Journal of Clinical and Aesthetic Dermatology最新文献

{"title":"Achievement of Optimal Treatment Targets with Oral Janus Kinase Inhibition in Elderly Patients with Atopic Dermatitis: A Real-world, Multicenter, Retrospective Study.","authors":"Diego Ruiz Dasilva, Noelle Desir, Iain Noel Encarnacion, Naiem Issa, E James Song, Nicholas K Mollanazar","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Oral Janus kinase inhibitors (JAKi) have demonstrated high levels of efficacy with acceptable safety in patients with atopic dermatitis (AD), yet there remains significant hesitancy among the dermatologic community to use JAKi in elderly populations due to the potential increased risk of serious adverse events in this population. We aimed to perform a retrospective review to describe real-world outcomes for the use of selective JAK-1 inhibitors in patients with AD aged 65 years or older.</p><p><strong>Methods: </strong>We conducted a multicenter retrospective review. AD cases were identified by ICD-10-CM codes L20.8/L20.89/L20.9. Patients aged 65 years or older years treated with a selective JAK-1 inhibitor were included. Body surface area (BSA), Investigator Global Assessment (IGA), and Peak Pruritus Numerical Rating Scale (NRS) were collected and evaluated independently.</p><p><strong>Results: </strong>Thirty-eight AD cases in patients aged 65 years or older treated with a selective JAK-1 inhibitor were identified. Patients were aged 65 to 96 years, and treatment duration ranged from 4 to 28 months. Thirty-six out of 38 patients (94.7%) tolerated treatment well; one was switched to another JAKi due to mood lability and another paused therapy during hospitalization for septic pneumonia. Thirty-five out of 37 (94.6%) patients achieved an IGA of 0/1, 28/30 (93.3%) achieved an NRS of 0/1, and 30/30 (100%) had a peak pruritus response with improvement of ≥4 points on NRS. There were no clinically meaningful laboratory abnormalities throughout the treatment course. No laboratory abnormality resulted in treatment discontinuation.</p><p><strong>Limitations: </strong>Limitations of this retrospective review include selection bias and missing data.</p><p><strong>Conclusion: </strong>We demonstrate the ability to achieve optimal treatment targets and safety of selective JAKi-1 inhibitors in elderly patients with AD.</p>","PeriodicalId":53616,"journal":{"name":"Journal of Clinical and Aesthetic Dermatology","volume":"18 2","pages":"25-29"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617841","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":"Investigating Efficacy of Atopic Dermatitis Systemic Therapeutics After Discontinuation Part I: Biologics.","authors":"Naiem T Issa, Rama Abdin, Kabir Al-Tariq, Dana Jaalouk, Michael Kaiser, James Del Rosso, Shawn Kwatra","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>The authors sought to review published literature on the efficacy of biologics as monotherapy for atopic dermatitis (AD) following discontinuation.</p><p><strong>Methods: </strong>A comprehensive search of PubMed/MEDLINE was conducted examining drug withdrawal in AD clinical trials where participants were treated with biologics. Trials were included if they exclusively involved participants with AD that reported the maintenance or achievement of Eczema Area and Severity Index (EASI)-75 and Investigator Global Assessment (IGA) scores of 0 or 1 after withdrawal of biologic therapy. Clinical trials involving multidrug regimens, including those investigating concomitant topical therapeutics, were excluded from our analysis.</p><p><strong>Results: </strong>Five clinical trial programs met our inclusion criteria, each investigating a different biologic: dupilumab, tralokinumab, lebrikizumab, amlitelimab, and rocatinlimab.</p><p><strong>Limitations: </strong>Limitations to this review include a small number of trials that met the inclusion criteria, variations in study design that hinder direct comparisons, and the absence of long-term follow up data.</p><p><strong>Conclusion: </strong>The variability in eligibility criteria, treatment durations, and withdrawal periods across trials presents a major challenge in assessing biologics for AD, complicating the comparison of their sustained responses in the absence of head-to-head studies. This heterogeneity, combined with factors such as disease duration and prior use of systemic medications before trial enrollment, hampers the identification of key pathways in AD pathogenesis and impedes efforts to better understand and characterize the disease.</p>","PeriodicalId":53616,"journal":{"name":"Journal of Clinical and Aesthetic Dermatology","volume":"18 2","pages":"33-37"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617846","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":"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.","authors":"Suparuj Lueangarun, Nutthawut Techalert, Therdpong Tempark","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>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).</p><p><strong>Objective: </strong>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).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":53616,"journal":{"name":"Journal of Clinical and Aesthetic Dermatology","volume":"18 2","pages":"38-43"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617842","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":"Environmental Impact and Sustainability Associated with the Practice of Dermatology.","authors":"Robert J Vanaria, Vishnu Bhupalam, Angelica Marrero-Perez, Aysham Chaudry, Nardin Awad, Mark Nestor","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":53616,"journal":{"name":"Journal of Clinical and Aesthetic Dermatology","volume":"18 2","pages":"50-55"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617843","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":"Successful Treatment of Recalcitrant Melasma with Picolaser and Isobionicamide-Cysteamine Combination.","authors":"Corey L Hartman, Michaela Crawford, Cheri Frey, Rawn Bosley, Riccardo Sfriso, Laure Dirlewanger, Behrooz Kasraee","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":53616,"journal":{"name":"Journal of Clinical and Aesthetic Dermatology","volume":"18 2","pages":"30-32"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617849","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":"He Who Wills the End Wills the Means: An Overview of Trusts for Physicians.","authors":"Clay Cockerell, Justine Galambus","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Even though physicians often have the access and ability to generate significant wealth, many report poor financial literacy and education. They may not fully understand the options available to them for passing on their wealth to their next of kin. Options include wills, trusts, or, if one dies without a will, simply following the states intestate succession laws. There are multiple types of trusts that each confer different benefits and drawbacks. Physicians in all stages of their career should be aware of these options and strongly consider working with an estate planning attorney and financial planner.</p>","PeriodicalId":53616,"journal":{"name":"Journal of Clinical and Aesthetic Dermatology","volume":"18 2","pages":"23-24"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617845","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":"Reversing Glycation with a Dietary Supplement Containing Rosemary Extract.","authors":"Zoe Draelos, Vivian Bucay, Jacqueline Watchmaker, Giuseppe Valacchi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Limitations: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":53616,"journal":{"name":"Journal of Clinical and Aesthetic Dermatology","volume":"18 2","pages":"44-49"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617847","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":"Skin 101: Understanding the Fundamentals of Skin Barrier Physiology-Why is This Important for Clinicians?","authors":"James Q Del Rosso, Leon Kircik","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article reviews epidermal barrier dysfunctions and more thoroughly discusses the stratum corneum (SC) permeability barrier, physiologic self-repair mechanisms in healthy skin, and the clinical and structural effects of an overstressed SC permeability barrier. Discussion includes epidermal barrier impairments induced by both exogenous exposures and endogenous factors such as specific dermatologic disorders. Due the plethora of skin care products on the market and the variability of their contents and vehicle formulations, this article addresses core concepts required to optimize skin care product selection, including for specific disease states such as atopic dermatitis, psoriasis, acne vulgaris, and rosacea. To summarize, the selection of skin care products is directed at maintaining SC hydration, including assisting the SC in self-repair when conditions are adverse. This approach optimizes the ability to sustain healthy skin structure, function and appearance.</p>","PeriodicalId":53616,"journal":{"name":"Journal of Clinical and Aesthetic Dermatology","volume":"18 2","pages":"7-15"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617848","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":"The Efficacy of Complementary and Alternative Medicines in Medical Dermatology: A Comprehensive Review.","authors":"Promise Ufomadu, Bartley Joseph Gill, Ida Orengo, Theodore Rosen, Ikue Shimizu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>In recent years, there has been a widespread patient use of complementary and alternative medicines (CAMs) for dermatological application, despite few RCT-level studies on these supplements. This creates a barrier for dermatologists and others in counseling patients who may be using or might be tempted to use these CAM agents. This review investigates various CAM modalities used by patients for medical dermatology, exploring their efficacy and toxicity profiles.</p><p><strong>Methods: </strong>A comprehensive review was performed on the effectiveness of several CAMs utilized in medical dermatology by patients. A literature search was conducted using PubMed, Embase, Google Scholar, Web of Science, and Cochrane.</p><p><strong>Results: </strong>Most CAM modalities had statistically insignificant results, and for agents that had significant results in efficacy, these studies were questionable with flawed designs and methodologies.</p><p><strong>Conclusion: </strong>These CAM supplements have promising potential in dermatologic use and are deserving of further investigation in well-crafted RCT-level studies. A more practical focus in future studies should involve a comparison of CAM agents to conventional therapies either alone or in an integrative fashion. This would accurately represent how these agents will be used clinically by actual patients and will be more helpful to clinicians. In the meantime, dermatologists should be aware of bias in published studies demonstrating the effectiveness of certain CAM modalities, and their corresponding toxicity. By doing so, physicians act as a valuable resource to patients who would like to explore various CAM products, better guiding patient interactions and treatment with improved patient outcomes.</p>","PeriodicalId":53616,"journal":{"name":"Journal of Clinical and Aesthetic Dermatology","volume":"18 2","pages":"E61-E79"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617851","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":"Sunscreen Coverage as Preventive Care Under the Affordable Care Act: A Low-Cost Way to Reduce the Prevalence of the Most Common Cancer.","authors":"Kylie A Fletcher, Eva Rawlings Parker, Brian C Drolet","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":53616,"journal":{"name":"Journal of Clinical and Aesthetic Dermatology","volume":"18 2","pages":"56-59"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617850","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}