Androgenetic alopecia: topical minoxidil vs. low-dose oral minoxidil
In a randomized, open-label trial published in the Journal of Cosmetic Dermatology, researchers compared the efficacy of oral and topical minoxidil in patients diagnosed with mild to moderate androgenetic alopecia (AGA). According to the study, 1 mg oral minoxidil had equal therapeutic efficacy compared with the standard 5% topical solution in improving mean hair diameter.
[A review of spironolactone for androgenetic alopecia. Read more.]
The study included 42 (64.1%) women and 23 (35.9%) men with a mean age of 31.62 years. Patients were randomly assigned to 1 mg oral minoxidil once a day or topical minoxidil 5% (1 cc twice daily for men and once daily for women) for six months. The patients were asked to return for evaluations three and six months after treatment initiation. Efficacy assessments included hair count and thickness, photographic assessment, and patient self-assessment questionnaires. Participants’ mean hair diameter at points 12, 16, and 24 cm from the glabella significantly increased from baseline to six months overall in both treatment groups. No significant difference was observed between the two groups.
What factors influence PRP efficacy in androgenetic alopecia? Read more.
DermWorld Insights and Inquiries: Short anagen syndrome — The long and short of it
Have you ever encountered a patient who says that their hair does not grow very much and that they rarely need to cut their hair? I have, and I suppose you have, too. Although considered uncommon, short anagen syndrome (SAS) is probably underrecognized. When patients (or their parents) ask why this happens, I usually shrug my shoulders, telling them that I do not know but suspect that it reflects the genetic, biological spectrum of growth — perfectly healthy people can be 4'10'' or 7'2" tall. That answer is momentarily satisfying, but it is not enough. This commentary focuses on SAS and new information that offers a potential clue to SAS pathogenesis in some cases. Keep reading!
Skin cancer incidence in patients with hidradenitis suppurativa
Authors of a study published in JAAD assessed whether there was an increased risk of keratinocyte carcinoma (KC) and malignant melanoma (MM) in patients with hidradenitis suppurativa (HS). A total of 2,778 patients seen between Jan. 1, 2012, and Aug. 23, 2022, were included compared to 1,532,246 patients without HS. Of those with HS, 33 were diagnosed with skin cancer (28 KC, 5 MM). Patients with both HS and skin cancer had a mean age of 60 and were most commonly white and female.
[Resorcinol’s resourcefulness in hidradenitis suppurativa. Read more.]
The incidence of skin cancer in patients with HS was 1,656 per 100,000 patients (KC was 1,476 per 100,000; MM was 359 per 100,000). The researchers found an increased risk of skin cancer among HS patients, with the greatest number of cases being KC. The mechanism of increased skin cancer risk is unknown. However, it has been proposed that chronic inflammation and secondary infection may lead to proliferative epidermal changes, including skin cancer development.
[Experts discuss the benefits of personalized treatment plans for patients with HS. Read more.]
Diagnosing and managing nail psoriasis, nail lichen planus
A review published in JAAD summarizes the clinical features, diagnostic techniques, grading assessment, and treatment modalities for nail psoriasis and nail lichen planus. Intralesional steroid injections are first-line treatment when the nail matrix of three or fewer nails is involved with nail psoriasis. For isolated nail bed involvement, topical steroids alone or in combination with vitamin D analogs are first-line treatment.
Newly approved treatments for nail psoriasis include brodalumab, tildrakizumab, risankizumab, bimekizumab, and deucravacitinib. The first-line treatment for nail lichen planus includes intralesional triamcinolone (when three or fewer nails are involved) and intramuscular triamcinolone (when more than three nails are involved), followed by oral retinoids. JAK inhibitors and intralesional platelet rich plasma injections are emerging treatment options for nail lichen planus.
Diagnosing nail unit melanomas at a faster clip. Read more.
According to new data from the CDC, there is a steep escalation of years-long national increase in syphilis and other sexually transmitted infections. Syphilis rates jumped more than 17% over last year’s record to reach the highest level since the 1950s. More than 2.5 million STD cases were reported to the CDC in 2022 — likely an undercount given challenges to access to testing. Adolescents and young adults aged 15-24 accounted for half of reported cases of chlamydia, gonorrhea, and syphilis, the CDC found. Gay and bisexual men were also more likely to have reported STDs. About 28% of syphilis cases in 2022 were the infectious forms of syphilis, and about a quarter were reported by women and nearly another one-fourth were reported by heterosexual men.
Particularly alarming, according to the CDC, is a surge in congenital syphilis. In 2022 there were 3,755 documented cases, which caused at least 282 stillbirths and infant deaths. The rate increased more than 30% from 2021 and is currently the highest its ever been since 1991. “The vast majority of congenital syphilis cases are preventable if infections are caught and treated in time, which can only happen if more doctors get comfortable asking patients about their sexual history and testing them for infection,” said Rachel Levine, chair of the National Syphilis and Congenital Syphilis Syndemic Federal Task Force.
Dermatologists discuss interview techniques for taking a sexual history and screening for sexually transmitted infections. Read more.
CMS field testing new cost measure for non-pressure ulcers, informational webinar scheduled for Feb. 14
CMS is currently testing a new episode-based cost measure for non-pressure ulcers, and this testing phase will run until Feb. 29, 2024. Clinicians and groups with at least 20 episodes for the non-pressure ulcer measure will receive a Field Test Report. These reports contain information regarding your cost performance based on draft measure specifications. The measurement period for these Field Test Reports is from Jan. 1 to Dec. 31, 2022. Please refer to the Field Test Report User Access Guide for guidance on accessing your report.
Register for the CMS webinar on 2024 Cost Measures Field Testing scheduled for Feb. 14, 2024, from 1 to 2 p.m. ET to learn more about the new cost measures. During this presentation, CMS will provide insights into the measure development process, field testing activities, discussion of the content of the Field Test Reports, how to access and interpret the reports, and information on the supplemental documentation posted on the CMS QPP Cost Measure Information webpage.
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