Dermatological Reviews最新文献

{"title":"Stem Cell Therapies in Dermatology: Current Status, Clinical Translation, Challenges, and Emerging Future Directions","authors":"Neha Akhoon,&nbsp;Aseem Sharma,&nbsp;Rajiv Kaul","doi":"10.1002/der2.70100","DOIUrl":"https://doi.org/10.1002/der2.70100","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Stem cell-based therapies are rapidly reshaping dermatology, driven by advances in regenerative medicine, tissue engineering, and molecular therapeutics. The skin, with its intrinsic regenerative capacity and well-defined stem cell niches, represents a uniquely accessible model for translational application.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To provide a critical overview of stem cell biology in dermatology, evaluate current and emerging clinical applications, and examine the key translational, regulatory, and safety challenges shaping the field.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A narrative review of the literature was conducted, incorporating recent clinical trials, systematic reviews, translational studies, and seminal mechanistic reports, with a targeted update through April 2026 to capture major subsequent clinical and regulatory developments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Cutaneous stem cells-including epidermal, hair follicle, melanocyte, and mesenchymal stromal cells-play central roles in tissue homeostasis, repair, and immune regulation. A paradigm shift has emerged from traditional cell-replacement strategies toward microenvironmental modulation, with therapeutic effects now understood to be largely mediated by paracrine signalling and extracellular vesicle-driven mechanisms. Clinical applications have been explored across inflammatory, autoimmune, pigmentary, and wound-related disorders, as well as in aesthetic dermatology. Among these, gene-corrected epidermal stem cell transplantation in epidermolysis bullosa represents a landmark example of successful clinical translation with durable outcomes. In contrast, most other indications remain investigational, limited by heterogeneity in study design, variability in cell processing, and insufficient long-term safety data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While stem cell–based therapies hold substantial promise, their integration into routine dermatological practice remains constrained by biological, technical, and regulatory challenges. Emerging approaches-including extracellular vesicle-based therapies, gene editing, induced pluripotent stem cell platforms, and precision regenerative strategies-are poised to define the next phase of the field. Robust clinical validation, standardization of protocols, and stringent regulatory oversight will be essential to translate this promise into safe, effective, and scalable therapies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"7 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.70100","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149145963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Efficacy and Safety of 755-nm Picosecond Alexandrite Versus Q-Switched Nd:YAG Lasers for Nevus of Ota: A Systematic Review and Meta-Analysis","authors":"Mishari Alrubaiaan,&nbsp;Sarah Almansour,&nbsp;Nouf Almagushi,&nbsp;Saif Alagha,&nbsp;Fahad Almalik,&nbsp;Abdullah Almeziny,&nbsp;Mohammed BinMayouf,&nbsp;Lamia Alakrash","doi":"10.1002/der2.70091","DOIUrl":"https://doi.org/10.1002/der2.70091","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Nevus of Ota is a pigmentary condition distinguished by blue to gray-brown macules. In recent years, laser therapy has become the favored treatment method, with the 1064 nm Q-switched Nd: YAG laser (QSNYL) considered the traditional treatment. 755-nm Picosecond alexandrite lasers (PSAL) have demonstrated potential as effective alternatives; however, direct comparative research between these two modalities is limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To present an updated comparison of the safety and efficiency of 755-nm PSAL and QSNYL in the management of nevus of Ota.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A PubMed, ScienceDirect, and Google Scholar search was performed. Studies were eligible for inclusion if they involved patients with nevus of Ota who received treatment with 755-nm PSAL or QSNYL and provided outcome data. Random-effects meta-analyses were performed using the R software.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-two studies included 2667 individuals with nevus of Ota. Success rates were markedly higher with PSAL (76.10%; 95% CI [33.62–95.24]) than with QSNYL (47.59%; 95% CI [19.48–77.31]). PSAL exhibited higher rates of post-inflammatory hyperpigmentation (PSAL: 16.74% compared to QSNYL: 8.02%) and hypopigmentation (PSAL: 8.41% <i>vs.</i> QSNYL: 4.48%). The recurrence rate was relatively low for both lasers, with PSAL exhibiting a slightly higher rate (PSAL: 5.32% vs. QSNYL: 2.54%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PSAL may have superior efficacy to QSNYL for pigment clearance in patients with nevus of Ota. However, they are also associated with a higher incidence of adverse events. Since QSNYL is an established, reliable traditional treatment, further research with direct comparison is still required to determine if PSAL is a reliable alternative.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"7 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.70091","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149146938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Crawling Beneath the Surface: Exploring the Medical Conditions Associated With Delusional Infestation","authors":"Allison Meihofer,&nbsp;Nathan Sagasser,&nbsp;Rafael Aviles Encarnacion,&nbsp;Lauryn J. San Juan,&nbsp;Kennedy O'Neill,&nbsp;Salma Bennis,&nbsp;Colin Burnette,&nbsp;Jessica Colon,&nbsp;Melissa Perez,&nbsp;Mohammad Jafferany","doi":"10.1002/der2.70098","DOIUrl":"https://doi.org/10.1002/der2.70098","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Delusional infestation is characterized by a fixed false belief of infestation despite no objective evidence. Although traditionally considered a primary psychiatric disorder, it may occur secondary to underlying medical conditions. This review examined medical disorders associated with delusional infestation and their implications for diagnosis and management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The literature was reviewed for endocrine, neuropsychological, substance-related, renal, hematologic, metabolic, and infectious conditions associated with delusional infestation, with emphasis on proposed mechanisms, diagnostic evaluation, and treatment response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Delusional infestationwas associated with thyroid dysfunction, diabetes and peripheral neuropathy, dementia, Parkinson's disease and dopaminergic medications, cerebrovascular disease, major depressive disorder, stimulant use, end stage renal disease, iron deficiency, and HIV associated neurocognitive disorders. Proposed mechanisms included dopaminergic dysregulation, neuroinflammation, cognitive impairment, and misinterpretation of abnormal sensory stimuli. Improvement or resolution was frequently reported after treatment of the underlying condition, discontinuation of causative medications or substances, and use of antipsychotic therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Delusional infestation may represent a manifestation of an underlying and potentially reversible medical condition, supporting comprehensive evaluation and individualized, multidisciplinary management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"7 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.70098","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149146975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary Modulation of Melanogenesis and Inflammation in Post-Inflammatory Hyperpigmentation: A Narrative Review","authors":"Leah Cliatt,&nbsp;Valerie Foy","doi":"10.1002/der2.70099","DOIUrl":"https://doi.org/10.1002/der2.70099","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Post-inflammatory hyperpigmentation (PIH) is a common acquired disorder that disproportionately affects Fitzpatrick skin types III-VI. Current treatment options include topical depigmenting agents, oral tranexamic acid, and laser treatments, which often have variable and incomplete results. This review examines dietary factors such as antioxidants found in vitamins C, D, and E, polyphenols including epigallocatechin gallate (EGCG), and omega-3 fatty acids that may modulate inflammatory signaling, melanogenic pathways, and oxidative stress, including emerging evidence from the gut-skin axis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A narrative literature review was conducted in April 2026 using PubMed, EMBASE, and Google Scholar. The initial search yielded 593 articles, after screening 104 underwent full-text review, and 54 were included. Related pigmentary disorders were included when relevant to melanogenesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The advanced glycation end-products/receptor for advanced glycation end-products (AGE/RAGE) and interleukin-18 (IL-18) axis provides evidence linking metabolic dysfunction to melanogenesis. Dietary antioxidants have been shown to modulate tyrosinase and reactive oxygen species (ROS)-mediated pigment production, while EGCG demonstrates both antimelanogenic and gut barrier effects. Omega-3 fatty acids reduce inflammatory cytokines and promote tyrosinase degradation in preclinical models. Emerging evidence from the gut-skin axis suggests that gut dysbiosis may influence cutaneous inflammation through shared immune and metabolic pathways.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although direct clinical evidence remains limited for dietary intervention in PIH and bioavailability gaps are another challenge, dietary modification may serve as an adjunct to standard therapies and warrants additional investigation through prospective clinical trials.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"7 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.70099","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149146941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nucleotide-Based Skin Boosters in Aesthetic Dermatology: A Scoping Review of Their Potential Role","authors":"Shreeya Nayak,&nbsp;V. Guhaneshram,&nbsp;Rachel Sharon Dias,&nbsp;Neha Akhoon,&nbsp;Abdul Mannan Faruk Ahmed,&nbsp;Sohil Khan,&nbsp;Mohammed Salim Karattuthodi,&nbsp;Aseem Sharma","doi":"10.1002/der2.70080","DOIUrl":"https://doi.org/10.1002/der2.70080","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Polydeoxyribonucleotides (PDRN) and polynucleotides (PN), the two skin boosters, have become increasingly popular in aesthetic dermatology recent years due to their extraordinary rejuvenating properties and biocompatibility. Their ability to enhance skin hydration, elasticity, and texture, as well as to improve overall skin parameters, has led to a strong clinical interest. However, the safety and efficacy of PDRN and PN are not well endorsed by the available data, despite their increasing use in the clinical setting.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This scoping review aimed to assess the safety and efficacy of PDRN and PN boosters by systematically charting available data on their use to improve facial skin quality and clinical outcomes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The review followed the methodological framework of Arksey and O'Malley. Databases including PubMed, Scopus, and Embase were systematically searched and filtered to assess the safety and efficacy of PDRN and PN boosters in clinical settings. A total of six articles were finalised and included.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Six studies were included. The available evidence highlighted PN or PN-HPT prevalence while one study that used PDRN skin booster for facial hyperpigmentation. PN/PN-HPT interventions showcased improvements in selected skin quality parameters PN can improve skin parameters, including hydration, elasticity, firmness, texture, hyperpigmentation, acne scars, and wrinkles. PDRN improved the status in hyperpigmentation through anti-melanogenesis activity. Various administration methods including intradermal injections, microneedling, and topical applications, demonstrated consistent, statistically significant improvement in the patients. Positive patient satisfaction scores through questionnaires and scales were reported. The safety profile was favourable, with only mild, transient side effects such as erythema, oedema, and minor injection-site pain were identified in the studies. No serious adverse events were noted, and the treatments were well tolerated alone or in combination.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;PN skin boosters enhances various skin quality parameters while being well-tolerated with no serious side effects. The clinical relevance of PDRN skin boosters remain limited in enhancing the aesthetic outcomes of the skin. Despite these promising outcomes, there is a need to establish their long-term safety and efficacy through studies involving larger populatio","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"7 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.70080","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149048329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Pigment Loss: Integrating Clinician-Reported Outcomes, Patient-Reported Outcomes, and Digital Biometrics to Quantify Vitiligo Morbidity","authors":"Shrruthi Velavan,&nbsp;Vishal Gupta","doi":"10.1002/der2.70094","DOIUrl":"https://doi.org/10.1002/der2.70094","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Vitiligo is an autoimmune depigmenting disease with multiple facets to disease severity. Accurate assessment of severity and therapeutic response is essential for both clinical care and research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This narrative review summarizes outcome measures for assessing different aspects of vitiligo severity, including extent, activity, treatment response, prognosis, and quality-of-life impact.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Several clinician-reported outcome measures (ClinROMs) and patient-reported outcome measures (PROMs) are available to assess different aspects of vitiligo severity. The Vitiligo Area Scoring Index (VASI) and Vitiligo Extent Score (VES) are commonly used ClinROMs for disease extent, with accepted treatment success thresholds for VASI. While the patient-reported Vitiligo Disease Activity Index (VIDA) has been traditionally used to assess activity, the Vitiligo Signs of Activity Score (VSAS) is a recently developed physician-reported measure of clinical markers of activity. The Vitiligo Disease Activity Score (VDAS) /Vitiligo Disease Improvement Score (VDIS) monitors global disease evolution, while the Vitiligo Extent Score for a Target Area (VESTA) and Vitiligo Noticeability Scale (VNS) evaluate a single patch. Psychosocial impact of vitiligo can be estimated using general dermatology or vitiligo-specific instruments (Vitiligo Impact Scale-22 [VIS-22], VitiQoL, Vitiligo Impact Patient Scale [VIPs]. Digital imaging and artificial intelligence models are being developed to aid diagnosis as well as offer objective assessment of vitiligo type, extent, and activity, but require further validation before widespread adoption.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Integrating ClinROMs, PROMs, and digital biometric tools will enable a more holistic and precise evaluation of vitiligo in clinical practice and therapeutic trials.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"7 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.70094","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148878410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nano Fat Grafting in Facial Rejuvenation: A Regenerative Approach Beyond Conventional Skin Boosters","authors":"Aamod Rao,&nbsp;Ankit Bhupatkar","doi":"10.1002/der2.70081","DOIUrl":"https://doi.org/10.1002/der2.70081","url":null,"abstract":"<div>\u0000 \u0000 <p>Facial rejuvenation has progressively shifted from volumetric correction toward biologically driven regenerative therapies. Autologous fat grafting has gained prominence due to its ability to restore both volume and tissue quality. Among its various forms, nano fat grafting has emerged as a purely regenerative technique, characterized by a high concentration of stromal vascular fraction and adipose-derived stem cells with minimal viable adipocytes. This article review discusses the biological basis, preparation techniques, clinical indications, and outcomes of nano fat grafting in facial rejuvenation. A comparison has been done between nano Fat grafting and injectable, hyaluronic, skin, boosters, and also emphasis has been taken on the importance of optimal donor [1–4].</p>\u0000 </div>","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"7 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.70081","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148878403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deoxycholic Acid Injection for Submental Fullness: An Anatomy-Based Narrative Review With Considerations for Off-Label Lower-Face Use","authors":"Chuan-Yuan Lin,&nbsp;Jui-Yu Lin","doi":"10.1002/der2.70095","DOIUrl":"https://doi.org/10.1002/der2.70095","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Deoxycholic acid (DCA) injection is an established minimally invasive treatment for localized submental fat (SMF) reduction. Although clinical trials and systematic reviews support its efficacy, submental fullness is anatomically heterogeneous and may not always represent targetable fat.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This narrative review summarizes evidence on DCA injection, emphasizing anatomy-based patient selection and safety planning for submental treatment and cautious off-label use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This structured narrative review was guided by the Scale for the Assessment of Narrative Review Articles. PubMed/MEDLINE was searched in August 2026 for evidence on DCA efficacy, mechanism, anatomy, imaging, injection technique, safety, and non-submental applications. Relevant reference lists were also examined. The literature was organized by mechanism, clinical evidence, anatomy, imaging, patient selection, off-label applications, and safety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>DCA produces adipocyte membrane disruption followed by inflammatory clearance and tissue remodeling. The strongest evidence supports SMF reduction in patients with localized superficial subcutaneous fat, particularly preplatysmal fat. Similar fullness may result from deep fat, laxity, platysmal banding, glandular or muscular prominence, soft-tissue ptosis, skeletal deficiency, or regional atrophy; these contributors require different strategies. High-frequency ultrasound may assist when clinical examination does not clearly identify the dominant contributor or intended tissue plane, but it is an adjunct rather than a stand-alone test of candidacy or safety. Evidence for non-submental applications remains limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>DCA should be regarded as an anatomy-dependent adipocytolytic procedure rather than a general “fat-dissolving” injection. Careful selection, precise placement, and realistic counseling may improve outcomes, reduce avoidable complications, and support cautious, individualized off-label use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"7 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.70095","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148878409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dermatologic and Aesthetic Implications of GLP-1 Receptor Agonist-Associated Weight Loss: Pathophysiology, Clinical Manifestations, and Management","authors":"Douglas Jaxon Vadner,&nbsp;Angela N. Brown,&nbsp;Michael H. Gold","doi":"10.1002/der2.70092","DOIUrl":"https://doi.org/10.1002/der2.70092","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have rapidly expanded in use for the management of type 2 diabetes and obesity, with growing adoption in cosmetically motivated populations. In parallel, clinicians are increasingly encountering patients with aesthetic concerns related to GLP-1RA-associated weight loss.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To review the aesthetic complications associated with GLP-1RA therapy, examine underlying pathophysiologic mechanisms, and provide practical considerations for dermatologic and aesthetic management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A narrative review of the literature was conducted, synthesizing clinical studies, body composition analyses, dermatologic reports, and aesthetic medicine literature addressing GLP-1RA-associated changes in facial volume, skin quality, and hair, as well as procedural considerations and management strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>GLP-1RA-associated weight loss is characterized by rapid adipose reduction, which may outpace dermal and connective tissue adaptation. This temporal mismatch contributes to facial volume loss, skin laxity, and changes in skin texture and hydration, often perceived as accelerated aging. Additional findings include hair shedding consistent with telogen effluvium and evolving body contour changes. These alterations occur within a dynamic soft-tissue environment, complicating aesthetic intervention. Implications extend to neuromodulators, dermal fillers, energy-based devices, and surgical planning, where treatment timing and modality selection are critical.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>GLP-1RA-associated aesthetic changes represent a distinct and increasingly relevant clinical entity. Recognition of the underlying structural and physiologic mechanisms, combined with a staged and individualized approach to treatment, is essential to optimize outcomes and avoid overtreatment. Further prospective, GLP-1RA-specific research is needed to guide evidence-based management in this evolving field.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"7 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.70092","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148784490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sunlight in Small Doses: Balancing Health Benefits and Dermatologic Risks","authors":"Kristina Mueller,&nbsp;Valerie Foy","doi":"10.1002/der2.70090","DOIUrl":"https://doi.org/10.1002/der2.70090","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sunlight exposure presents a dual challenge in dermatology: it is the primary modifiable risk factor for skin cancer, yet it provides essential systemic health benefits, including vitamin D synthesis and potential mental health advantages. Controlled “microdosing” of sunlight may help balance these risks and benefits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This review highlights the physical and mental health benefits of limited sun exposure and evaluates practical frameworks for safe, personalized sun exposure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A narrative review was conducted examining sub-erythemal ultraviolet-B (UVB) doses required for maintaining endogenous vitamin D levels. Key frameworks analyzed include the ¼ minimum erythema dose (MED) rule and the standardized erythema dose (SED) approach based on the UV Index (UVI). Factors influencing safe exposure (skin type, season, geographic location, and prior skin disease history) were considered.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sub-erythemal UVB doses vary significantly by individual and environmental factors. The ¼ MED rule offers a practical estimate but remains influenced by personal variability and conditions. The SED/UVI-based method provides a more standardized alternative, independent of many patient-specific variables. The combined use of the MED and SED frameworks supports individualized sun exposure guidance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>MED and SED-based approaches together offer a balanced framework for personalized sun exposure that minimizes skin cancer risk while preserving systemic health benefits. These strategies can guide public health recommendations and clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100366,"journal":{"name":"Dermatological Reviews","volume":"7 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/der2.70090","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148784157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}