Does low-dose oral minoxidil improve hair density in traction alopecia?
Authors of a JAAD research letter assessed the efficacy and safety of low-dose oral minoxidil (LDOM) in the treatment of traction alopecia (TA). The researchers retrospectively reviewed the records of patients with TA aged >12 years who had been treated with LDOM for at least six months.
[Acne scars: Low-dose oral isotretinoin monotherapy vs. combined therapy with picosecond laser. Read more.]
Fifty-eight patients with a mean age at onset of 32.7 years were included, with a majority of Caucasian patients. The mean duration of hair loss was 6.4 years. The most commonly affected areas were the frontal (50%) and temporal (65.5%) regions of the scalp. The mean starting and final doses of LDOM were 0.75 mg and 2.5 mg, respectively. The dose was increased if hair regrowth was deemed suboptimal. The mean duration of treatment was 2.1 years. LDOM treatment resulted in a reduction in the mean M-TAS score from 5.1 to 3.6. Adverse effects of LDOM were mild and included hypertrichosis (22.4%) and lightheadedness (5.2%), with none of the patients requiring dose reduction or treatment discontinuation. The authors concluded that LDOM therapy demonstrates considerable improvement in hair density in patients with TA.
Are concentrations higher than 5% minoxidil of benefit for androgenic alopecia patients? Read more.
DermWorld Insights and Inquiries: A medal-worthy diagnosis: Medallion-like dermal dendrocyte hamartoma
A personal joy of dermatology is rendering a diagnosis in a lesion or rash that I have only read about but never previously encountered in practice. Beyond being intellectually satisfying, having a precise diagnosis is reassuring, as it allows an understanding of expectations, whether or not we grasp the underlying pathophysiology of the disorder. During a routine physical examination of a 61-year-old man, I noticed a suprasternal lesion; the patient confirmed that it was asymptomatic, present “for the longest time,” has not changed, and was never traumatized or treated. The location and morphology (round, atrophic, red-brown, with telangiectasia) are compatible with the diagnosis of a medallion-like dermal dendrocyte hamartoma. This commentary delves into this unusual lesion. Keep reading!
Methotrexate: Drug survival and predicative factors for discontinuation in psoriasis patients
An article published in the International Journal of Dermatology evaluated the drug survival of methotrexate in patients with psoriasis. This single-center retrospective study assessed the clinical course of patients with psoriasis treated with methotrexate to determine factors associated with drug discontinuation. Over the seven-year study period, the average duration of methotrexate therapy was 10.1 months. Patients treated with more than 15 mg of methotrexate for more than three months were more likely to continue therapy. Palmoplantar pustular psoriasis was associated with methotrexate ineffectiveness. According to the study authors, methotrexate is a cost-effective treatment for psoriasis; however, the drug survival is lower than that of newer biologic agents, largely owing to adverse events and ineffectiveness.
Is low-dose methotrexate associated with a higher risk of melanoma development? Read more in DermWorld.
Perioperative antiplatelet, anticoagulant medication management in dermatologic surgery
A prospective cohort study published in the Journal of the European Academy of Dermatology and Venereology examined the impact of antiplatelet/anticoagulant (AP/AC) medications on bleeding risk in dermatologic surgery. After evaluating the results of 1,852 procedures, the authors found that postoperative bleeding occurred in 15.9% of the procedures. Although severe bleeding was rare, patients on dual AP therapy and those on bridging therapy with a vitamin K antagonist had a significantly higher risk of severe postoperative bleeding compared with those not taking AP/AC medications. The duration of the preoperative direct oral anticoagulants–free period did not significantly affect the frequency of severe bleeding.
Dermatologists discuss perioperative management of patients on anticoagulant therapy. Read more in DermWorld.
Now available: MIPS performance feedback
The AADA is encouraging all members to log in to the CMS Quality Payment Program website to review their 2022 MIPS performance feedback scores, which includes details about the 2024 MIPS payment adjustments. We have heard concerns that dermatologists reporting as groups may inappropriately be attributed the diabetes episode-based cost measure, which may negatively impact your payment adjustment. If you have been attributed the diabetes cost measure, please email jwinans@aad.org.
Virtual physician summit on Medicare payment reform
Join the American Academy of Dermatology Association on Sept. 6 from 8 p.m. to 9 p.m. ET for a Medicare physician payment reform summit with U.S. Representatives Larry Bucshon, MD (R-IN), Raul Ruiz, MD (D-CA), and Ami Bera, MD (D-CA), who are leaders in Medicare physician payment reform, along with leaders from the house of medicine, to discuss the impact of Medicare physician fee schedule cuts.
Physician practices face cuts while hospitals, skilled nursing facilities, and other physicians receive annual inflationary increases, creating a disconnect in patients’ access to care. The event will encourage a unified messaging for Congress to establish a positive annual inflation adjustment to Medicare physician payment and remove budget neutrality requirements.
Advertisement
The American Academy of Dermatology is a non-profit professional organization and does not endorse companies or products. Advertising helps support our mission.
