Is there an association between isotretinoin and adverse neuropsychiatric outcomes?
A cohort study published in the British Journal of Dermatologycompared the incidence of neuropsychiatric outcomes in acne patients treated with and without isotretinoin. Patients with acne had greater odds of adverse neuropsychiatric outcomes compared with those without.
In acne patients, isotretinoin exposure was associated with a lower risk of neuropsychiatric outcomes compared with acne patients who were not prescribed anti-acne medication (odds ratio, 1.06), those with topical anti-acne medications (odds ratio, 0.94), and those on oral antibiotics (odds ratio, 0.80). The study showed that isotretinoin therapy may reduce the risks of neuropsychiatric risks associated with moderate-to-severe acne.
DermWorld Insights and Inquiries: Early recognition of rituximab-induced late onset neutropenia is essential
Rituximab is an anti-CD20 chimeric antibody directed against a surface transmembrane protein marker (CD20) expressed on B-cells during differentiation from pre-B-cell until the plasma cell stage, involved in the maturation and activation of B cells. Approved in 1998, rituximab’s off-label use has been expanding beyond its other FDA-approved indications (CD-20 positive B-cell non-Hodgkin lymphoma, chronic lymphocytic leukemia, rheumatoid arthritis, microscopic polyangiitis, and granulomatosis with polyangiitis). The list of off-label uses of rituximab continues to increase exponentially; from a dermatologic perspective, its use in bullous pemphigoid, dermatomyositis, systemic lupus erythematosus, and refractory graft-versus-host disease are just a few examples where the drug may be impactful.
Rituximab’s well-recognized adverse events include infusion reactions, lymphopenia, hepatitis B virus reactivation, and progressive multifocal leukoencephalopathy. Early-onset neutropenia is extremely rare, with only a handful of cases reported to date. Rituximab-induced late-onset neutropenia (R-LON), although underrecognized, has been increasingly reported. Keep reading!
Treating seborrheic keratosis with hydrogen peroxide
A study published in the International Journal of Dermatology, evaluated the efficacy of 30% hydrogen peroxide to treat 51 seborrheic keratoses (SK) in five patients. A toothpick was used to apply hydrogen peroxide to lesions for 20 seconds (each session included four applications per lesion). About half of the lesions cleared completely after a single session, while 41% showed near-complete clearance. In half of the lesions, repeat application was performed at two weeks. Patients reported complete satisfaction with 67% of treated lesions and adequate satisfaction with 22%.
IL-17 blockade reduces psoriatic lesional expression of COVID-19 receptor
In a research letter published inJAAD, the authors note that treatment with an anti-IL-17 antibody may reduce the risk of COVID-19 in psoriatic patients by downregulating ACE2 expression (main viral host receptor in the epidermis of lesional skin) in affected skin and that perhaps psoriatic patients who become infected with COVID-19 may benefit from IL-17−targeted treatment.
[What’s coming down the psoriasis pipeline? Find out inDermWorld.]
The researchers reviewed data from samples of normal skin, psoriatic nonlesional skin, and lesional skin at baseline. Samples were also obtained from lesional skin after treatment with placebo, brodalumab, secukinumab, etanercept, ustekinumab, tofacitinib, and other therapies. Only the IL-17 receptor A subunit inhibitor (brodalumab) and anti-IL-17A monoclonal antibodies (secukinumab and LY2439821) remarkably reduced ACE2 expression in psoriatic skin. Dose-dependent ACE2 expression was observed in the brodalumab groups.
Can COVID-19 be transmitted through the skin? Learn more inDermWorld Weekly.
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