What’s the best treatment for squamous cell carcinoma in situ?
According to study results published in the Journal of the European Academy of Dermatology and Venereology, surgery may be the most effective treatment for patients with cutaneous squamous cell carcinoma in situ compared with other treatment options. The highest lesion clearance rate of 0.97 occurred in patients who received surgical treatment, followed by those who received CO2 laser, dermabrasion, and 5-FU 5% combination therapy. The lowest lesion recurrence rate was for CO2 laser, dermabrasion, and 5-FU 5% combination therapy, followed by laser and methyl aminolevulinate photodynamic therapy. Based on all studies, surgery was the superior treatment for lesion recurrence rate, the authors concluded.
DermWorld Insights and Inquiries: Darier disease is rough clinically and therapeutically. MEK inhibition may offer a smoother future.
Consultative medical dermatology is stressful because challenging patients come with high hopes. Usually, the referring dermatologist is thorough, thoughtful, and on-target diagnostically and therapeutically. The key is setting expectations — if the dermatosis is easily manageable, they would not be referred. Patients want answers and guarantees. I understand that. My only promise is that I will do my best to help them. The impetus for writing this commentary is preparation for a patient with recalcitrant Darier disease (DD) referred to me for a second opinion by an outstanding dermatologist. Is there anything new that I could offer? Keep reading!
Oral tranexamic acid as an adjuvant therapy for melasma
A systematic review published inClinical and Experimental Dermatology evaluated the effectiveness of oral tranexamic acid (TXA) as an adjuvant to triple combination cream (TCC) therapy in patients with melasma. The study included four trials involving 480 patients. The results showed a significant reduction in the Melasma Area and Severity Index scores and a lower recurrence rate of melasma among patients treated with TXA plus TCC compared with those treated with TCC therapy alone. There was no significant difference in the risk of erythema or burning between patients treated with TXA plus TCC therapy and those treated with TCC therapy alone.
Managing dupilumab-related ocular surface disorders in patients with AD
An article published in The British Journal of Dermatology highlighted consensus guidelines on managing dupilumab-related ocular surface disorders (DROSD) in patients with atopic dermatitis (AD). Dupilumab treatment for AD should generally not be delayed, except for acute problems (infections) or severe eye conditions. The prophylactic use of lubricant drops is not recommended. Dermatologists should assess the severity of DROSD and refer children younger than 7 years for ophthalmology advice. For patients 7 years and older, dermatologists can initiate treatment and consult ophthalmology in severe or unresponsive cases.
A case report published in theInternational Journal of Dermatology highlighted data from an African woman with histopathology-confirmed advanced stage central centrifugal cicatricial alopecia (CCCA) that improved with topical metformin 10% along with minoxidil 5% lotion. The 54-year-old woman had refractory hair loss despite treatment with topical corticosteroids and minoxidil. After eight months of daily application of topical metformin 10% compounded cream and minoxidil 5% lotion, the patient had substantial hair regrowth in the vertex region without adverse effects.
Academy HAIR grants enable new research on hair loss and skin of color. Read more in this two-part DermWorld article: Part 1 and Part 2.
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