Ciclosporin vs. methotrexate for young patients with atopic dermatitis
A study published in the British Journal of Dermatology assessed the safety and efficacy of ciclosporin versus methotrexate in patients with severe atopic dermatitis aged between two and 16 years. Ciclosporin was more effective in improving disease severity at 12 weeks, but by week 60, methotrexate demonstrated superiority. Ciclosporin use resulted in a higher occurrence of post-treatment flares. Both treatments improved quality of life and resulted in similar rates of adverse events.
DermWorld Insights and Inquiries: Taming toxic erythema of chemotherapy with high-dose vitamin D
In 2008, Bolognia et al published their landmark editorial introducing the umbrella term TEC. Previously, clinical diagnoses (acral erythema, hand-foot syndrome, erythodysesthesia, intertriginous eruption of chemotherapy, and others) or histologically based entities (eccrine squamous syringometaplasia, chemotherapy-associated neutrophilic eccrine hidradenitis, and others) were reported and, understandably, might have been construed as distinct disorders. The recognition that TEC is a nonimmunologic toxic phenomenon provided a framework for diagnosing and managing this adverse reaction to chemotherapy. Chemotherapeutic agents such as cytarabine, doxorubicin, docetaxel, capecitabine, and 5-fluorouracil are among the most frequently reported agents causing TEC. In the appropriate context and characteristic clinical presentation, TEC may be diagnosed clinically. Keep reading!
Moisturizing cream with 20% urea for treatment of keratosis pilaris
A study published in the Journal of Drugs in Dermatology assessed the outcomes of using a moisturizing cream with 20% urea for the treatment of patients with keratosis pilaris. The participants applied the cream daily for four weeks after a five-day washout period. Significant improvement in skin/smoothness/texture was observed after one week and four weeks of treatment. Participants reported satisfaction with the feel of their skin, increased confidence, and reduced embarrassment related to their skin after four weeks of treatment. The authors conclude that using a 20% urea cream can be a well-tolerated and effective treatment for the management of keratosis pilaris.
Topical estradiol for treating female patients with adult acne
A split-face study published in Clinical and Experimental Dermatology evaluated the safety and efficacy of weekly topical estradiol 0.05% in the treatment of female patients with adult acne. Overall, 20 female patients with adult acne applied estradiol 0.05% and placebo masks to opposite sides of the face weekly for eight weeks. A significant improvement in acne was observed on the treated side at the end of the treatment period. After treatment cessation, the lesion count increased at two months, although it remained significantly lower on the estradiol side with no reported side effects. The authors conclude that topical estradiol 0.05% peel-off masks could be a novel and cost-effective treatment option for female patients with adult acne.
Acne: Clindamycin-tretinoin vs. benzoyl peroxide-adapalene. Read more in DermWorld Weekly.
A research letter published in JAAD examined patterns of metastatic spread of basal cell carcinoma (mBCC) within a multicenter cohort of malignant BCC. A total of 53 cases of mBCC were treated among three institutions between Jan.1, 2005, and Dec. 31, 2021. The mean size of the primary tumor was 72.9 mm.
Fewer than half of cases were limited to regional lymph nodal spread (41.5%). There were 31 cases of distant metastasis (28.3%), and 16 cases (30.2%) involved both nodal and distant spread. Within this large cohort, almost a third of cases involved distant metastatic spread without concomitant lymph nodal metastasis, which according to the authors, differ from previously published data indicating that metastatic spread typically begins with lymph nodes before spreading to distant sites. Physicians should appreciate the potential of mBCC to spread to distant sites, most commonly lung and bone, even without preceding regional lymph node spread, the authors note.
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