Topical tofacitinib for lichen planopilaris, frontal fibrosing alopecia
Authors of a JAAD Short Communication performed a retrospective chart review on lichen planopilaris and frontal fibrosing alopecia (LPP/FFA) patients treated with topical tofacitinib. Patients were treated for a minimum of three months. Disease activity was evaluated with the Lichen Planopilaris Activity Index (LPPAI). Topical tofacitinib 2% cream was used as monotherapy (24.4%) or adjunctive therapy (75.6%) and the mean treatment duration was nine months. Patients demonstrated a significant reduction in LPPAI scores after receiving topical tofacitinib with an overall 48% decrease in LPPAI score at six months. This improvement was observed independent of concurrent use of other hair-loss therapies. Of the 38 patients with FFA or FFA/LPP overlap, 92.1% exhibited improvement or stabilization of frontotemporal hairline while 7.9% had progression of hairline recession.
Academy HAIR Grants enable new research on hair loss and skin of color. Read more in DermWorld.
DermWorld Insights and Inquiries: Caveat mTOR revisited — Neurofibromatosis
It is understandable how dermatologists may forget about many details of rare genodermatoses after taking their board examinations. Neurofibromatosis Type 1 (NF1, AKA von Recklinghausen disease, OMIM 162200) must be an exception — every dermatologist will encounter patients in their practice, as the birth incidence is approximately 1 in 2,600 to 3,000. Café au lait macules, skin-fold freckling [Crowe sign], Lisch nodules [iris hamartoma], optic pathway gliomas, and bone deformities characterize NF1. NF1 patients are prone to developing innumerable peripheral nerve sheath tumors. Cutaneous neurofibromas, while benign, have significant psychosocial implications due to itchiness, physical disfigurement, and sometimes pain. Similarly, plexiform neurofibromas often cause pain, deformity, and can potentially develop into highly aggressive malignant peripheral nerve sheath tumors. Keep reading!
Risk factors for development of tinea pedis, onychomycosis
A study published in The Journal of Dermatology identified risk factors for tinea pedis and onychomycosis in Japan. The study included 2,476 patients, with 337 of them with tinea pedis, 346 with onychomycosis, and 259 with both conditions. Advanced age, male sex, diabetes, and lower-limb ischemia were the independent risk factors for tinea pedis, whereas diabetic peripheral neuropathy was a risk factor for onychomycosis. The study found significant associations between the severity of diabetic peripheral neuropathy or lower-limb ischemia and the development of onychomycosis or tinea pedis.
Dermatologist nail experts discuss the diagnosis and management of onychomycosis as well as increasing resistance to anti-fungal therapies. Read more.
Mpox continues to circulate in the U.S.: Clinical clues and management resources
According to the CDC, mpox continues to circulate in the United States. Although reported cases of Clade II MPXV have significantly declined since the height of the outbreak in 2022, small clusters are still occurring in the United States. Convinced by the benefits of the vaccine, the Advisory Committee on Immunization Practices now recommends persons with potential risk of exposure receive two doses of the JYNNEOS vaccine.
[Physicians should remain vigilant in identifying, preventing mpox. Read more.]
In addition to the Clade II mpox virus (MPXV) cases that have been reported in the United States since May 2022, the CDC recently issued an advisory to raise awareness about a concerning increase of cases of Clade I MPXV in the Democratic Republic of Congo (DRC). Clade I is associated with increased transmission and more severe illness.
Within the past two months, some health departments have reported an increase in cases among men who report having sexual contact with men. Vaccination remains an important, but underutilized, tool in stopping the spread of MPXV. Modeling data suggest that if vaccine coverage in the United States does not increase, we may experience large outbreaks in the future.
View the Academy’s Mpox Resource Center, which includes guidance on recognizing mpox infection, resources on treatment and pain, and an mpox registry to gather information on dermatologic manifestations of the disease.
Is there an association between psychiatric conditions and rosacea?
A cross-sectional study published in Clinical and Experimental Dermatology assessed the association between psychiatric conditions and rosacea. Psychiatric conditions, specifically major depressive disorder, generalized anxiety disorder, obsessive–compulsive disorder, and alcohol use disorder, among others, were more prevalent among the 8,515 patients with rosacea compared with the 34,060 controls. The authors conclude that additional research is needed to further elucidate these possible relationships, and that dermatologists should consider a comprehensive approach to rosacea that includes psychosocial well-being.
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