April 22, 2026
IN THIS ISSUE / April 22, 2026
Spironolactone and oral minoxidil in women with alopecia
A study published in JAAD evaluated the tolerability and safety of the combination of spironolactone and oral minoxidil in women at least 18 years old with hair loss. The most common comorbidity was hypertension (19%). Adverse effects were reported by more than one-third (37.7%) of patients. The most common adverse effects included hypertrichosis in 12.3% of patients and dizziness/lightheadedness/orthostasis in 12%. During treatment, most patients (62.5%) increased their spironolactone dose. Discontinuation of spironolactone was seen in 17.6% of patients, with discontinuation due to adverse effects in 26.3% of cases. Most patients (64.1%) increased their LDOM dose, with 15.5% who discontinued the medication, of which 37.3% was due to adverse effects. The mean dose was 87.6 mg for spironolactone and 1.8 mg for LDOM at the time of adverse effects.
[Shedding light on treatments for female pattern hair loss. Read more.]
Hypertrichosis risk was reduced by 64.8% with simultaneous initiation of spironolactone and LDOM. Initiation of combination therapy significantly reduced the risk of hypertrichosis and did not significantly increase the risk of adverse drug effects related to blood pressure changes, the researchers concluded.
Spironolactone for alopecia: Blood pressure changes. Read more.
DermWorld What’s Hot: Nicotinamide and nonmelanoma skin cancer
The chemopreventive role of nicotinamide, a vitamin B3 derivative available over the counter, was first established in the ONTRAC trial published in The New England Journal of Medicine in 2015. This randomized controlled trial demonstrated that nicotinamide 500 mg twice daily reduced the incidence of nonmelanoma skin cancer (NMSC) by 23% in immunocompetent patients with a history of at least two prior NMSCs. Although nicotinamide is now widely recommended by dermatologists for skin cancer prevention, the optimal timing of initiation has remained unclear until recently. Read more from Ashley Decker, MD, FAAD.
Infliximab dosing intervals for hidradenitis suppurativa
A Brief Report published in JAAD explored whether shorter dosing intervals of infliximab (IFX) may offer superior disease control. The study included 27 patients diagnosed with hidradenitis suppurativa (HS) who received IFX at three-week intervals. Most of the patients were Hurley stage III. IFX dosing included 7.5 mg/kg (3.7%), 10 mg/kg (51.9%), and 12.5 mg/kg (44.4%).
[HS experts discuss the latest therapeutic, procedural updates to optimize disease management. Read more.]
After increasing infusion frequency from every four to three weeks, the mean HS-Physician Global Assessment scores decreased from 3.59 to 2.70. Two-thirds of patients reported moderate or major improvement with increased dose frequency.
Read the JAAD HS supplement and take the course (11 CME credits).
Weekly vs. daily bathing for people with atopic dermatitis
A study published in the British Journal of Dermatology assessed the impact of weekly vs. daily bathing in people with atopic dermatitis for four weeks.
[Read the AAD’s first guidelines specific to the management of pediatric atopic dermatitis. Get the highlights.]
The primary analysis included 195 participants allocated to daily bathing (bath or shower at least six times weekly) and 193 to weekly bathing (bath or shower once or twice weekly) who completed at least one follow-up questionnaire. The authors noted that there was no evidence of a difference in atopic dermatitis symptoms between bathing or showering weekly vs. daily.
Take the AAD’s online guidelines course: Phototherapy and Systemic Therapies for Atopic Dermatitis in Adults.
Does immunosuppression impact cSCC outcomes?
An article published in JAAD explored whether immunosuppression independently predicts poor outcomes in cutaneous squamous cell carcinoma (cSCC). A total of 11,930 patients with 18,760 tumors (14,766 in immunocompetent and 3,994 in immunosuppressed) were included.
Immunosuppressed patients had a higher prevalence of high-risk tumor features and poor disease outcomes. Immunosuppression was independently associated with local recurrence (LR), distant metastasis, disease-specific death (DSD), and major poor outcomes. Organ transplantation was predictive of LR, distant metastasis, and DSD, whereas chronic lymphocytic leukemia independently predicted LR, DSD, and major poor outcomes.
2026 MIPS Value Pathways registration now open
Registration for 2026 MIPS Value Pathways (MVPs) is now open. Individuals, groups, subgroups, and APM entities may register to participate using the CMS QPP website through Nov. 30, 2026. Visit the CMS MVPs page and download the 2026 Finalized MVPs Guide to learn more.
Get answers to your questions about the Dermatological Care MVP in the Academy’s 2026 MIPS Reporting Guide.
