The Journal Of Clinical And Aesthetic Dermatology[JOURNAL]
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200 papers
Treatment of Recalcitrant Scalp Psoriasis with Topical Roflumilast Cream 0.3%: A Case Report.
Domingues E
J Clin Aesthet Dermatol · 2025 Jul · PMID 40778012
Scalp psoriasis is a chronic immune skin disease affecting up to 80 percent of patients with psoriasis. Treatments include topical steroids, keratolytics, tar, anthralin, vitamin D analogs, and retinoids. However, treatm...
Scalp psoriasis is a chronic immune skin disease affecting up to 80 percent of patients with psoriasis. Treatments include topical steroids, keratolytics, tar, anthralin, vitamin D analogs, and retinoids. However, treatment can be difficult due to the presence of hair. Roflumilast 0.3% cream was approved in 2022 for the treatment of chronic plaque psoriasis, including intertriginous areas. Here, we present the case of a 28-year-old female patient with scalp psoriasis, who had previously trialed both topical and systemic treatments for her disease without success. Use of once daily roflumilast 0.3% cream resulted in rapid scalp psoriasis clearance, with results seen as early as Day 3 and complete clearance by Day 5 of treatment without adverse events or tolerability concerns.
Aesthetic Treatment Considerations in Patients with Cutaneous Autoimmune Disease.
Mojica R, Hingtgen G, Saikaly SK … +1 more , Gray T
J Clin Aesthet Dermatol · 2025 Jul · PMID 40778011
OBJECTIVE: The increasing prevalence of autoimmune disease alongside the growing popularity of cosmetic treatments has placed physicians in a unique position to understand how utilizing such treatments can serve as both...
OBJECTIVE: The increasing prevalence of autoimmune disease alongside the growing popularity of cosmetic treatments has placed physicians in a unique position to understand how utilizing such treatments can serve as both beneficial and potentially harmful interventions. The objective of this study was to analyze available literature and identify areas where additional research is needed to guide use of facial aesthetic treatments in patients with cutaneous autoimmune disease. METHODS: A literature search was performed on PubMed and Google Scholar for articles describing aesthetic treatments in the setting of autoimmune disease. Additional articles were found through examining the reference sections of resulting articles. RESULTS: This analysis revealed numerous gaps in the literature regarding therapeutic use of aesthetic treatments in the management of autoimmune disease. Several case reports and smaller studies suggested positive outcomes with some interventions, however larger-scale studies are needed to create generalizable guidelines for physicians regarding usage of aesthetic treatments as a therapeutic modality. LIMITATIONS: Many studies regarding both efficacy and adverse outcomes of aesthetic treatments excluded patients with cutaneous manifestations of autoimmune disease. Few articles specifically sought to analyze how individual treatments can be used for therapeutic outcomes in this patient population. CONCLUSION: Many cosmetic treatments can serve a therapeutic role in the management of autoimmune conditions with cutaneous manifestations. Treatments such as neurotoxin, filler, light-based devices, autologous platelet-rich plasma, microneedling, and chemical peels may be selectively chosen for use in management of certain autoimmune conditions.
Structural Insights: What Makes Some PDE4 Inhibitors More Effective in Inflammatory Dermatoses.
Issa NT, Wang J, Hanly A … +6 more , Ho M, Obagi S, Damiani G, Del Rosso JQ, Kang Y, Bunick CG
J Clin Aesthet Dermatol · 2025 Jul · PMID 40778010
Psoriasis, seborrheic dermatitis, and atopic dermatitis are chronic inflammatory skin diseases affecting millions of people in the United States and worldwide across the human lifespan. The immune pathways underlying the...
Psoriasis, seborrheic dermatitis, and atopic dermatitis are chronic inflammatory skin diseases affecting millions of people in the United States and worldwide across the human lifespan. The immune pathways underlying the pathogenesis of these dermatoses include Type I (IFN-γ, TNF-α), Type II (IL-4, IL-5, IL-13), and Type III (IL- 17A/F, IL-22, IL-23) cytokines. These cytokines function downstream of the enzyme phosphodiesterase-IV (PDE4), which makes PDE4 an upstream central regulator of inflammatory dermatoses. PDE4, therefore, is a key drug target for alleviating inflammatory skin diseases. In this brief review, we discuss and simplify into clinically relevant terminology the molecular findings of a 2024 study by Wang et al, which analyzed the structural properties of dermatologic PDE4 inhibitors and thereby provided molecular rationale as to why roflumilast has the greatest potency and is highly efficacious across multiple inflammatory dermatoses.
Optimizing Local Anesthesia Use in Office-based Dermatologic Procedures.
Ceilley RI, Sureshbabu S
J Clin Aesthet Dermatol · 2025 Jul · PMID 40778009
A key strategy for pain management in dermatologic procedures is the use of local anesthesia, yet the injection itself often causes significant discomfort. This article explores evidence-based strategies to minimize pain...
A key strategy for pain management in dermatologic procedures is the use of local anesthesia, yet the injection itself often causes significant discomfort. This article explores evidence-based strategies to minimize pain during anesthetic administration in office-based dermatologic settings. Techniques discussed include buffering and warming lidocaine, selecting the optimal needle gauge, orienting the bevel properly, as well as adopting advanced injection methods such as subdermal bleb formation and parallel needle insertion. Additional methods like tactile distraction, hand stabilization, and psychological engagement are also emphasized. Together, these approaches enhance patient comfort, procedural efficiency, and overall satisfaction with dermatologic care.
Improving Molluscum Treatment Options: Overcoming the Challenge of Poor Adherence.
Al-Dojaily Y, Feldman SR
J Clin Aesthet Dermatol · 2025 Jul · PMID 40778008
OBJECTIVE: This review aims to understand medication adherence and its influence on efficacy for existing and novel topical treatments for molluscum contagiosum. METHODS: A PubMed search was performed on clinical studies...
OBJECTIVE: This review aims to understand medication adherence and its influence on efficacy for existing and novel topical treatments for molluscum contagiosum. METHODS: A PubMed search was performed on clinical studies from 2000 to 2023 assessing adherence and treatment efficacy for topical and non-topical therapies used to treat molluscum. RESULTS: Adherence to individual topical treatments for molluscum is poor and limits their utility in clinical practice, despite demonstrated safety, painless administration, and advantages for pediatric and home use. Studies suggested lower adherence for topical rather than procedural treatments due to delayed effects, long treatment duration, and uncertain perceived benefits. New topical agents, VP-102 (ie, cantharidin 0.7% drug-device combination) and SB206 (ie, berdazimer gel 10.3%), showed promising efficacy in clinical trials, but their ability to address adherence is unclear. LIMITATIONS: There is a lack of sufficient clinical studies on topical medications for molluscum contagiosum, limiting our overall understanding of adherence and practical efficacy. CONCLUSION: Several studies suggest that commonly used topical medications for molluscum suffer from poor adherence, reducing treatment efficacy. Addressing adherence to these medications may promote the utility of topicals to deliver the need for safe, painless, and efficacious treatments for molluscum. Larger, well-designed trials accounting for adherence are needed before evidence-based treatment recommendations can be made for topical molluscum treatments. Our findings propose that in-office topicals like cantharidin may overcome nonadherence and enhance efficacy compared to daily home-administered topical medications.
Managing Rosacea with Nanodiamond-zinc Oxide: Real-world Evidence for Reduction in Redness and Acne Lesions.
Zhang XD, Bai XS, Teng C … +4 more , Chilukuri S, Teng J, Ablon G, Gold MH
J Clin Aesthet Dermatol · 2025 Jul · PMID 40778007
OBJECTIVE: The authors sought to observe the effect of nanodiamond-zinc oxide (ND-ZnO)-containing skincare preparations on facial erythema and acne-like lesions in subjects with rosacea or rosacea-like symptoms. METHODS:...
OBJECTIVE: The authors sought to observe the effect of nanodiamond-zinc oxide (ND-ZnO)-containing skincare preparations on facial erythema and acne-like lesions in subjects with rosacea or rosacea-like symptoms. METHODS: An eight-week, real-world case series was compiled, with 35 included patients who exhibited facial redness and/or papulopustular features. Participants were assigned to one of two regimens: (1) ND-ZnO-containing cream applied once daily, or (2) ND-ZnO-containing serum applied twice daily with the cream layered on in the morning. Redness was assessed via expert grading using a standardized scale, while lesion counts (inflammatory and non-inflammatory) were evaluated by a board-certified dermatologist at baseline, Week 4, and Week 8. Participants also completed a self-assessment questionnaire on skin tone and radiance. RESULTS: Of the participants evaluated for redness, 94.7 percent showed improvement by expert grading. Self-assessment revealed that 95 percent reported brighter, more even skin tone. Mean erythema scores decreased from 0.86 at baseline to 0.69 at Week 4 and 0.54 at Week 8. Non-inflammatory lesions declined from 22 to 1, and inflammatory lesions resolved completely by Week 8. Representative case studies confirmed visible improvement in redness, skin texture, and clarity. LIMITATIONS: The absence of a placebo control and the short duration limit generalizability and long-term assessment. Results should be confirmed in randomized controlled trials. CONCLUSION: ND-ZnO-containing skincare preparations were effective in reducing facial redness and acneiform lesions, with improvements observed across multiple skin types. These findings support their potential use in the topical management of rosacea.
Recommendations for Topical Corticosteroid Use and the Role of Alternative, Advanced Targeted Topical Treatments in the Treatment of Chronic Inflammatory Skin Diseases.
DiRuggiero D, Agopian J, Baker A … +10 more , Blair A, Brunner M, Dinallo A, Love J, Rygg K, Sookhoo A, Young M, Higham R, Seal M, Hanna D
J Clin Aesthet Dermatol · 2025 · PMID 40735011
Safety concerns associated with topical corticosteroids (TCS) have been increasingly recognized and well documented in medical literature for many decades. In response, advanced targeted topical (ATT) therapies have emer...
Safety concerns associated with topical corticosteroids (TCS) have been increasingly recognized and well documented in medical literature for many decades. In response, advanced targeted topical (ATT) therapies have emerged as safer, effective alternatives for managing chronic inflammatory skin diseases. In this review, a group of experienced dermatology nurse practitioners (NPs) and physician assistants/associates (PAs) summarize key consensus statements from a 2025 physician-expert-panel literature review and consensus statement publication addressing the safety and efficacy of TCS and the role of ATT therapies for chronic inflammatory skin diseases. It highlights practical recommendations for incorporating ATT therapies into clinical practice and emphasizes the vital role of NPs and PAs in monitoring cumulative corticosteroid exposure to minimize the risk of both cutaneous and systemic adverse effects associated with TCS use.
Bilateral Submental Superficial Thrombophlebitis Following Hyaluronic Acid Filler Injections.
Hawkins M
J Clin Aesthet Dermatol · 2025 · PMID 40735010
Superficial thrombophlebitis is an uncommon but notable complication following dermal filler injections. This case highlights a 39-year-old female individual presenting with bilateral submental superficial thrombophlebit...
Superficial thrombophlebitis is an uncommon but notable complication following dermal filler injections. This case highlights a 39-year-old female individual presenting with bilateral submental superficial thrombophlebitis following hyaluronic acid filler to the jawline and chin. To the author's knowledge, this is the first reported case of superficial venous thrombosis (SVT) in the neck following dermal filler injection. This report uniquely highlights longitudinal follow-up, ultrasound imaging documentation, and outcome, making it the first case documented in such detail. Through clinical evaluation and a multidisciplinary approach to management, this case emphasizes the importance of diagnosis and continued follow-up when addressing rare complications in aesthetic medicine.
Selected Abstracts from RAPIDS Immuno-Dermatology Conference.
J Clin Aesthet Dermatol · 2025 · PMID 40735009
Abstract loading — click title to view on PubMed.
Hidden in Plain Sight: Accurately Diagnosing Skin Infections in Skin of Color.
Sangha AM
J Clin Aesthet Dermatol · 2025 · PMID 40735008
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Topical Corticosteroid Use in Everyday Clinical Practice: Cautionary Tales.
Young M
J Clin Aesthet Dermatol · 2025 · PMID 40735007
Despite the development of advanced targeted topical treatments for chronic inflammatory skin diseases and recent calls for caution when prescribing topical corticosteroids (TCS), TCS continue to be the most prescribed d...
Despite the development of advanced targeted topical treatments for chronic inflammatory skin diseases and recent calls for caution when prescribing topical corticosteroids (TCS), TCS continue to be the most prescribed dermatologic agent. Yet the perception that adverse effects are uncommon with TCS use persists. To combat this misperception, I selected examples of patients from my practice that illustrate the real-world risks associated with TCS use. This case series provides several key clinical pearls for managing TCS use in everyday clinical practice including: 1) Even using TCS for short periods and as prescribed is not without risks. 2) Long-term TCS use (even intermittent use) can result in permanent skin changes that can even outlast the disease the TCS was used to treat. 3) TCS overuse can have serious adverse effects resulting in hospitalization, including adrenal suppression, infection, and even sepsis. 4) Patients who are dissatisfied with older TCS-sparing treatments might continue to seek more potent TCS, resulting in doctor/clinic hopping and potential TCS misuse. 5) Patients might repurpose TCS prescriptions for other body areas, leading to high-potency TCS being applied to thin-skinned areas and irreversible skin damage.
Systemic Cryotherapy: A Potential Therapeutic Option for Mild to Moderate Atopic Dermatitis.
Park A, Wan L, Lio P
J Clin Aesthet Dermatol · 2025 Jun · PMID 40575607
Abstract loading — click title to view on PubMed.
Established and Emerging Laser Treatments for Acne Vulgaris in Diverse Skin Types.
Huerth K, Ohanenye C, Quartey A … +2 more , Jackson B, Callender V
J Clin Aesthet Dermatol · 2025 Jun · PMID 40575606
OBJECTIVE: This review examined studies published during the past two decades in which lasers were used to treat acne vulgaris. Its aim was to assess the mechanism, efficacy, and safety of lasers as a treatment modality...
OBJECTIVE: This review examined studies published during the past two decades in which lasers were used to treat acne vulgaris. Its aim was to assess the mechanism, efficacy, and safety of lasers as a treatment modality for this vexingly common and potentially disfiguring condition. METHODS: PubMed searches were performed to identify articles published through December 2023 that discuss the use of lasers for the treatment of acne vulgaris. RESULTS: Various lasers, including visible light, infrared, fractional ablative CO₂ lasers with isotretinoin, and two 1726-nm lasers approved by the United States Food and Drug Administration, show efficacy in treating acne vulgaris. Studies vary widely in their design, characteristics, and methodological rigor. LIMITATIONS: The available literature on using lasers to treat acne is limited by variability in study design, short-term follow up, and small sample sizes. CONCLUSION: Lasers have demonstrated efficacy as primary or adjunctive treatment modalities for acne vulgaris in certain clinical scenarios. Larger randomized, controlled, double-blinded studies with sufficiently long follow-up periods and standardized objective measurements are needed to substantiate the efficacy of lasers in treating acne vulgaris.
The Colorimetric Scale for Skin of Color Should Replace the Fitzpatrick Skin Type Scale for Classifying Individuals with Darker Skin.
Cohen PR
J Clin Aesthet Dermatol · 2025 Jun · PMID 40575605
Abstract loading — click title to view on PubMed.
The Efficacy of Complementary and Alternative Medicines Utilized In Cosmetic and Surgical Dermatology: A Comprehensive Review.
Ufomadu P, Gill BJ, Rosen T … +2 more , Shmizu I, Orengo I
J Clin Aesthet Dermatol · 2025 Jun · PMID 40575604
BACKGROUND: Lately, there has been a growing demand for the utilization of complementary and alternative medicines (CAMs) with dermatological applications. This is true despite limited RCT-level studies on such agents. T...
BACKGROUND: Lately, there has been a growing demand for the utilization of complementary and alternative medicines (CAMs) with dermatological applications. This is true despite limited RCT-level studies on such agents. This presents a barrier for dermatologists and fellow clinicians in counseling patients who may be using or are tempted to use these CAM modalities. This review highlights CAM agents used by patients for applications in cosmetic and surgical dermatology, exploring their efficacy and toxicity profiles. METHODS: A comprehensive review was conducted on the effectiveness of several CAMs utilized in cosmetic and surgical dermatology by patients. A literature search was performed using PubMed, Embase, Google Scholar, Web of Science, and Cochrane. RESULTS: Most CAM agents studied had statistically insignificant results, and for CAM agents that had significant results in efficacy, the studies were questionable due to flawed randomization, lack of proper blinding, faulty data analysis, poor study design, suggestion of bias, small sample size, and limited clinical application. CONCLUSION: CAM agents have promising potential in dermatologic use; however, more RCT-level studies are needed. A study design that either emphasizes a comparison between the CAM agent and conventional therapy, or the CAM agent with or without conventional therapy should be incorporated in future studies. As of now, dermatologists should be cognizant of bias in published studies demonstrating the effectiveness of certain CAM agents, as well as the possible adverse effects.
Physician and Trainee Beliefs and Comfort Regarding Psychodermatology Management: A Cross-sectional Survey From a Large Tertiary Care Center Faculty.
Hansen AM, Seifert R, Beshay A … +2 more , Hopkins Z, Secrest A
J Clin Aesthet Dermatol · 2025 Jun · PMID 40575603
BACKGROUND: Both primary and secondary psychodermatoses are prevalent and dermatologists can play a pivotal role in their managment. We sought to understand dermatologists' training, comfort, and concerns for prescribing...
BACKGROUND: Both primary and secondary psychodermatoses are prevalent and dermatologists can play a pivotal role in their managment. We sought to understand dermatologists' training, comfort, and concerns for prescribing psychotropic medication for these condtions. METHODS: We surveyed 49 dermatologists at the University of Utah, querying demographic variables, training enviroment, exposure to psychotropic medication use in training, current prescribing comfort, and current prescribing patterns. Associations between questionnaire responses and dermatologist demographics and training patterns were evaluated using ordinal logistic regression. RESULTS: Across the 42 collected surveys, most had limited exposure to psychotropic medication and psychodermtoses managment in residency, most were encouraged to refer these patients to psychiatry, and lack of training on use and side effects were the most commonly cited reasons for not prescribing psychotropic medications. Having more faculty who advocated for psychtropic medication use and training during residency on psychodermatoses were associated with greater prescribing comfort (OR=6.77, 1.54-29.8 and OR=6.09, 1.80-20.6 respectively). CONCLUSION: Most dermatologists surveyed had limited exposure and training using psychotrophic medications for psychodermatoses. Lack of training and experience with these medications was a significant factor affecting prescribing comfort, highlighting the improtance of expanded residency training on the use of psychotrophic medications and the managent of primary and secondary dermatoses.
The Current State of Patient Adherence to Lab Monitoring Guidelines for Janus Kinase Inhibitors in Patients with Alopecia Areata.
Shanmugam SK, Palmer V, McMichael A
J Clin Aesthet Dermatol · 2025 Jun · PMID 40575602
BACKGROUND: While Janus kinase inhibitors (JAKi) show excellent outcomes in Phase2b/3 trials for alopecia areata (AA), they do have potential side effects due to their immunosuppressive nature and other effects on the JA...
BACKGROUND: While Janus kinase inhibitors (JAKi) show excellent outcomes in Phase2b/3 trials for alopecia areata (AA), they do have potential side effects due to their immunosuppressive nature and other effects on the JAK-STAT pathway. These side effects can be mitigated by adherence to lab monitoring. OBJECTIVE: The authors sought to analyze patients, using JAKi, to manage symptoms of AA, to determine frequency of lab monitoring and check for adherence to the recommended rate of every three months. METHODS: A retrospective chart review was conducted by first identifying all patients diagnosed with AA at a specialty hair clinic in an academic dermatology department between January 2021 and May 2024. Each patient chart was reviewed for past and current use of any known oral JAKi. Fifty-seven patients were identified to meet our inclusion criteria and all of their charts were reviewed. The primary outcome is the average time between lab monitoring dates for each patient. The hypothesis was formulated after the data collection in the form of whether patients were being adherent to lab monitoring protocol. RESULTS: Most patients were non-adherent to the lab testing frequency standard. Significant differences were found in blood test times between adherent and non-adherent patients and between non-adherent and extremely non-adherent patients with -values less than 0.01 for both sets. CONCLUSION: Patients with AA undergoing JAKi treatment are not adhering to the recommended lab monitoring frequency. New tactics to improve adherence need to be taken.
Refractory Acrodermatitis Continua of Hallopeau in a Pediatric Patient: Unveiling Underlying Mixed Connective Tissue Disorder.
Del Rosario NA, Nguyen SHU, Nguyen EQH
J Clin Aesthet Dermatol · 2025 Jun · PMID 40575601
Acrodermatitis continua of Hallopeau (ACH) is a rare pustular psoriasis variant that presents as sterile pustules on the hands and feet with a relapsing course. This condition is not easily treated, but literature shows...
Acrodermatitis continua of Hallopeau (ACH) is a rare pustular psoriasis variant that presents as sterile pustules on the hands and feet with a relapsing course. This condition is not easily treated, but literature shows some cases are successfully controlled with biologics such as etanercept, adalimumab, secukinumab, and ustekinumab. Mixed connective tissue disease (MCTD) is a type of autoimmune disease and is rarely seen in the pediatric population. It is characterized by overlapping features of various autoimmune disorders, often involving scleroderma, systemic lupus erythematosus, polymyositis, and other organ dysfunction. MCTD is typically diagnosed with lab testing to indicate the presence of specific autoantibodies to a nuclear matrix protein, such as ribonucleoprotein. This communication emphasizes the importance of revisiting diagnoses in patients with persistent, refractory skin conditions and highlights the need for comprehensive evaluation in the presence of evolving or atypical presentations, especially when autoimmune diseases are suspected. Steps for diagnostic workup and treatment may provide clinical benefits to patients and serve as a reference for other clinicians. The course of treatment for ACH and MCTD in the pediatric and adolescent population is discussed.
Multidisciplinary Dermatology: A Framework from the Association of Academic Cosmetic Dermatology.
Richmond A, Ray L, Truong-Balderas K … +13 more , Vashi N, Blalock T, Hordinsky M, Ortiz A, Kelly KM, Hoss E, Shive ML, Almukhtar R, Jackson Cullison SR, Kang BY, Levin Y, Wyles SP, Alam M
J Clin Aesthet Dermatol · 2025 Jun · PMID 40575600
Cross-specialty collaboration can be helpful in the treatment of patients with complex medical conditions involving dermatologic manifestations. This article underscores the utility of multidisciplinary collaboration thr...
Cross-specialty collaboration can be helpful in the treatment of patients with complex medical conditions involving dermatologic manifestations. This article underscores the utility of multidisciplinary collaboration through discussion of seven hypothetical case scenarios, including patient care in the clinical contexts of hidradenitis suppurativa, venous varicosities, scleroderma, gender-affirming care, sequelae from cancer, solid organ transplantation, and neurocutaneous syndromes. Through these cases, we highlight how a holistic healthcare approach that encompasses multiple specialties can positively contribute to dermatologic patient care.
Analysis of Reddit Reveals Risankizumab Questions Among Patients with Psoriasis.
Wang J, Patel P, Mineroff J … +1 more , Jagdeo J
J Clin Aesthet Dermatol · 2025 Jun · PMID 40575599
OBJECTIVE: The rapid expansion of the internet, specifically social media, has reshaped how patients approach their health and obtain their medical information. Specifically, Reddit communities have become important spac...
OBJECTIVE: The rapid expansion of the internet, specifically social media, has reshaped how patients approach their health and obtain their medical information. Specifically, Reddit communities have become important spaces for patients with psoriasis to engage in discussions, particularly regarding the newly United States Food and Drug Administration-approved medication, risankizumab. The objective of this study was to analyze questions from patients with psoriasis about risankizumab on Reddit. METHODS: The authors analyzed all risankizumab-related questions posted on the r/Psoriasis and r/Skyrizi subreddits. Questions were categorized and subcategorized for analysis. RESULTS: A total of 222 questions from 181 posts were analyzed. The largest proportion of questions were regarding side effects (26.1%) and cost and insurance (14.9%). This analysis of risankizumab questions on Reddit reveals key insights into the informational needs of patients with psoriasis and demonstrates the value of utilizing online platforms to better understand patient concerns. LIMITATIONS: One limitation of this study is that Reddit users may not be representative of the overall psoriasis population. CONCLUSION: The study presents a distinct approach by harnessing the power of social media data to understand patient perspectives, which may not be readily apparent in clinical settings. This information may help physicians improve the overall patient experience and provide more tailored clinical care.
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