Does low-dose oral minoxidil improve short anagen syndrome?
Authors of a research letter published in JAAD evaluated the efficacy of low-dose oral minoxidil (LDOM) for the treatment of short anagen syndrome. Treatment with LDOM was initiated in individuals who experienced either an unsatisfactory response to topical minoxidil or substantial psychosocial distress due to their short anagen syndrome.
The study included 10 female patients ranging in age from five to 27 years. LDOM was initiated at a mean daily dose of 0.4 mg and titrated based on response and tolerability. The mean final daily dose was 0.9 mg and the mean treatment duration was 24.9 months. Hair length improved in seven patients and global hair density improved in seven patients. A subjective reduction in hair shedding was reported by seven patients. All patients who experienced an unsatisfactory response to topical 5% minoxidil responded positively to LDOM.
DermWorld Insights and Inquiries: Weighing in on glucagon-like peptide-1 receptor agonists in dermatology
Glucagon-like peptide-1 (GLP-1) receptor agonists — your patients are on them, and perhaps you are too (or at least have thought about it). In 2023, more than 500 million people worldwide were afflicted with obesity and type 2 diabetes mellitus. According to Sabina and Alsamman, GLP-1 receptor agonists (GLP1RA) offer a beacon of hope for these patients. GLP1RA promotes delayed gastric emptying; the drugs also increase insulin secretion while inhibiting glucagon release, but only when glucose levels are elevated via the incretin effect, thus reducing the likelihood of hypoglycemia. GLP-1 receptor agonists are now approved for weight loss, which may benefit dermatoses associated with excess weight. Dermatologists should be familiar with the potential adverse effects and benefits of these drugs. Keep reading!
The CDC issued statements last week about patients with botulism-like symptoms after being injected with counterfeit botulinum toxin. As of April 12, 2024, a total of 19 people from 9 states have reported harmful reactions after receiving botulinum toxin injections from unlicensed or untrained individuals or in non-healthcare settings, such as homes and spas. States reporting these reactions include Colorado, Florida, Illinois, Kentucky, Nebraska, New Jersey, New York, Tennessee, and Washington.
When the first news reports appeared, the Academy quickly issued a statement from President Seemal R. Desai, MD, FAAD, emphasizing the expertise of dermatologists in this area. “Dermatologists pioneered the use of Botox to relax wrinkles and to address conditions such as hyperhidrosis, and they have a long track record of safety and effectiveness. Botox injections are a medical procedure and should only be performed in a medical office by board-certified dermatologists or an appropriately trained non-physician clinician, under the direct on-site supervision of a board-certified dermatologist.”
The statement urged caution among patients: “Patient safety is the top priority for the Academy and its member dermatologists, who have the most extensive medical training to avoid complications and provide patients with the best outcomes. The Academy cautions patients about the safety risks of seeking cosmetic treatments and encourages them to carefully consider the expertise of those providing care and the environment where that care is administered.”
The AAD also posted an Instagram reel from Your Dermatologist Knows Social Media Correspondent Ronda Farah, MD, FAAD, offering the Academy’s @AADSkin1 audience of nearly 100,000 followers similar warnings.
Evaluating SCC: Reflectance confocal microscopy and optical coherence tomography
A prospective study published in JAAD enrolled consecutive patients with AK, squamous cell carcinoma in situ (SCCIS), and invasive SCC from September 2020 and December 2020. There were 44 lesions imaged using combined reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) from 37 patients.
Twenty-three lesions were referred for biopsy of SCC, and 21 lesions were confirmed SCC or SCCIS and were referred for Mohs surgery. RCM-OCT had a sensitivity of 87.5% for the detection of invasive SCC and a specificity of 92.9%. Negative predictive value was 92.9% and positive predictive value was 87.5%. For the detection of SCCIS/AK, RCM-OCT had a sensitivity of 88.2% and a specificity of 100%. Negative predictive value was 93.1% and a positive predictive value was 100%. The authors conclude that combined RCT-OCT can help in the diagnosis of SCC and aid in the differentiation between invasive SCC vs. SCCIS or AK in clinically suspected lesions.
A tool to improve communication with patients with hidradenitis suppurativa
Authors of an article published in the Journal of Drugs in Dermatology embarked on a quality improvement project to modify an existing questionnaire to better suit the needs of hidradenitis suppurativa (HS) patients. Patients with HS presenting at Mount Sinai Union Square were invited to complete the Shine a Light on HS as Modified by the IDEOM HS Workgroup Questionnaire before their appointments.
[Experts discuss the benefits of personalized treatment plans for patients with hidradenitis suppurativa. Read more.]
Most patients found the questionnaire helpful for their clinic visit, and survey helpfulness was found to be positively correlated with their overall clinical experience. The patients reported significant morbidity, including pain and emotional burden, across various life domains. The common comorbidities reported included heart disease, arthritis, polycystic ovarian syndrome, diabetes, and irritable bowel disease. The authors conclude that integrating this questionnaire into routine visits can aid discussion and enhance health outcomes among patients with HS.
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