A study published in JAAD reviewed antiandrogen treatments for female pattern hair loss (FPHL), including finasteride, dutasteride, spironolactone, hormonal contraceptives, and more.
[Shedding light on treatments for female pattern hair loss. Read more.]
The authors recommended starting with topical minoxidil, the only FDA-approved therapy for FPHL. Topical antiandrogens, including finasteride or spironolactone, may be compounded with minoxidil for increased efficacy. Patients who fail or do not prefer topicals may be treated with oral minoxidil, which has demonstrated efficacy in treating FPHL with a favorable safety profile. A minimum of six months on minoxidil is necessary to determine efficacy before switching treatments, they added.
The authors explained that oral antiandrogens can be considered for patients who do not respond to topicals or oral minoxidil or have patient-specific factors that may benefit from oral antiandrogen therapy (e.g., hyperandrogenism, need for contraception). They recommended concomitant treatment with topical or oral minoxidil when initiating oral antiandrogens. For postmenopausal patients, the authors recommended finasteride (2.5-5-mg/day) or dutasteride (0.5-mg/day). Spironolactone, up to 200-mg/day, may be considered in adolescents or younger patients, particularly those with signs of hyperandrogenism.
Emerging treatments, including clascoterone, pyrilutamide, and intradermal dutasteride may be considered in refractory cases, although the evidence is still being evaluated.
DermWorld Insights and Inquiries: Long COVID has a lot of nerve
The profound medical and socioeconomic trauma of the COVID-19 pandemic may seem as though it is in the rearview mirror, but it is not. Last week, I evaluated a 37-year-old man complaining of “feeling thousands of small paper cuts” on his abdomen, back, and thighs for the past couple of months. There was no rash. His symptoms appeared a month after his severe pulmonary symptoms during a three-month course of COVID-19 resolved. My presumptive diagnosis was that he had a post-COVID-19 peripheral neuropathy. Somehow, patients with long COVID and cutaneous paresthesias fell beneath my radar. Keep reading!
Hidradenitis suppurativa treatment during pregnancy, lactation
Authors of a review article published in the International Journal of Dermatology summarized current literature on the treatment of hidradenitis suppurativa (HS) during pregnancy and lactation, with guidance to support decision-making.
[HS experts discuss the latest therapeutic and procedural updates to optimize disease management. Read more.]
Treatment options, including topical clindamycin, oral clindamycin-rifampicin, adalimumab, metformin, antiseptic washes, and certolizumab pegol, have evidence supporting their relative safety in pregnant and lactating women. Certolizumab pegol has shown promising safety data among biologics, although it requires more efficacy data in HS. While newly approved HS medications, such as secukinumab and bimekizumab, show promise for the general population, further research is necessary to evaluate their safety profiles in pregnant and breastfeeding individuals. The minimal available research on HS in pregnant and lactating women highlights the need for a comprehensive investigation into the safety, efficacy, and suitability of management strategies, the authors concluded.
Authors of a study published in JAAD Reviews reviewed the physiologic functions of magnesium in skin biology and summarized data on therapeutic applications in dermatology. According to the findings, magnesium influenced keratinocyte proliferation, fibroblast migration, collagen synthesis, and barrier function. Preclinical and clinical evidence suggested potential benefits in atopic dermatitis, psoriasis, acne, wound healing, and photoprotection. Magnesium is a clinically promising adjunct in dermatology, although larger randomized controlled trials are needed.
Authors of a Special Communication in JAMA Dermatology discussed best practices for capturing clinically accurate digital images — emphasizing techniques to improve photography portraying individuals with skin of color, dermatologic conditions in skin of color, and pigmentary disorders.
In photographing darker skin, royal blue backgrounds are often preferred, the authors stated, as it offers increased contrast without creating aberrant hues. Soft diffuse lighting, such as that emitted from an attachable ring light, should be used when possible. Other aspects of photography in the clinical setting should be standardized to include a fixed distance from the patient, consistent settings, and a dedicated space for photography. In accurately capturing erythema, inflammation, and pigmentary alterations in skin of color, specific lighting techniques such as cross-polarization may be used, they recommended.
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