Frontal fibrosing alopecia: The effects of sunscreens and moisturizers
In a systematic review published inJAAD, the study authors identified nine controlled studies assessing the association between frontal fibrosing alopecia (FFA), sunscreen use, and moisturizer use. The included studies, which were rated as moderate quality, found a significant association between sunscreen use and FFA (odds ratio, 2.21). Eight studies found a significant association between FFA and the use of moisturizers (odds ratio, 2.09).
[Is dutasteride an effective treatment for frontal fibrosing alopecia? Find out inDermWorld Weekly.]
While the exact mechanisms are unclear, the authors discuss proposed mechanisms regarding the role of sunscreen in the development of FFA, including an immune lichenoid reaction, generation of reactive oxygen species, and hormone disruption among others. They note that oxybenzone and other preservatives found in moisturizers are known to induce allergic reactions.
Coming full circle (almost): Low dose oral minoxidil for alopecia. Read more.
DermWorld Insights and Inquiries: The vexing verruciform xanthoma
Verruciform xanthomas (VX) were first described fifty years ago, and they are still a source of debate. Only the most astute dermatologists will make the diagnosis clinically, with the possible exception of recognizing such lesions in patients with the CHILD syndrome. Indeed, in a series of genital VX from 24 patients, the diagnosis was never suspected clinically, but were considered with diagnoses ranging from fibroepithelial polyp to squamous cell carcinoma.
VX are very uncommon papillary growths seen chiefly in the oral mucosa. with an incidence rate of 0.025-0.05% of all pathology cases. The gingiva, alveolar mucosa, and hard palate are the most common intraoral sites of its occurrence. Rarely, the tongue may be involved. The other major site of involvement is the anogenital region; in a study of Taiwanese patients, more genital than oral lesions were observed, with a male:female ratio of 6.75:1. Rarely, VX may present on the extremities, including the sole and subungual region. Keep reading!
DermWorld Young Physician Focus: The patient experience — there’s an app for that
I’m sure many of us have a love-hate relationship with modern technology — or maybe you just love to hate it. The adoption of electronic health records has made many physicians feel like glorified secretaries, and many of us are guilty of taking our work home with us. The COVID pandemic has accelerated this issue: the advent of remote meetings and more widespread use of telemedicine has made it all too easy to be available at any time, all the time. Though patients love the real-time access to their physician, being on the receiving end of all that access is often draining. Read more from DermWorld Young Physician Advisor Jenna O’Neill, MD, FAAD.
Red light vs. blue light therapies for acne
An article published in Photodermatology, Photoimmunology & Photomedicine assessed whether red light or blue light therapy was more effective for treating mild-to-moderate acne. Acne patients were randomized to receive treatment with light-emitting diode red light (RL) or blue light (BL) for three sessions weekly over four weeks. At the two-week follow-up, improvement in total acne lesions was similar in the RL (36%) and blue light (31%) groups. RL trended toward better improvement in inflammatory acne lesions. No adverse events were reported in the RL groups while three of 14 (21%) BL patients reported skin dryness, desquamation, or itching.
Read about the latest acne treatments and formulations as well as what’s on the horizon in DermWorld.
A review published in JAMA Dermatology analyzed 392 randomized controlled trials to assess trends in non-white representation of participants in dermatologic clinical trials from 2010 to 2015 and 2015 to 2020. The proportions of RCTs reporting race and ethnicity were 60% in 2010 to 2015 and 72% in 2015 to 2020. Eczema and acne studies tended to be more racially diverse than studies on psoriasis. There was no difference in the proportion of trials reporting at least 20% non-white representation in the two time periods. While clinical trials conducted in 2015 to 2020 were more likely to report race and ethnicity, the proportion of studies with at least 20% non-white participation remains unchanged at 38%.
Experts discuss the role of technology in clinical trials and what the future may (or may not) hold for dermatology. Read more inDermWorld.
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