Minoxidil, finasteride, dutasteride monotherapy for male pattern hair loss
Authors of a study published in the Journal of Cosmetic Dermatology determined the relative effect of various dosages and administrative routes of minoxidil, finasteride, and dutasteride. Included studies investigated monotherapy with minoxidil, finasteride, and dutasteride of any dosage and route on the following outcomes: 24- and 48-week changes in total and terminal hair density, and 24-week change in independent observer assessment. The active comparators included minoxidil (oral, topical, sublingual), finasteride (oral, topical, mesotherapy), and dutasteride (oral, mesotherapy).
[Topical finasteride with minoxidil vs. topical minoxidil alone for male-pattern androgenic alopecia. Read more.]
The researchers found dutasteride 0.5 mg/day to be the most effective option. Among FDA-approved treatments, topical minoxidil 5% was the most effective topical monotherapy, while finasteride 1 mg/day was the most effective oral option. Dutasteride mesotherapy appears significantly less effective than oral administration.
Low-dose oral minoxidil vs. combination therapy with dutasteride or finasteride. Read more.
DermWorld Insights and Inquiries: Further dermatologic observations in cystic fibrosis
This commentary salutes Schwartzman et al., who propose a unifying concept to long-standing observations of rashes and episodic arthritis in patients with cystic fibrosis (CF), naming the constellation of features the “cystic fibrosis dermatitis arthritis syndrome” (CF-DAS). Dermatologic features of CF include “salty sweat,” aquagenic wrinkling of the palms, nutritional deficiency dermatoses (acrodermatitis enteropathica secondary to zinc deficiency, kwashiorkor from protein malnutrition, and essential fatty acid deficiency) due to malabsorption from pancreatic insufficiency, and vasculitis. CF-DAS should be suspected in young (mostly female) CF patients presenting with episodic arthritis and rash. Keep reading!
DermWorld Insights and Inquiries — Another Viewpoint: The squeeze of the FBSEs: An academic department perspective
On April 16, DermWorld Insights & Inquiries published “The not-so-full body skin examination,” including a commentary from Warren R. Heymann, MD, FAAD, and viewpoints from Jane M. Grant-Kels, MD, FAAD, and Jeffrey J. Miller, MD, FAAD. This week we have added “Another Viewpoint” from Suephy Chen, MD, FAAD, Laura Ferris, MD, FAAD, and Lindsay Strowd, MD, FAAD, offering a perspective from three academic department chairs in a relatively rural state. Read their viewpoint now.
A review of dupilumab and alopecia areata
Authors of a brief report published in JAAD investigated the clinical characteristics and outcomes in cases of dupilumab-treated alopecia areata and dupilumab-induced alopecia areata. A total of 89 patients were included, 71 of which had concurrent atopic dermatitis. Sixty-nine patients (77.5%) reported improvement after starting dupilumab. Patients with alopecia totalis, alopecia universalis, and alopecia areata reported average decreases in the Severity of Alopecia Tool score of 74.4, 59.5, and 28.4, respectively.
[Dermatologists discuss the latest clinical guidance for managing hirsutism. Read more.]
Conversely, 22.5% of patients experienced new-onset or worsening alopecia areata. Patients experienced hair loss an average of 4.7 months after starting dupilumab. After the drug was discontinued, the three most common treatment strategies were topical/intralesional/oral corticosteroids, cyclosporine, and topical minoxidil. Patients experienced hair regrowth after an average of 3.7 months after the intervention. As the dupilumab regimen increased, two cases of dupilumab-induced hair loss resolved, suggesting that a spaced-out regimen not only retains therapeutic value but holds promise for reversing drug-induced cases, the authors concluded.
Early termination of adjuvant immunotherapy in melanoma
A study published in the Journal of the European Academy of Dermatology and Venereology investigated the survival outcomes depending on the duration of adjuvant anti-PD1 therapy (nivolumab or pembrolizumab). Recurrence-free survival (RFS) and overall survival (OS) were compared between patients with regular treatment duration (52 ± 4 weeks and no disease recurrence during therapy; cohort A1) and patients with a premature end of treatment (<48 weeks; cohort B). Patients with disease recurrence during adjuvant treatment were included in cohort A2.
[Experts discuss neoadjuvant vs. adjuvant immunotherapy for melanoma. Read more.]
The two-year rate of RFS was 72.4% for patients in group B and 51.5% for patients with regular and intended treatment duration (A1 plus A2). A comparison of patients who relapsed after 12 months showed a trend for improved RFS in patients who were treated for the whole intended period compared to patients with a shorter treatment duration. However, there was no difference in OS. The authors concluded that in patients with resected metastatic melanoma, shorter treatment duration with anti-PD1 therapies is not associated with a worse outcome.
CMS announces MIPS EUC policy for clinicians following Texas severe storms
In response to the declaration from HHS and FEMA for Texas severe storms, straight-line winds, and flooding, CMS will apply the MIPS automatic Extreme and Uncontrollable Circumstances (EUC) policy for MIPS-eligible clinicians in the designated affected counties in Texas for the 2025 performance period. MIPS eligible clinicians in the specified counties will have all performance categories reweighted to 0% for the 2025 period, resulting in a neutral payment adjustment for 2027.
Learn more about Quality Payment Program Exception Applications and updated 2025 MIPS Automatic EUC Policy Fact Sheet in the QPP Resource Library.
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