Dutasteride microinjections with oral minoxidil vs. oral minoxidil for androgenetic alopecia
A study published in the Journal of the European Academy of Dermatology and Venereology explored the effectiveness and safety of dutasteride intralesional microinjections (DIM) in combination with oral minoxidil compared with oral minoxidil monotherapy in men with androgenetic alopecia. In this retrospective single-center study, male patients were treated with oral minoxidil 1-5 mg daily alone or in combination with DIM. Observed side effects were related to oral minoxidil in both groups, and no sexual dysfunction was reported in any participant.
Combination therapy of oral minoxidil with the intralesional dutasteride led to significantly greater improvement at the vertex compared with the outcomes of the oral minoxidil monotherapy. While more research is needed, the authors said that treatment efficacy and relief from risk of sexual dysfunction may provide an alternative therapeutic option for men.
Find out what research has revealed about the pathogenesis of androgenetic alopecia, alopecia areata, and CCCA as well as new potential therapeutics inDermWorld.
DermWorld Insights and Inquiries: Infantile digital fibromatosis – Inclusions and exclusions
In 1965, Reye described 18 small, fibrous tumors from 12 children submitted to his laboratory for histological examination, that he had accumulated over two decades. Initially, these lesions were tentatively classified as well-differentiated fibrosarcomas. His seminal observation was: “The feature which sets these tumors apart from all other fibrous tumors at the histological level is the presence, within the cell cytoplasm, of inclusion bodies.” He titled his manuscript, “Recurring digital fibrous tumors of childhood.”
Now known as infantile digital fibromatosis (IDF), the disorder is also known as a Reye tumor, recurring digital fibrous tumor of childhood, and inclusion body fibromatosis. IDF is a rare, benign, spontaneously regressing, fibrous tissue tumor of infancy and childhood that characteristically appears in the first year of life; it is congenital in one-third of cases. IDF tends to be locally recurrent without bony invasion or metastasis. Single or multiple, firm reddish-pink slowly growing nodules, about 2 cm in size are present on the extensor aspects of the phalanges of the last four fingers or toes, sparing the thumb and great toe. (Why thumb and great toes are spared still defies explanation.) The natural history of IDF is characterized by slow growth in the lesions’ first month, followed by rapid growth in the ensuing 10 to 14 months, before the lesions steadily regress. Should lesions be extensive or cross joints, they may result in limited joint mobility and digital deformity. Keep reading!
CMS outlines payment changes for 2023 in proposed fee schedule
On July 7, CMS released its proposed rule for the CY 2023 Medicare Physician Fee Schedule (PFS) and the Quality Payment Program (QPP), which includes important proposed policy changes to fee-for-service payments. The proposed 2023 Medicare conversion factor would be reduced by almost 4.5% from $34.6062 to $33.0775, and more cuts due to PAYGO budget rules are possible. Learn more about these potential cuts, what the AADA is doing about them, and how you can take action.
FDA approves roflumilast for treatment of plaque psoriasis for patients 12 and older
Last week, the FDA approved roflumilast cream 0.3% (Zoryve™) for the treatment of plaque psoriasis, including intertriginous areas in individuals aged 12 and older. Roflumilast, the first and only PDE-4 inhibitor approved for the treatment of plaque psoriasis, is a once-daily, steroid-free cream approved to treat varying degrees of plaque psoriasis, including mild, moderate, and severe, with no limitations on the duration of use.
[Experts break down emerging psoriasis treatment options and what they can offer patients and physicians. Read more in DermWorld.]
The approval is based on data from the pivotal DERMIS-1 and DERMIS-2 phase 3 studies. Roflumilast cream improved the severity and impact of itch as early as week two, and two-thirds of patients with a Worst Itch-Numerical Rating Score (WI-NRS) of 4 or higher at baseline achieved more than a 4-point reduction in itch at week eight. A few common adverse events include diarrhea, headache, insomnia, nausea, application site pain, upper respiratory tract infection, and urinary tract infection.
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Treating patients with skin-picking disorder
In a study published in TheJournal of Dermatology, 279 patients with body-focused repetitive behaviors (BFRB) were randomly assigned to receive either treatment with a self-help manual focused on habit-reversal training and decoupling techniques or a control group. Participants could endorse multiple disorders: skin picking 68%, trichotillomania 28%, nail biting 52%, lip-cheek biting 53%.
At six weeks, patients in the experimental group reported significant improvement in BFRBs, improved quality of life, and lower depression scores. The rate of patient satisfaction was high, although the noncompletion rate was 39%.
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