The Journal Of Clinical And Aesthetic Dermatology[JOURNAL]
Sun
200 papers
Roflumilast Cream 0.3% for a Patient With Genital Psoriasis Refractory to Other Topical and Systemic Treatments: A Case Report.
Young M
J Clin Aesthet Dermatol · 2025 · PMID 40212438
Genital involvement is a frequent complication of plaque psoriasis (PsO) and is associated with substantial emotional and physical burden. We report a case of a male patient with genital PsO who did not respond to multip...
Genital involvement is a frequent complication of plaque psoriasis (PsO) and is associated with substantial emotional and physical burden. We report a case of a male patient with genital PsO who did not respond to multiple systemic and topical therapies but achieved complete clearance with roflumilast cream 0.3% (a potent phosphodiesterase 4 inhibitor). After 28 weeks of initial treatment with guselkumab, body surface area (BSA) affected had fallen from 42 to 8 percent; however, new genital lesions were noted. After eight months of additional topical treatment, BSA affected had fallen to 2 percent, but the patient had developed gluteal cleft lesions as well. Over the next three years, several topical and systemic treatments were tried, but his genital and gluteal cleft disease persisted and intense pruritus developed. Based on concerns about continued topical corticosteroid use, the lack of efficacy observed thus far, and the potential for rebound flare, once-daily roflumilast cream 0.3% was initiated. At Week 8, BSA affected had fallen to 1 percent, and was limited to residual scalp disease (which had not been treated with roflumilast); the genitals and gluteal cleft were clear, with slight erythema present only on the scrotum. At 16 weeks, genital and gluteal cleft disease remained well-controlled with no evidence of active disease. Overall, roflumilast cream 0.3% was well tolerated with no pruritus, folliculitis, irritation, or contact dermatitis observed.
Improving Knowledge and Awareness of Diabetes-associated Skin Manifestations in a Resource Limited Setting: A Video Education Pilot Study.
Carnemolla AR, Tung-Hahn E, Solorzano G … +5 more , Farid M, Quint N, Campbell C, Tung R, Pettersen T
J Clin Aesthet Dermatol · 2025 · PMID 40212437
OBJECTIVE: Although skin findings in patients with diabetes mellitus (DM) are common, many patients are unaware of these associations. A pilot study using an educational video was conducted to assess the effectiveness of...
OBJECTIVE: Although skin findings in patients with diabetes mellitus (DM) are common, many patients are unaware of these associations. A pilot study using an educational video was conducted to assess the effectiveness of a video-based tool in evaluating and enhancing the knowledge of patients with Type 2 diabetes about the cutaneous manifestations of their disease. METHODS: An instructional video in English and Spanish highlighting DM-associated skin conditions was created. This included xerosis, diabetic dermopathy, acanthosis nigricans (AN), acrochordons, infections, hidradenitis suppurativa (HS), wound healing, and cancer incidence. A convenience cohort of patients with diabetes were included. Participants completed a 10-question survey to assess their knowledge of DM-associated skin conditions either after watching the instructional video or without viewing it. A history-based questionnaire was also administered. RESULTS: Fourty-five participants were enrolled. Thirty participants viewed the video, and 15 controls did not prior to completing the knowledge survey. The average total score (69%) in participants who watched the video was significantly better than controls (49%). Fourty-two percent of participants reported no prior knowledge of DM-associated cutaneous effects. Greater than half of this cohort endorsed a history of xerosis, acrochordons, and diabetic dermopathy. More than 40 percent of participants affirmed having AN and infection of the skin or nails. Twenty-nine percent had a history of foot ulcers, and 13 percent had cellulitis in the past. LIMITATIONS: This was a pilot study with a small sample size, limiting generalizability. CONCLUSION: These findings demonstrate the effectiveness of bilingual video education to enhance knowledge of DM-associated skin manifestations. Given the limited awareness of and high self-reported incidence of DM-associated cutaneous disorders, accessible educational resources like this video could help patients better recognize these entities and seek appropriate treatment.
Interpreting Safety Analyses in Psoriasis Clinical Trials.
Zirwas M, Trickett C, Gorelick J … +4 more , Wang K, Wittstock K, Rosenberg C, DiRuggiero D
J Clin Aesthet Dermatol · 2025 · PMID 40212436
Clinical trials are designed to evaluate the efficacy and safety of new drugs. However, greater focus is often placed on efficacy rather than safety. This review article discusses the fundamentals involved in evaluating...
Clinical trials are designed to evaluate the efficacy and safety of new drugs. However, greater focus is often placed on efficacy rather than safety. This review article discusses the fundamentals involved in evaluating the safety of a new drug. In addition, the principal challenges involved in the collection, analysis, reporting, and interpretation of safety data in clinical trials are described using relevant examples. These challenges include the fact that clinical trials are generally limited in size and duration, exclude high-risk populations, and have limited statistical power to detect rare but potentially serious adverse events (AEs) that might occur in real-world situations. Reporting of safety data across clinical trials is also inconsistent. A thorough understanding of the interpretation of safety data, especially the appropriate use of exposure-adjusted incidence rates (EAIRs) in relation to AEs, as well as the importance of comparing rates to those reported in the general population and in patients with psoriasis, is vital for making a well-informed assessment of the safety of a new drug. The information provided in this article could be useful to healthcare providers who must evaluate a large volume of safety data when providing evidence-based treatment suggestions and recommendations to their patients.
An Overview of Atopic Dermatitis Disease Burden, Pathogenesis, and the Current Treatment Landscape: Recommendations for Appropriate Utilization of Systemic Therapies.
Martin G, Aldredge L, DiRuggiero D … +2 more , Young M, Simpson E
J Clin Aesthet Dermatol · 2025 Mar · PMID 40135184
OBJECTIVE: To review the disease impact, immunopathogenesis, and treatment landscape of atopic dermatitis (AD), including recommendations for appropriate utilization of systemic treatments. METHODS: A PubMed search for r...
OBJECTIVE: To review the disease impact, immunopathogenesis, and treatment landscape of atopic dermatitis (AD), including recommendations for appropriate utilization of systemic treatments. METHODS: A PubMed search for relevant articles on AD and the treatment landscape was conducted using the key words "atopic dermatitis," "biologic," "therapeutic inertia," "Janus kinase (JAK) inhibitor," and "systemic treatment." RESULTS: AD is a common, chronic inflammatory skin disease that can have a profound negative impact on quality of life. With recent advancements and approvals of systemic treatments, it is now possible to offer targeted therapy to patients with moderate-to-severe AD. When topical treatments are no longer sufficient for managing AD, recently published AD management guidelines recommend that providers consider/offer advanced systemic treatments. LIMITATIONS: More data are needed on the use of systemic treatments in special populations, including head-to-head comparisons of available systemic treatments in these populations. CONCLUSION: An increased awareness of the immunopathogenesis, diagnosis, and treatment landscape of AD is needed amongst healthcare providers (HCPs). Special consideration of diagnosis and treatment options should be given to certain populations, including patients of different ages, those who may be pregnant or become pregnant, are biologic-experienced, and/or have comorbidities. Of note, HCPs should be aware of the clinical presentation in patients with skin of color. Therapeutic inertia can prevent HCPs from intensifying treatment when needed, and HCPs should know when it is appropriate to offer systemic treatments, including biologics and JAK inhibitors.
A Review of Glucagon-like Peptide-1 in Dermatology.
Patino W, Thomas A, Jain S … +2 more , Del Rosso JQ, Issa NT
J Clin Aesthet Dermatol · 2025 Mar · PMID 40135183
OBJECTIVE: Glucagon-like peptide-1 (GLP-1) is a hormone produced in response to meal intake by endocrine intestinal cells. GLP-1 binds to its receptors which are expressed on various cells throughout the body. GLP-1 rece...
OBJECTIVE: Glucagon-like peptide-1 (GLP-1) is a hormone produced in response to meal intake by endocrine intestinal cells. GLP-1 binds to its receptors which are expressed on various cells throughout the body. GLP-1 receptors (GLP-1R) have become a target for the treatment of diabetes mellitus and weight loss, and GLP-1 receptor agonist (GLP-1RA) use has become more common among patients. In addition to the anti-hyperglycemic effects, recent studies have exhibited anti-inflammatory effects of GLP-1RAs. Current research surrounding GLP-1Rs and GLP-1R agonism in dermatology is limited. This review aims to describe the current knowledge of GLP-1Rs and GLP-1RA use in dermatology and suggest future directions. METHODS: A literature search focused on GLP-1RAs and their effect on cutaneous disease processes was performed across various databases. The databases were searched through May 2024. RESULTS: The use of GLP-1RAs have shown promising anti-inflammatory effects and improvement in wound healing, psoriasis, and hidradenitis suppurativa. Several cutaneous adverse reactions to GLP-1RAs were also identified with injection site pruritus, erythema, and rash being the most commonly reported. LIMITATIONS: Current literature is limited to case reports and small-scale studies. CONCLUSION: The literature suggests anti-inflammatory effects of GLP-1RAs may provide direct benefit in the treatment of dermatologic conditions independent of glucose control in addition to indirect improvement via modulation of blood glucose and weight loss. Further studies investigating the implications of GLP-1RA use and the possible therapeutic potential of GLP-1RAs in inflammatory skin conditions are warranted.
The Impact of Acne Scarring on Quality of Life, Willingness-to-pay, and Time Trade-off: A Cross-sectional Analysis.
De La Garza H, Trepanowski N, Flores R … +3 more , Visutjindaporn P, Patzelt N, Vashi NA
J Clin Aesthet Dermatol · 2025 Mar · PMID 40135182
OBJECTIVE: We sought to evaluate the impact of the presence of acne scarring in patients with acne vulgaris on quality of life as assessed by the Dermatology Life Quality Index (DLQI) and the Cardiff Acne Disability Inde...
OBJECTIVE: We sought to evaluate the impact of the presence of acne scarring in patients with acne vulgaris on quality of life as assessed by the Dermatology Life Quality Index (DLQI) and the Cardiff Acne Disability Index (CADI); disease severity using the Investigator's Global Assessment of Acne (IGA); and health utility measures including willingness-to-pay, time trade-off, time spent on concealment, and percent of income willing to exchange for resolution of disease. METHODS: We conducted a cross-sectional, single-institution survey. RESULTS: In total, 94 patients with acne vulgaris participated, of which 53.2 percent had acne scarring and 46.8 percent did not. The presence of acne scarring was associated with higher DLQI, CADI, and IGA scores. Utility measures including willingness-to-pay, time trade-off, concealment time, and percent of income willing to exchange for resolution of disease were similar for participants with and without scarring. For participants with and without scarring, a greater impairment of quality of life as assessed by the DLQI was positively correlated with WTP25, percent of monthly income, IGA, and the CADI. LIMITATIONS: As the study design was single-site and cross-sectional, and therefore results may not be generalizable. CONCLUSION: The presence of acne scarring significantly impacts quality of life. A greater impairment of quality of life in patients with acne vulgaris correlates positively with severity of acne and some measures of health economics. Interventions to minimize or prevent acne scarring may reduce psychosocial burden of disease.
Efficacy of Strontium Cream in Alleviating Pruritus in Hidradenitis Suppurativa.
Walker R, Brooks B, Daveluy S
J Clin Aesthet Dermatol · 2025 Mar · PMID 40135181
OBJECTIVE: Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition with limited treatment options and a significant impact on quality of life. This prospective, open-label, real-world study aimed to evalua...
OBJECTIVE: Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition with limited treatment options and a significant impact on quality of life. This prospective, open-label, real-world study aimed to evaluate the efficacy of strontium cream in alleviating pruritus in HS. METHODS: Fifty participants completed baseline and one-week post-intervention surveys. Pruritus was assessed using a numeric severity scale and a qualitative survey on overall itch reduction. RESULTS: Statistical analysis revealed a significant reduction in itching symptoms post-intervention, with mean itch scores decreasing from 3.80±0.90 at baseline to 2.28±1.50 post-intervention (<0.001). Participant feedback also indicated overall satisfaction, with 84 percent of participants willing to recommend the cream to other HS patients. LIMITATIONS: The study relied on self-reported data, which introduces subjectivity, and the absence of a control group limits causal inference. CONCLUSION: Strontium cream demonstrates promise as a therapeutic option for managing pruritus in HS, warranting further research.
From Psyche to Skin: A Call for Interdisciplinary Care in the Management of Psychodermatologic Conditions.
Sun MD, Block BR, Ohri S … +1 more , Rice T
J Clin Aesthet Dermatol · 2025 Mar · PMID 40135180
Despite increasing academic discourse surrounding psychodermatology, few dermatologists or psychiatrists demonstrate a clear understanding of the field. Barriers to physician awareness are double-edged, stemming from bot...
Despite increasing academic discourse surrounding psychodermatology, few dermatologists or psychiatrists demonstrate a clear understanding of the field. Barriers to physician awareness are double-edged, stemming from both inadequate educational opportunities and patient non-disclosure of psychodermatologic symptoms during clinical encounters. It is crucial that medical practitioners, especially in the field of dermatology, become accustomed to recognizing, diagnosing, and treating psychocutaneous disorders, which disproportionately affect members of historically marginalized populations. In this commentary, we propose recommendations for pedagogic supplements to be implemented throughout medical, post-graduate, and post-residency education to build familiarity with this subdiscipline and confidence in managing its associated conditions. In particular, we endorse the integration of components of psychiatry education into dermatology residency training and current practice, as skin symptoms tend to be more openly disclosed than mental health struggles, so dermatologists are often the first physicians to encounter many of these conditions. We also advocate for interdisciplinary collaboration to bridge the gap between the uniformity of standard specialty training and the complexity of psychocutaneous disease.
Managing Advanced Basal Cell Carcinoma: A Guide for the Dermatology Clinician.
Burshtein J, Schlesinger T
J Clin Aesthet Dermatol · 2025 Mar · PMID 40135179
OBJECTIVE: Basal cell carcinoma (BCC) is the most common form of skin cancer. Advanced BCCs include locally advanced BCCs (laBCCs), primary or recurrent tumors that are not amenable to surgery or radiation therapy, and m...
OBJECTIVE: Basal cell carcinoma (BCC) is the most common form of skin cancer. Advanced BCCs include locally advanced BCCs (laBCCs), primary or recurrent tumors that are not amenable to surgery or radiation therapy, and metastatic BCCs (mBCCs). The management of advanced BCC has been revolutionized in recent years by the development of hedgehog inhibitors (HHIs) and immunotherapies (ie, PD-1 inhibitors). We aim to review the current literature on therapeutic options and outline treatment strategies to optimize care for patients with advanced BCC. METHODS: A comprehensive literature search was completed using the keywords "advanced basal cell carcinoma," "treatment," "hedgehog inhibitor," "vismodegib," "sonidegib," "PD1-inhibitor," and "cemiplimab." The authors reviewed all studies and included those which addressed the topic of the review. RESULTS: Surgery or radiotherapy may not be an option for certain high-risk BCCs due to due to invasion into local tissue, location near anatomically sensitive areas, or metastasis. There is increasing evidence for the efficacy of HHIs, including vismodegib and sonidegib, as the first-line treatment for these advanced BCCs. Despite known efficacy, utility of HHIs can be limited by their adverse event profiles. If patients fail HHIs due to inefficacy or adverse effects, there is evidence for use of the PD-1 inhibitor cemiplimab. LIMITATIONS: This is a review article and is limited by the information available in the published literature. In addition, comparison between studies is limited as they utilized varying methodologies. CONCLUSION: Treatment of advanced BCCs can be complex and poses challenges for clinicians. HHIs are currently the first-line treatments for laBCC and mBCC, while cemiplimab can be used if patients do not respond to or are unable to tolerate HHIs, or for whom HHIs are not appropriate.
Biostimulatory Fillers to Treat Post-liposuction Skin Irregularities.
Guida S, Proietti I, Conforti C … +4 more , Cantisani C, Zerbinati N, Pellacani G, Galadari H
J Clin Aesthet Dermatol · 2025 Mar · PMID 40135178
BACKGROUND: Treatment of post-liposuction skin irregularities (PLSI), a complication of liposuction, can be challenging. OBJECTIVE: Considering the increasing request of treatment of PLSI, the aim of this study is to eva...
BACKGROUND: Treatment of post-liposuction skin irregularities (PLSI), a complication of liposuction, can be challenging. OBJECTIVE: Considering the increasing request of treatment of PLSI, the aim of this study is to evaluate the efficacy and safety of CaHA diluted/hyperdiluted to PLSI. METHODS: A retrospective study on a total of eight PLSI areas in six women treated with CaHA diluted/hyperdiluted was performed. Efficacy was estimated on pictures of affected areas collected before and four months after treatment, according to the recently validated PLSI scale and Student's t-test for paired samples was performed to analyze data. Eventual adverse events were used to evaluate safety. RESULTS: Our results showed a statistically significant improvement of number and depth of depressions and a trend toward reduction of skin laxity. CONCLUSION: This study reported the efficacy and safety of CaHA diluted/hyperdiluted for PLSI treatment. Larger studies are encouraged to support the results of this pilot study.
Reversing Oxinflammation Associated with Glycative Stress and Formation of Advanced Glycation End Products with a Dietary Supplement Containing Rosemary Extract.
Guiotto A, Pecorelli A, Draelos ZD … +3 more , Gueniche A, Yatskayer M, Nelson DB
J Clin Aesthet Dermatol · 2025 Mar · PMID 40135177
OBJECTIVE: Skin aging is accelerated by glycative stress, which promotes the accumulation of advanced glycation end products (AGEs) and impairs the extracellular matrix. A randomized, double-blinded, placebo-controlled t...
OBJECTIVE: Skin aging is accelerated by glycative stress, which promotes the accumulation of advanced glycation end products (AGEs) and impairs the extracellular matrix. A randomized, double-blinded, placebo-controlled trial evaluated a dietary supplement containing rosemary extract (BioR), demonstrating tissular and visible improvements in skin quality. The data reported herein evaluated markers associated with glycative stress and AGEs from skin biopsies and tape strips obtained following dietary supplement use. METHODS: Female participants (N=104), aged 40 to 65 years, with moderate-to-severe skin dullness and roughness/texture, and mild-to-moderate erythema, pore size, and uneven pigmentation were randomized to BioR (n=52) or placebo ([PLB] n=52). Capsules were taken with food over 12 weeks. Subjects (n=16, BioR; n=16, PLB) underwent 3mm punch biopsies (volar upper arm) and tape stripping (16 tape strips, each; volar forearm) at baseline and 12 weeks for analysis of 4-hydroxynonenal protein adducts (4HNE [oxidative stress marker]) and AGEs. RESULTS: Immunohistochemistry and ELISA revealed that levels of 4HNE protein adducts were significantly decreased from baseline in the BioR versus PLB group (<0.005; biopsies) and significantly decreased from baseline in the BioR group alone (<0.05; tape strips) at 12 weeks. Significant reductions in AGEs occurred in the BioR versus PLB group (<0.005; biopsies) at 12 weeks. No significant changes from baseline occurred in 4HNE protein adduct levels or AGEs in the PLB group. CONCLUSION: After 12 weeks, a dietary supplement containing rosemary extract led to significant reductions in a marker associated with oxidative stress, a component of glycation, and AGEs versus placebo in skin in addition to visible improvements in skin quality.
Exploring the Link Between Atopic Dermatitis and Eosinophilic Esophagitis.
Jaros J, Ahuja K, Lio P
J Clin Aesthet Dermatol · 2025 Mar · PMID 40135176
Eosinophilic esophagitis (EoE) and atopic dermatitis (AD) are two known and sometimes comorbid type 2 helper cell-mediated diseases. EoE shares clinical features, immunologic pathways, susceptibility loci, and risk with...
Eosinophilic esophagitis (EoE) and atopic dermatitis (AD) are two known and sometimes comorbid type 2 helper cell-mediated diseases. EoE shares clinical features, immunologic pathways, susceptibility loci, and risk with atopic conditions including food allergies (food allergies), asthma, allergic rhinitis (AR), and AD. These conditions share an impaired immunological response against a range of antigens or allergens, leading to CD4+ Th2 differentiation and overproduction of immunoglobulin E (IgE). The emerging coexistence of EoE and AD presents a compelling area of study. Both diseases manifest on stratified squamous epithelium along the skin-gut continuum and have overlapping treatment algorithms that include avoidance of triggers, topical steroids, and dupilumab. This narrative review highlights the clinical and immunologic nuances underlying these two conditions and sheds light on potential new research and therapeutic avenues.
A Single-center, Double-blinded, Randomized, Placebo-controlled Trial Evaluating the Safety and Efficacy of a Dietary Supplement Containing Rosemary Extract on Visible Facial Skin Quality.
Draelos ZD, Gueniche A, Yatskayer M … +1 more , Nelson DB
J Clin Aesthet Dermatol · 2025 Mar · PMID 40135175
OBJECTIVE: Glycative stress promotes the accumulation of advanced glycation end products (AGEs), impairing extracellular matrix proteins and accelerating skin aging. Rosemary extract has been shown to deglycate AGE cross...
OBJECTIVE: Glycative stress promotes the accumulation of advanced glycation end products (AGEs), impairing extracellular matrix proteins and accelerating skin aging. Rosemary extract has been shown to deglycate AGE crosslink proteins. The safety of a dietary supplement containing rosemary extract (BioR) and its efficacy on skin quality parameters was evaluated over 12 weeks. METHODS: The randomized, double-blinded, placebo-controlled trial included female participants, aged 40 to 65 years, with moderate-to-severe skin dullness and roughness/texture, and mild-to-moderate erythema, pore size, and uneven pigmentation based on a six-point grading scale. Subjects were randomized to either BioR (n=52) or placebo ([PLB] n=52). The dosing schedule was as follows: from Weeks 1 to 4, two capsules three times daily; from Weeks 5 to 8, two capsules twice daily; from Weeks 9 to 12, one capsule twice daily. Capsules were taken with food. Investigator assessments occurred at baseline and Weeks 4, 8, and 12. Global skin quality (total sum of scores) and adverse events (AEs) were recorded over 12 weeks. RESULTS: Mean age, severity and baseline demographics of subjects were similar across groups. Significant mean improvements in BioR versus PLB were observed in skin dullness (=0.04), roughness/texture (=0.001), erythema (=0.05) and pore size (=0.04) at Week 12. No significant differences occurred in uneven pigmentation. Significant mean improvements in global skin quality were demonstrated in BioR versus PLB at Weeks 8 (<0.0001) and 12 (=0.002). One subject (BioR) discontinued at Week 4 due to possibly related, moderate gastrointestinal upset. CONCLUSION: Following 12 weeks of use, a dietary supplement containing rosemary extract and its natural cofactors led to significant mean visible improvements compared to placebo in skin dullness, roughness/texture, erythema, and pore size, and was well tolerated.
Beyond Skin Deep: The Systemic Impact of Topical Corticosteroids in Dermatology.
DiRuggiero D, DiRuggiero M
J Clin Aesthet Dermatol · 2025 · PMID 40083540
Corticosteroids are widely prescribed for a variety of dermatologic indications. However, since 2020, regulatory bodies from Canada and the United Kingdom, as well as academic and patient advocacy societies, are increasi...
Corticosteroids are widely prescribed for a variety of dermatologic indications. However, since 2020, regulatory bodies from Canada and the United Kingdom, as well as academic and patient advocacy societies, are increasingly calling for limiting topical corticosteroid use due to safety concerns. This article reviews the variety and extent of both cutaneous adverse effects (i.e., steroid-induced damage) and systemic adverse effects from topical corticosteroids and explores alternative therapies. The risk of adverse effects increases with steroid potency, amount, duration, and frequency of use across indications, routes of administration, and prescribers (i.e., cumulative steroid dose). In order to reduce these safety risks, clinicians should prescribe steroids appropriately and counsel patients on appropriate use and consider combination topical corticosteroid therapy or newer alternative steroid-sparing treatments.
Identification and Treatment Challenges.
Ferguson B
J Clin Aesthet Dermatol · 2025 · PMID 40083538
Cutaneous mycobacterial infections present an ongoing challenge in terms of diagnosis and treatment options. Accurate diagnosis of cutaneous mycobacterial infections can take eight weeks, and they often provide few medic...
Cutaneous mycobacterial infections present an ongoing challenge in terms of diagnosis and treatment options. Accurate diagnosis of cutaneous mycobacterial infections can take eight weeks, and they often provide few medication options. Increasing antibiotic resistance limits treatment options, especially by mouth. Negative diagnostic tests such as biopsies, serology, and cultures in the presence of a cutaneous mycobacterial infection are common and could prolong the diagnosis. This report highlights key features, including the atypical appearance of discharge, the eruption of an adjacent abscess with potential sinus tract formation, and lack of pain in discomfort that is often seen in cellulitis. The purpose of this case report is to discuss the lengthy process from suspected diagnosis to treatment, as well unanticipated challenges such as laboratory errors, to assist clinicians in prompt decision making.
Efficacy of Mild-to-Moderate Chronic Hand Eczema Treatment Using Petrolatum and Panthenol Ointment vs. 0.1% Triamcinolone Acetonide in 10% Urea Cream: A Split-hand, Evaluator-blinded, Randomized, Controlled Trial.
Lueangarun S, Techalert N, Tempark T
J Clin Aesthet Dermatol · 2025 Feb · PMID 40078865
BACKGROUND: There are many side effects resulting from the long-term use of conventional therapy (eg, high potency topical corticosteroids) for treatment of chronic hand eczema (CHE). OBJECTIVE: This study aimed to explo...
BACKGROUND: There are many side effects resulting from the long-term use of conventional therapy (eg, high potency topical corticosteroids) for treatment of chronic hand eczema (CHE). OBJECTIVE: This study aimed to explore the efficacy of CHE treatment using the healing ointment (HO) of anti-inflammatory ingredients compared with 0.1% triamcinolone acetonide in 10% urea cream (TAU). METHODS: A split-hand, evaluator-blinded, randomized, controlled study was conducted in 26 patients (88.5% female, mean age 50.04 ± 9.63 years) with mild-to-moderate CHE. All patients were randomly assigned to apply HO or TAU twice daily on each side of the hand for consecutive 28 days. RESULTS: There was an improvement of HECSI, TEWL, SCH, hemoglobin index, DLQI, and VAS on the HO treated side at Day 28, with statistical significance. Also, a statistically significant difference of TEWL reduction was observed on the HO treated side when compared to the TAU treated side at the same visit. Moreover, the superior post-moisturizing efficacy at seven days was noted for TEWL and SCH on the HO treated side. CONCLUSION: The use of HO with anti-inflammatory ingredients could be alternatively efficacious for treatment of CHE to prevent complications from the long-term application of steroids.
Sunscreen Coverage as Preventive Care Under the Affordable Care Act: A Low-Cost Way to Reduce the Prevalence of the Most Common Cancer.
Fletcher KA, Parker ER, Drolet BC
J Clin Aesthet Dermatol · 2025 Feb · PMID 40078864
Skin cancer is the most commonly diagnosed malignancy in the United States, costing more than $8.1 billion annually in treatment-related expenses, yet with ultraviolet exposure considered the most significant risk factor...
Skin cancer is the most commonly diagnosed malignancy in the United States, costing more than $8.1 billion annually in treatment-related expenses, yet with ultraviolet exposure considered the most significant risk factor for skin cancer development, cutaneous malignancy is also highly preventable. The Affordable Care Act (ACA) is committed to covering demonstrably effective preventive health care measures without patient cost sharing. To prevent skin cancer, the American Academy of Dermatology recommends applying sunscreen, donning sun-protective clothing, seeking shade, and avoiding midday sun. Additionally, The US Preventive Services Task Force recommends behavioral counseling for skin cancer prevention, including application of broad-spectrum sunscreen, from ages six months to 24 years of age. Despite these evidence-based recommendations and widespread precedent for ACA coverage of certain over-the-counter medications, dermatologic products such as sunscreen are notably excluded. Herein, we address an under-recognized insurance coverage gap for patients by outlining the evidence that sunscreen, as a primary prevention, dually reduces skin cancer incidence and healthcare costs, highlighting the critical need to address barriers to sunscreen utilization. As such, we advocate for amendment of current ACA coverage to include the cost of sunscreen as an evidence-based strategy to decrease the incidence of UV-induced cutaneous disease and associated treatment expenses.
Successful Treatment of Recalcitrant Melasma with Picolaser and Isobionicamide-Cysteamine Combination.
Hartman CL, Crawford M, Frey C … +4 more , Bosley R, Sfriso R, Dirlewanger L, Kasraee B
J Clin Aesthet Dermatol · 2025 Feb · PMID 40078863
Melasma is a highly recurrent disorder that is challenging to treat and significantly affects the quality of life of patients. Cysteamine is an endogenous antioxidant produced during the coenzyme A metabolism cycle and i...
Melasma is a highly recurrent disorder that is challenging to treat and significantly affects the quality of life of patients. Cysteamine is an endogenous antioxidant produced during the coenzyme A metabolism cycle and is naturally present in all mammalian cells. The depigmenting efficacy of topical cysteamine has been shown in several double-blind, randomized, placebo-controlled clinical trials. Isobionicamide is a derivative of vitamin B3 and a new depigmenting agent that inhibits melanosomal transfer and was found to potentiate cysteamine's inhibitory effect on tyrosinase. Picosecond lasers have been shown to be effective in treating melasma in dark-skinned individuals. Herein, we report the case of a 50-year-old patient (phototype V) with recalcitrant melasma who significantly responded to picosecond laser associated with the topical application of isobionicamide-cysteamine.
Reversing Glycation with a Dietary Supplement Containing Rosemary Extract.
Draelos Z, Bucay V, Watchmaker J … +1 more , Valacchi G
J Clin Aesthet Dermatol · 2025 Feb · PMID 40078862
OBJECTIVE: The authors sought to explore the skin deglycation ability of rosemary extract dietary supplements to support skin health and improve the signs of skin aging. METHODS: A PubMed literature search for English-la...
OBJECTIVE: The authors sought to explore the skin deglycation ability of rosemary extract dietary supplements to support skin health and improve the signs of skin aging. METHODS: A PubMed literature search for English-language articles on rosemary extract effects on glycation and skin aging in clinical and/or preclinical settings was conducted. RESULTS: Endogenous and exogenous glycative stress and reactive oxygen species lead to the accumulation of advanced glycation endproducts (AGEs), accelerating skin aging. Rosemary extract, and its active polyphenol, rosmarinic acid (RA), exhibit antiglycative and antioxidant effects, preventing AGE formation. Rosemary reduces reactive intermediates in the glycation pathway, decreases protein carbonylation, and protects against environmental stressors. Rosemary has shown potential in reversing glycation, benefiting skin health by protecting collagen and elastin. Both topical and oral delivery methods have been investigated and have shown to be beneficial. Manufacturing and extraction methods are critical in preserving essential and synergistic components of the extract when optimizing formulation development. LIMITATIONS: As a narrative review, the selection of the literature was not fully comprehensive, thus introducing a potential for bias. However, our aim was to provide insights into the impacts of glycation and RA on skin quality and health. CONCLUSION: Rosemary extract and RA appear to exhibit antiglycative effects, both interrupting AGE formation and AGE-protein crosslinks, making them promising compounds for skin health. However, further research is needed to fully understand their mechanisms and therapeutic potential.
Environmental Impact and Sustainability Associated with the Practice of Dermatology.
Vanaria RJ, Bhupalam V, Marrero-Perez A … +3 more , Chaudry A, Awad N, Nestor M
J Clin Aesthet Dermatol · 2025 Feb · PMID 40078861
OBJECTIVE: The environmental impact of the practice of medicine, including dermatology, can be significant, driven by a growing and aging population that increasingly demands medical resources. This review explores the e...
OBJECTIVE: The environmental impact of the practice of medicine, including dermatology, can be significant, driven by a growing and aging population that increasingly demands medical resources. This review explores the environmental effects of the practice of dermatology and identifies actionable solutions to reduce negative environmental impacts. METHODS: A PubMed search was conducted using the terms ("environmental impact" OR "sustainability") AND "dermatology." Results were screened to include English-only articles between 2018 to 2024 and excluded duplicates. Further exploration of dermatology's environmental effects was enhanced through citation tracking and additional PubMed searches. RESULTS: A total of 25 articles were included based on relevance and search terms and an additional 21 were added. Results were categorized into six categories for data representation. Patient travel was the largest contributor to negatively impact the environment, followed by waste management practices, journal publication and written patient material, and traveling to medical conferences. The environmental impact of pharmaceuticals, including topicals, is also notable. Potential sustainable alternatives include teledermatology, more appropriate waste production and segregation, and electronic versus printed formats and more virtual conferences. Additionally, dermatologic disease evolves in response to a changing environment, with new data indicating epidemiological shifts due to climate change. More sustainable practices within dermatology also have the potential to cut total overhead expenses. CONCLUSION: Clinical and surgical subspecialties, specifically dermatology, can contribute significantly to environmental pollution, leading to environmental and financial impacts, but implementing simple, documented methods can reduce their ecological footprint and provide potential financial benefits.
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