Efficacy of upadacitinib in patients with recalcitrant vitiligo
In a study published in JAAD, the researchers evaluated upadacitinib for its effectiveness and safety in treating patients with recalcitrant vitiligo. Patients who had failed previous treatments with systemic steroids, calcineurin inhibitors, and phototherapy for at least three months were included in the study. Upadacitinib was given at a dose of 15 mg once daily to 12 patients for at least 16 weeks. The average Vitiligo Area Severity Index (VASI) was 2.89±3.20 and dropped to 1.49±1.55 at follow-up, with an average improvement of 38.7%. An average improvement in pigmentation of 51% was observed in seven patients with facial vitiligo, with facial lesions showing more improvement than acral lesions. The most common adverse event was acne (16.7%).
Read about treating hidradenitis suppurativa with upadacitinib inDermWorld Weekly.
DermWorld Insights and Inquiries: Vascular abnormalities in FFA, artificial intelligence, and Winston Churchill
Once a rare oddity, FFA is now the most common cause of cicatricial alopecia worldwide. Although FFA is most common in postmenopausal white women, it may be observed in patients with skin of color, prior to menopause, in men and children. Astute dermatologists will recognize the “lonely hair sign,” eyebrow hair loss, occasional involvement of other hair-bearing sites facial papules, facial erythema, glabellar follicular red dots, pigmented macules, and prominent and/or depressed forehead veins. Despite having seen innumerable patients with FFA, I was not familiar with depressed forehead veins as a clinical finding. On a follow-up examination of a 67-year-old woman with FFA treated with clobetasol prominent veins on her left forehead were evident. Befuddled by the striking depression correlating exactly with these veins, I questioned whether this was a function of steroid atrophy, as she also displayed fine telangiectasias. Keep reading!
Efficacy of tretinoin creams in treating acanthosis nigricans
Authors of a study published in the Archives of Dermatological Research compared the efficacy and safety of 0.025% and 0.05% tretinoin creams for the treatment of acanthosis nigricans. The outcome of reduced skin pigmentation was determined by changes in melanin and erythema obtained using narrowband reflectance spectrophotometry. Both concentrations of tretinoin significantly improved the melanin index and severity score at week eight. A majority of patients in both groups rated more than 75% improvement in their skin findings. There was no significant difference in efficacy or side effects between the two groups.
A study published in Contact Dermatitis investigated the prevalence of positive patch test reactions to the hydroperoxides of limonene and linalool in consecutive patients. The study authors examined the patch test results of 5,511 patients to hydroperoxides of limonene 0.3% in petrolatum and linalool 1.0% in petrolatum from 2018 to 2020. Positive reaction to limonene and linalool were noted in 3.1% and 8.8%, respectively. However, most of the positive reactions were weak, doubtful, or irritant reactions. According to the study authors, positive patch test reactions to limonene and linalool should be interpreted carefully, as they have high potential for false-positive rates, especially when tested at higher concentrations.
Pediatric dermatologists share clues for distinguishing contact dermatitis from atopic dermatitis and discuss noteworthy allergens in DermWorld.
Dermatologist expertise needed: Increased rates of laser-induced scarring
Dermatologists are needed to remedy the increasing incidence of laser complications and educate patients on the risks involved with laser treatment, Healio reports from the Pigmentary Disorders Exchange Symposium in Chicago. While these complications are mainly inflicted by inexperienced non-dermatologists, dermatologists are now in the position to remedy these complications and educate their patients on how to avoid permanent laser-inflicted scarring — especially hypopigmented scarring.
[Non-physician providers seek authority to perform cosmetic medical procedures, threatening patient safety and the value of specialty medical training. Read more in DermWorld.]
The researchers conducted a study evaluating possible ways to stimulate pigment in cosmetic and medical hypopigmentation conditions. Results showed that the best technique was laser-assisted delivery of bimatoprost, a growth hormone used to treat glaucoma that exhibits a hyperpigmentation side effect due to increased melanogenesis. As laser-induced scarring continues to be a problem, there is a growing need for dermatologists to not only treat these scars, but also educate patients on how to prevent them, according to the researchers.
Your Dermatologist Knows is a new consumer positioning strategy that engages the public with questions on their health and wellness, putting dermatologists in the foreground with an upbeat and approachable message. Learn more.
The American Academy of Dermatology is a non-profit professional organization and does not endorse companies or products. Advertising helps support our mission.
