The Journal Of Clinical And Aesthetic Dermatology[JOURNAL]
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200 papers
Pumping Up Dermatologic Drug Reformulation: A Review of How Proton Pump Inhibitors May Revolutionize Scleroderma Treatment.
Cheng A, Cotter DG, Ahir M … +3 more , Khan MA, Bonnen MD, Ghebre YT
J Clin Aesthet Dermatol · 2026 Mar · PMID 42027413
Scleroderma is a rare and often debilitating connective tissue disorder of unknown etiology affecting the skin, lungs, and other visceral organs. Current medical therapies are limited and largely focused on symptoms, par...
Scleroderma is a rare and often debilitating connective tissue disorder of unknown etiology affecting the skin, lungs, and other visceral organs. Current medical therapies are limited and largely focused on symptoms, particularly in advanced disease. Recent preclinical studies have shown that topically reformulated proton pump inhibitors (PPIs) reduce inflammation and fibrosis, suggesting therapeutic potential in scleroderma. In this article, we explore the emerging role of PPIs as an adjuvant therapy in scleroderma. We also describe the key mechanisms of scleroderma and current therapeutic options and highlight how PPIs modulate molecular pathways central to fibrotic disease.
Management of Multiple Miliary Osteoma Cutis Using CO Laser: A Case-Based Exploration.
Aristizabal-Torres MA, Hobbs MM, Pincelli T … +2 more , Sokumbi O, Bruce AJ
J Clin Aesthet Dermatol · 2026 Feb · PMID 41890781
Miliary osteoma cutis is an underreported condition that typically presents with firm papules on the face, although involvement of other areas has been described. It commonly presents in middle-aged women with fair skin....
Miliary osteoma cutis is an underreported condition that typically presents with firm papules on the face, although involvement of other areas has been described. It commonly presents in middle-aged women with fair skin. Treatment options for this condition are limited. We describe two patients with miliary osteoma cutis, detailing the treatment strategies used, including the successful use of carbon dioxide laser-assisted extraction.
Plant-Derived Extracellular Vesicles in Dermatology: A Review of Emerging Therapeutic Applications.
Burshtein J, Wei J, Majewska L … +1 more , Schlesinger T
J Clin Aesthet Dermatol · 2026 Feb · PMID 41890780
OBJECTIVE: This article aims to evaluate and discuss the therapeutic potential of plant-derived extracellular vesicles (PEVs) in clinical and aesthetic dermatology by examining their mechanisms, clinical application, eff...
OBJECTIVE: This article aims to evaluate and discuss the therapeutic potential of plant-derived extracellular vesicles (PEVs) in clinical and aesthetic dermatology by examining their mechanisms, clinical application, efficacy, and safety profiles. METHODS: A comprehensive literature search was completed using the keywords "plant-derived exosomes," "dermatology," "skin disorders," "treatment," "inflammatory skin conditions," "cosmetic," "regenerative medicine," "wound healing," and "chemotherapeutic skin-related toxicities." The authors reviewed all studies and included those that addressed PEVs. RESULTS: PEVs demonstrate multifaceted therapeutic properties: (1) immunomodulation through suppression of proinflammatory cytokines (interleukin 17, tumor necrosis factor-α), (2) restoration of skin barrier function, (3) promotion of tissue regeneration in wounds and scars, and (4) effective stabilization and delivery of therapeutic cargo (microRNAs, hydrophobic drugs). Clinical case studies, particularly with rose stem cell exosomes, show efficacy in atopic dermatitis, psoriasis, wound healing, and chemotherapy-induced dermatologic toxicities, with rapid symptom relief and structural improvement. LIMITATIONS: Current evidence is constrained by predominance of preclinical data focused primarily on mammalian-derived exosomes as well as variability in PEV isolation and characterization methods across studies. Clinical data regarding the use of PEVs remains limited in the literature. CONCLUSION: PEVs represent a promising new class of dermatologic therapeutics combining plant-derived biocompatibility with targeted therapeutic effects. Future research should prioritize controlled clinical trials, standardization of production methods, and exploration of engineered PEVs for precision medicine applications in dermatology.
Exploring the Advancements and Applications of AI-Powered Hair Analysis Tools.
Nawaz T, Williams G, Yoo J
J Clin Aesthet Dermatol · 2026 Feb · PMID 41890779
OBJECTIVE: We aim to evaluate a subset of artificial intelligence (AI)-powered hair analysis tools and their role in improving diagnostic accuracy, treatment planning, and personalized care in trichology and professional...
OBJECTIVE: We aim to evaluate a subset of artificial intelligence (AI)-powered hair analysis tools and their role in improving diagnostic accuracy, treatment planning, and personalized care in trichology and professional hair care. METHODS: A cross-sectional review was conducted using publicly accessible sources, including Google Scholar, company websites, and industry reports. Tools were selected based on professional use, incorporation of AI, and availability of measurable outcomes such as hair density evaluation and treatment monitoring. Devices were categorized by primary function: diagnostic systems, product recommendation platforms, growth monitoring technologies, and surgical planning applications. RESULTS: Ten AI-driven tools were evaluated, each using machine learning or computer vision to assess parameters such as follicle density, scalp condition, and hair thickness. Diagnostic tools provided noninvasive trichoscopic analysis; others enabled personalized product suggestions, tracked treatment outcomes, or supported surgical planning. These technologies automate traditional methods and deliver objective, data-rich insights that can enhance clinical decision-making and user engagement. LIMITATIONS: Findings are limited by the scarcity of peer-reviewed validation and reliance on manufacturer-provided data. Many tools lacked comprehensive public documentation, and dataset diversity used in model training was often unspecified, raising concerns about potential algorithmic bias and reduced generalizability. CONCLUSION: AI-powered hair analysis tools offer transformative potential in trichology by increasing diagnostic precision and enabling tailored treatment strategies. Their broader adoption will require addressing limitations in accessibility, ethical considerations, and dataset inclusivity to ensure equitable and reliable integration into dermatologic and cosmetic practice.
Isolated Hand Involvement as the Presenting Sign of Dermatitis Herpetiformis.
Sejdiu Z, Garakani R, Ansah-Addo S … +3 more , McCoy K, Hafeez F, Krakowski AC
J Clin Aesthet Dermatol · 2026 Feb · PMID 41890778
Dermatitis herpetiformis (DH) is an autoimmune blistering disease associated with celiac disease, classically presenting as intensely pruritic erythematous vesicles and papules on the elbows, knees, buttocks, and scalp....
Dermatitis herpetiformis (DH) is an autoimmune blistering disease associated with celiac disease, classically presenting as intensely pruritic erythematous vesicles and papules on the elbows, knees, buttocks, and scalp. Involvement of the dorsal hands is extremely rare, complicating diagnosis. We report a unique case of DH confined solely to the dorsal hands in a 68-year-old woman with a five-year history of recurrent, pruritic vesicles initially misdiagnosed as hand eczema. Direct immunofluorescence confirmed the diagnosis of DH with granular immunoglobulin (Ig) A deposition along the dermo-epidermal junction, and serologic testing revealed elevated tissue transglutaminase IgA. This case highlights an uncommon presentation of DH and emphasizes the need to consider it in chronic, unexplained dorsal hand eruptions to prevent misdiagnosis and delayed treatment.
Feeding the Skin? Foods in Personal Care Products and the Risk of Allergy.
O'Connor M, Lio P
J Clin Aesthet Dermatol · 2026 Feb · PMID 41890777
The interrupted skin barrier seen in atopic dermatitis (AD) increases exposure to environmental antigens including those in food, which contributes to the increased prevalence of food allergies in the AD population. This...
The interrupted skin barrier seen in atopic dermatitis (AD) increases exposure to environmental antigens including those in food, which contributes to the increased prevalence of food allergies in the AD population. This relationship is further explored in the dual allergen exposure hypothesis, which examines the differences in immune system response between cutaneous and oral exposures. It was previously thought that avoiding early oral exposure would decrease the likelihood of developing food allergy; however, several studies have demonstrated that earlier oral exposure increases tolerance. On the other hand, exposure to food antigens through the skin activates the helper T-cell 2 pathway, which promotes development of allergy. There have also been several studies demonstrating that aggressive treatment of AD decreases the risk of developing food allergies. Based on these findings, there is concern that inclusion of food-based ingredients in personal care products, such as moisturizers that act as main components of AD treatment regimens, may increase the likelihood of developing allergies to the included foods. However, there are many commonly used food-based ingredients that have low rates of allergy, which raises the question of why some antigens are more likely to result in allergic sensitization while many others remain benign.
A Transient "Blueberry Muffin" Rash in a Neonate with Acute Myeloid Leukemia: A Case Report and Review of the Literature.
Cheng A, Guzman J, Cotter DG
J Clin Aesthet Dermatol · 2026 Feb · PMID 41890776
A "blueberry muffin rash," typically attributed to congenital toxoplasmosis, rubella, cytomegalovirus, and herpes simplex virus (TORCH) infections, is a rare and underreported cutaneous manifestation of serious underlyin...
A "blueberry muffin rash," typically attributed to congenital toxoplasmosis, rubella, cytomegalovirus, and herpes simplex virus (TORCH) infections, is a rare and underreported cutaneous manifestation of serious underlying pathology, including hematologic malignancies. We report a case of congenital acute myeloid leukemia (AML) in a full-term newborn who presented at day-of-life 0 with multiple blue to purple macules, patches, and indurated papulonodules and plaques on the trunk and extremities consistent with a "blueberry muffin rash". Notably, the rash was transient and spontaneously resolved within 24 hours of life, making it easy to overlook, potentially delaying life-saving treatment. This case reinforces the need for a full diagnostic workup and high clinical suspicion for leukemia in neonates presenting with a "blueberry muffin rash."
Insights into Tanning Biology and Tanning Products.
Resnick G, Khajeh-Afzaly M, Yousefian F … +2 more , Raza A, Issa NT
J Clin Aesthet Dermatol · 2026 Feb · PMID 41890775
OBJECTIVE: This systematic review aims to critically assess the literature on the mechanisms of action, clinical uses, formulation strategies, and adverse effects of self-tanning agents, with a focus on dihydroxyacetone...
OBJECTIVE: This systematic review aims to critically assess the literature on the mechanisms of action, clinical uses, formulation strategies, and adverse effects of self-tanning agents, with a focus on dihydroxyacetone (DHA), melanotan, forskolin, and carotenoids. METHODS: A systematic literature review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were screened for relevance to the mechanisms of action, clinical applications, chemical formulations, or adverse effects of self-tanning molecules. A total of 68 peer-reviewed studies were included. RESULTS: DHA induces pigmentation via the Maillard reaction and has demonstrated additional dermatologic applications, including use in vitiligo and erythropoietic protoporphyria and as a potential topical antifungal. Concerns persist about DHA-related cytotoxicity, genotoxicity, and systemic absorption. Unregulated melanotan I and II use has caused serious adverse effects, including rhabdomyolysis, renal infarction, and priapism. While forskolin stimulates melanin production independently of melanocortin receptors and has demonstrated efficacy in animal models, carotenoids, when ingested orally, accumulate in skin and subcutaneous fat, creating a yellow-orange hue. Both agents remain underresearched in human populations. LIMITATIONS: Limitations include lack of standardized reporting across included studies, variability in study outcomes, and limited long-term safety data. CONCLUSION: Sunless tanning agents offer UV-free alternatives for cosmetic pigmentation but are not without risk. While DHA and melanotan remain the dominant agents in current use, forskolin and carotenoids offer alternative pathways for pigmentation and photoprotection. Further clinical studies are necessary to evaluate long-term safety, efficacy across skin types, and formulation optimization. Regulatory frameworks and dermatologic guidance must evolve to reflect the expanding landscape of sunless tanning modalities.
Clearance of Cutaneous Lichen Planus with Deucravacitinib.
Machynia K, Hawkes JE
J Clin Aesthet Dermatol · 2026 Feb · PMID 41890774
Lichen planus (LP) is an idiopathic, immune-mediated inflammatory disorder commonly characterized by pruritic, violaceous papules and plaques that often involve the extremities. Although a variety of topical and systemic...
Lichen planus (LP) is an idiopathic, immune-mediated inflammatory disorder commonly characterized by pruritic, violaceous papules and plaques that often involve the extremities. Although a variety of topical and systemic therapies are used, no targeted treatments are currently approved by the US Food and Drug Administration for this indication, and management of refractory disease remains challenging. Tyrosine kinase 2 (TYK2) inhibitors selectively modulate several cytokine signaling pathways, including interleukin (IL)-12, IL-23/IL-17, and type I interferon signaling, which are implicated in the pathogenesis of LP. Here, we report a case of biopsy-confirmed, treatment-refractory, cutaneous LP that achieved near-complete resolution after 2 months of therapy with the oral TYK2 inhibitor, deucravacitinib.
Safety and Efficacy of Aminolevulinic Acid Hydrochloride Topical Gel, 10%, with Red Light in the Treatment of Facial Cutaneous Squamous Cell Carcinoma In Situ.
Nestor MS, Chaudry A, Vanaria RJ … +3 more , Lam W, Devries A, Lawson A
J Clin Aesthet Dermatol · 2026 Feb · PMID 41890773
BACKGROUND: Cutaneous squamous cell carcinoma in situ (isSCC) is a common skin cancer often arising on the face. Standard care involves excision or destruction, but less invasive therapies are becoming increasingly explo...
BACKGROUND: Cutaneous squamous cell carcinoma in situ (isSCC) is a common skin cancer often arising on the face. Standard care involves excision or destruction, but less invasive therapies are becoming increasingly explored. Aminolevulinic acid photodynamic therapy (ALA-PDT) with red light has shown potential for treating isSCC. This study assesses the safety, tolerability, and efficacy of ALA-PDT with red light for facial isSCC. METHODS: Twenty patients with biopsy-confirmed facial isSCC (0.4-1.3cm) were treated. Lesions were prepared with a 4×4 gauze, followed by application of ALA gel 10% with 3-hour incubation. Red light therapy (13 minutes and 30 seconds; 37J/cm²) was then administered. Patients received two sessions 28±3 days apart. Eight weeks after the second treatment, lesions were excised for histopathologic analysis. The primary endpoint was complete histologic clearance, with clinical clearance as a secondary endpoint. Safety was evaluated through adverse events (AEs), local skin reactions (LSRs), and treatment-site pain. RESULTS: All 20 patients completed the study. Complete histologic clearance was achieved, and complete clinical clearance was observed in 100% (20 of 20) patients. No treatment-related AEs occurred. One unrelated case of contact dermatitis was reported. The most common LSR was moderate erythema, peaking after treatment and resolving over time. Mild scaling was also observed with similar resolution. Median posttreatment pain scores were 0 (range: 0-3) after ALA application and 3.5 (range: 0-10) after red light therapy. CONCLUSION: ALA-PDT with 10% gel and red light demonstrated excellent efficacy, safety, and tolerability, supporting its role as a promising noninvasive treatment for facial isSCC.
The Therapeutic Potential of Glucagon-Like Peptide-1 Receptor Agonists in Psoriasis and Hidradenitis Suppurativa.
Morales JK, Keelin J, Vu TN … +6 more , Camacho SC, Kizy SM, Kazemeini S, Metellus R, Hebo N, Cotter DG
J Clin Aesthet Dermatol · 2026 Feb · PMID 41890772
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), commonly prescribed for type 2 diabetes and obesity, have demonstrated potential anti-inflammatory and immunomodulatory effects that may be beneficial in chronic inf...
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), commonly prescribed for type 2 diabetes and obesity, have demonstrated potential anti-inflammatory and immunomodulatory effects that may be beneficial in chronic inflammatory skin conditions such as psoriasis and hidradenitis suppurativa (HS). A systematic review of the literature was conducted, focusing on prospective studies, case reports, and systematic reviews that evaluated the impact of GLP-1 RAs on these diseases. In psoriasis, GLP-1 RAs, particularly liraglutide, have been associated with improvements in the Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI), especially among patients with T2D. Reported benefits include enhanced glycemic control, weight reduction, and decreased levels of inflammatory markers, suggesting that GLP-1 RAs may modulate immune pathways and proinflammatory cytokine activity involved in the pathogenesis of psoriasis. Similarly, in HS, GLP-1 RAs such as liraglutide and semaglutide have shown promising results, including decreased lesion severity, improved quality of life, and reduced systemic inflammation. Weight loss induced by these agents may also contribute to symptom improvement by reducing mechanical stress in intertriginous areas and mitigating inflammatory responses associated with HS. Although preliminary evidence suggests that GLP-1 RAs may play a role in managing psoriasis and HS through both metabolic and immunologic mechanisms, current data are limited to early-phase studies and case reports. Further large-scale randomized controlled trials, some of which are ongoing, with diverse study populations are necessary to better understand their efficacy, safety, and long-term impact in the treatment of these chronic inflammatory skin conditions.
Selected Abstracts from GDPA Pearls Conference 2025.
J Clin Aesthet Dermatol · 2025 · PMID 41821852
Abstract loading — click title to view on PubMed.
Clinical Management of Dupilumab-related Conjunctivitis, Erythema, and Arthralgia in Atopic Dermatitis: Evidence From Two Cases Treated with Nemolizumab.
Cheng A, Qeleshi A, Kosa A … +1 more , Cotter DG
J Clin Aesthet Dermatol · 2026 Jan · PMID 41648097
Atopic dermatitis (AD) is the most common chronic inflammatory skin condition and typically presents with pruritus, xerosis, eczematous lesions, and lichenification. Treatment options vary depending on severity; however,...
Atopic dermatitis (AD) is the most common chronic inflammatory skin condition and typically presents with pruritus, xerosis, eczematous lesions, and lichenification. Treatment options vary depending on severity; however, core management involves trigger avoidance, daily skin care, and anti-inflammatory therapies. Dupilumab, a monoclonal antibody that blocks interleukin-4 (IL-4) receptor α, is approved for the treatment of moderate-to-severe AD in patients aged 6 months or older. While this approval represents a significant advancement in AD therapy, the full extent of its side effect profile continues to emerge. Herein, we report two cases of refractory AD in which dupilumab therapy was limited by conjunctivitis and paradoxical worsening of cutaneous symptoms. We present these cases to describe the presentation, clinical progression, and management of dupilumab-associated adverse reactions in AD treatment, thereby contributing to a deeper understanding of its side effect profile. Notably, these cases demonstrate the successful use of nemolizumab as a therapeutic alternative in the setting of dupilumab intolerance.
A Randomized, Double-blind, Split-face Trial Evaluating the Safety and Efficacy of a Serum Containing Plant Adaptogens Versus Moisturizing Lotion Pre- and Post-fractional Laser in Patients with Mild-to-moderate Photodamage.
Watchmaker J, Nelson DB
J Clin Aesthet Dermatol · 2026 Jan · PMID 41648096
OBJECTIVE: We aimed to evaluate the safety and efficacy of a serum containing plant adaptogens (MYS) compared to a moisturizing lotion (ML) pre- and post-laser treatment. METHODS: A double-blind, split-face controlled st...
OBJECTIVE: We aimed to evaluate the safety and efficacy of a serum containing plant adaptogens (MYS) compared to a moisturizing lotion (ML) pre- and post-laser treatment. METHODS: A double-blind, split-face controlled study enrolled women with mild-to-moderate photodamaged skin. Participants were randomized to twice-daily application of MYS and ML to one side of their face and ML only to the opposite side two weeks prior to and 10 days following a single, non-ablative fractional laser treatment. Tolerability and global skin healing were assessed immediately post-procedure and on Days 1, 2, 4, 7, and 10. Global skin quality (the total sum of scores for erythema, dullness, rough skin texture, pores, and uneven pigmentation) was calculated at baseline, Week 2 (pre-procedure/skincare only), and Day 10 (post-procedure). RESULTS: Fifteen participants completed the study (mean age: 52 years). Significantly less dryness occurred on the MYS vs. the ML side of the face on Days 1 and 2 (=0.05 and =0.001, respectively), with less erythema on the MYS vs. the ML side (29% vs. 17%) on Day 2. Significant improvements occurred in global skin healing on the MYS vs. the ML side of the face on Days 1, 2, and 4 (=0.04, =0.003, and =0.003, respectively) and in global skin quality at Week 2 and Day 10 (=0.03 and =0.001, respectively). All adverse events were temporary and related to the procedure. CONCLUSION: Twice-daily application of a serum containing plant adaptogens before and after non-ablative fractional laser treatment demonstrated significant reductions in dryness and erythema, and improvements in global skin healing and skin quality compared to ML.
Seasonal and Geographic Trends in Photodynamic Therapy and Cryosurgery Use in the United States: A Cross-sectional Study From 2015-2022.
Merritt D, Lyons J, Mikati M … +2 more , Geils C, Schlesinger T
J Clin Aesthet Dermatol · 2026 Jan · PMID 41648095
BACKGROUND: Photodynamic therapy (PDT) is an effective field treatment for actinic keratoses (AKs). It is an ideal option for patients who prefer a minimally invasive procedure conveniently administered in their physicia...
BACKGROUND: Photodynamic therapy (PDT) is an effective field treatment for actinic keratoses (AKs). It is an ideal option for patients who prefer a minimally invasive procedure conveniently administered in their physician's office. Anecdotal clinician insights suggest that it may not be used at the same rate year-round. OBJECTIVE: This study investigates whether PDT and cryosurgery usage is affected by season and geographic location in the United States. METHODS: The data source is an aggregate of closed and open United States medical procedural claims ( [] and Healthcare Common Procedure Coding System [HCPCS]) from a broad selection of commercial payers and Centers for Medicare & Medicaid Services (CMS) from 2015 to 2022. Patient records associated with cryosurgery and PDT codes were extracted. A total of 79.1 million patients from 50 states and 4 territories between 2015 to 2022 were included in the analysis. The data were further stratified using meteorologically defined seasons and geographic locations. RESULTS: PDT utilization is affected by season and geographic location. Procedural claims peak during cooler months and decrease during warmer months, particularly where seasonal changes are more drastic. This trend repeats throughout the study period, including the COVID-19 pandemic. In contrast, use of cryosurgery remains unchanged. LIMITATIONS: The dataset does not capture claims from all commercial payers and CMS. CONCLUSION: To our knowledge, this study provides the first evidence of PDT seasonal usage patterns across the nation. This pattern could be attributed to several factors and the findings could serve as a learning opportunity for clinicians to reevaluate their approach in treating AKs.
Venous Thromboembolism Risk in Patients with Atopic Dermatitis Treated with Abrocitinib: A Review of Female Patients on Oral Contraception and Nicotine Exposure From the JADE Clinical Trial Program.
Dasilva DR, Litchman GH, Soto-González A … +4 more , Issa N, Song EJ, Bunick CG, Del Rosso JQ
J Clin Aesthet Dermatol · 2026 Jan · PMID 41648094
OBJECTIVE: Oral Janus kinase inhibitors (JAKi) are effective in managing moderate-to-severe atopic dermatitis (AD), but concerns regarding venous thromboembolism (VTE) risk persist, particularly in female patients with o...
OBJECTIVE: Oral Janus kinase inhibitors (JAKi) are effective in managing moderate-to-severe atopic dermatitis (AD), but concerns regarding venous thromboembolism (VTE) risk persist, particularly in female patients with overlapping risk factors such as oral contraceptive pill (OCP) use and nicotine exposure (primarily smoking). We evaluated VTE events in this population using data from the abrocitinib clinical trial program. METHODS: We reviewed the Phase II and Phase III clinical trial data (JADE program) for abrocitinib in AD, focusing on VTE incidence in female patients with documented OCP use and nicotine exposure to contextualize thromboembolic risk. RESULTS: VTE events were rare. Nonfatal VTE incidence was low, with dose-specific incidence rates less than 1.0 per 100 patient-years (PY). Among female patients taking OCPs and current or former smokers, no VTEs occurred (0 of 78). In the overall active study group, most VTEs arose in patients with multiple baseline risk factors (eg, obesity, immobilization, prior thrombosis). Discontinuation due to VTE-related adverse events was infrequent (n=7, 0.13/100 PY) in the overall study group. No VTE-related deaths were reported. Comparative rates were consistent with or lower than background risk in AD populations with similar demographics. LIMITATIONS: This review is limited by the lack of publicly available patient-level data, possible underreporting of lifestyle risk factors, inability to quantify total nicotine exposure, small sample size, and unmeasured confounding variables. CONCLUSION: VTE events in female patients with AD treated with abrocitinib, including those taking OCPs and with nicotine exposure, were rare and generally associated with multiple concurrent risk factors for VTE. No VTE events were noted in female patients treated with abrocitinib who were taking OCPs and with history of smoking/nicotine exposure. These findings may help contextualize VTE risk in real-world treatment decisions.
The Enigma of Intramuscular Triamcinolone and Its Versatility as a Safe and Effective Dermatologic Therapy.
Robins D, Vemugunta V
J Clin Aesthet Dermatol · 2026 Jan · PMID 41648093
Intramuscular triamcinolone acetonide (IMT) has been used for the past 60 years, but a recent survey of 800 dermatologists showed that 55% use it rarely or not at all, primarily because of fear of adverse events. With a...
Intramuscular triamcinolone acetonide (IMT) has been used for the past 60 years, but a recent survey of 800 dermatologists showed that 55% use it rarely or not at all, primarily because of fear of adverse events. With a unique mechanism of action vs. other systemic corticosteroids, a relatively low dose, and short half-life, IMT can produce a long-term clinical anti-inflammtatory effect. This paper presents an argument for the efficacy of IMT with proper, safe use. In addition, this paper will discuss many of the clinical conditions for which IMT can be effective.
Real-world Medicolegal Issues in Dermatology and Dermatopathology.
Cockerell CJ
J Clin Aesthet Dermatol · 2026 Jan · PMID 41648092
Medicolegal exposure is a pervasive challenge in both dermatology and dermatopathology. Despite advancements in diagnostic and therapeutic technology, malpractice litigation continues to affect clinicians and laboratorie...
Medicolegal exposure is a pervasive challenge in both dermatology and dermatopathology. Despite advancements in diagnostic and therapeutic technology, malpractice litigation continues to affect clinicians and laboratories. Errors can occur at multiple stages, from biopsy technique and clinical judgment to histopathologic interpretation and patient follow-up. This article seeks to examine the medicolegal landscape affecting dermatologists and dermatopathologists, identify recurring sources of litigation, and provide practical strategies to minimize legal risk while upholding high standards of care. The majority of malpractice cases in dermatology and dermatopathology do not stem from gross negligence but from miscommunication, documentation lapses, sampling errors, and system-level failures. Common issues include delayed melanoma diagnosis, failure to recognize aggressive nonmelanoma skin cancers, incomplete biopsies, mismanaged follow-up, and inadequate documentation of informed consent. Systemic pressures such as managed care, private equity ownership, and unrealistic patient expectations further amplify exposure risk. Complete elimination of malpractice risk is impossible. However, dermatologists and dermatopathologists who practice meticulous clinicopathologic correlation, document decision-making, communicate clearly, and maintain professional boundaries within corporate systems can significantly reduce exposure.
Prurigo Nodularis and the Pain Cascade: Understanding the Pathogenesis and Approach to Management.
Burshtein J, Burshtein A, Schlesinger T
J Clin Aesthet Dermatol · 2026 Jan · PMID 41648091
OBJECTIVE: Prurigo nodularis (PN) is a chronic inflammatory dermatologic condition characterized by symmetrically distributed, intensely pruritic, hyperkeratotic nodules. This review aims to explore the role of the centr...
OBJECTIVE: Prurigo nodularis (PN) is a chronic inflammatory dermatologic condition characterized by symmetrically distributed, intensely pruritic, hyperkeratotic nodules. This review aims to explore the role of the central and peripheral nervous systems in PN, focusing on the pain cascade pathway and its implications for novel therapeutic approaches. METHODS: A review of the literature on PN and the pathophysiology of the pain cascade was performed. Original and review articles published before April 1, 2025, were evaluated for relevance. RESULTS: The pathophysiology of PN involves repetitive scratching that leads to skin thickening and an exaggerated immune response, with key roles played by eosinophils, helper T (Th) cell 2 cytokines (interleukin [IL]-4, IL-13, IL-31), and neuroimmune interactions that perpetuate the itch-scratch cycle and the pain cascade. Management requires a multimodal approach including behavioral strategies, topical corticosteroids, intralesional therapies, and phototherapy. Systemic treatments, ranging from immunosuppressants and neuromodulators to targeted biologics, are often necessary due to the refractory nature of PN. Monoclonal antibodies such as dupilumab and nemolizumab, which target specific cytokine pathways, have significantly advanced treatment options. Ongoing trials with emerging agents emphasize the importance of immunomodulation in transforming PN care and guiding future therapies. CONCLUSION: PN is a chronic dermatologic condition that severely impacts quality of life. Emerging research into its pathophysiology indicates immune and neuronal dysregulation. Recent therapeutics have changed the standard of care for patients with PN. Continued future research into pathophysiology and the pain cascade can inform development of additional novel therapeutics.
Overview of the Efficacy and Safety of Topical Hormonal Therapies for the Treatment of Acne Vulgaris: A Narrative Review.
Del Rosso JQ, Baldwin H, Layton AM
J Clin Aesthet Dermatol · 2026 Jan · PMID 41648090
OBJECTIVE: Although systemic hormonal therapies (spironolactone, oral contraceptives) are clinically effective for the treatment of acne vulgaris (AV) in female patients, perceived safety concerns have contributed to the...
OBJECTIVE: Although systemic hormonal therapies (spironolactone, oral contraceptives) are clinically effective for the treatment of acne vulgaris (AV) in female patients, perceived safety concerns have contributed to the growing interest in topical hormonal AV therapies. METHODS: We searched PubMed using the terms "topical," "antiandrogen," "hormonal," "clascoterone," "spironolactone," and "acne vulgaris." RESULTS: The majority of articles identified related to clascoterone and topical spironolactone. Clascoterone cream 1% was approved in 2020 by the US Food and Drug Administration (FDA) for patients with AV aged 12 years or older based on two Phase III randomized controlled trials (RCTs) in 1440 patients (722 randomized to clascoterone) and an open-label extension study; other evaluations included a Phase IIa pharmacokinetic study and a Phase IIb RCT. Six clinical studies-mostly small, randomized trials-reported 193 patients treated with topical spironolactone as 5% cream, 5% gel, 2% solution, and 1% nanogel, and 1 RCT evaluated topical flutamide gel in 27 patients. The efficacy and safety of topical spironolactone and flutamide are supported by limited data with some conflicting results; neither agent is approved by the FDA and both must be compounded extemporaneously with no supporting pharmacokinetic data. LIMITATIONS: Clinical studies of topical spironolactone are limited by the small number of patients and wide range of formulations evaluated. CONCLUSION: Available evidence supports the use of clascoterone cream 1% and suggests potential benefits and limitations of topical spironolactone in patients with AV; however, for topical spironolactone, pharmacokinetic studies and large-scale RCTs are needed to better characterize both efficacy and safety profiles.
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