSION: This case uniquely demonstrates the rapid onset and relapsing nature of post-COVID-19 AU, distinguishing it from idiopathic AU and emphasizing the need for modified long-term treatment strategies. While Janus kinase (JAK) inhibitors and other immunomodulatory therapies show promise, the risk of relapse upon treatment discontinuation highlights the need for further research into long-term management strategies and maintenance therapy in post-viral AU.
BACKGROUND: Topical oxymetazoline hydrochloride 0.1% is a pharmacologic agent for eyelid elevation. OBJECTIVE: This study investigates changes in eyelid position and patient-reported aesthetic outcomes following topical...BACKGROUND: Topical oxymetazoline hydrochloride 0.1% is a pharmacologic agent for eyelid elevation. OBJECTIVE: This study investigates changes in eyelid position and patient-reported aesthetic outcomes following topical oxymetazoline. METHODS AND MATERIALS: A prospective cohort investigation was conducted at a single institution. Participants received one drop of oxymetazoline in each eye. Margin reflex distance-1 and palpebral fissure height were recorded pre- and 15 minutes post-instillation. FACE-Q validated surveys regarding patient-reported upper eyelid appraisal and perceived age were administered pre- and post-intervention and a survey regarding outcome satisfaction was administered post-intervention. RESULTS: One hundred participants were enrolled. The mean age was 52.0 years. Participants predominantly self-identified as female (90%) and white (94%). Following oxymetazoline administration, there were statistically significant increases in margin reflex distance-1 (mean increase 0.8 mm, P<0.001) and palpebral fissure height (mean increase 0.8 mm, P<0.001). Significantly, upper eyelid appraisal improved by 23.5% (P<0.001) and perceived age decreased by 1.4 years (P<0.003) after oxymetazoline instillation. Overall, 85% of participants reported 51% or higher outcome satisfaction. There were no reported treatment-associated adverse events. CONCLUSIONS: Administration of topical oxymetazoline was associated with statistically significant improvements in eyelid position, upper eyelid appraisal, and perceived age. The majority of participants reported outcome satisfaction.