January 21, 2026
IN THIS ISSUE / Jan. 21, 2026
DermWorld What’s Hot: A tool to modernize, personalize biologic dosing for psoriasis
Misdiagnoses of hair, scalp disorders in patients with skin of color
Does finasteride lead to depression, suicide?
Authors of a study published in the Journal of Cosmetic Dermatology evaluated the causal relationship between finasteride use and the risk of depression or suicide.
[Oral vs. topical finasteride: Sexual, neuropsychiatric AEs. Read more.]
A Mendelian randomization analysis showed that prescribing finasteride was not related to depression or suicide. A COX regression analysis also showed that finasteride use was not significantly associated with depression or suicide events. After adjusting for all covariates, there was an increase in depression risk in finasteride users, the authors noted. Although the increase was not statistically significant, the potential risk of depression should still be noted in patients who take finasteride regularly.
Topical finasteride with minoxidil vs. topical minoxidil alone for male-pattern androgenic alopecia. Read more.
DermWorld What’s Hot: A tool to modernize, personalize biologic dosing for psoriasis
A recent Journal of Investigative Dermatology study introduced a tool to modernize and personalize biologic dosing for psoriasis. I remember when our biologic toolbox included three medication choices, all within the same mechanistic drug class (TNF inhibitors). Now, with over 12 options with varying molecular targets and approved dosing schedules, we are due for more precise prescribing and long-term management rubrics. Read more from Lorraine Rosamilia, MD, FAAD.
Misdiagnoses of hair, scalp disorders in patients with skin of color
Authors of an article published in the International Journal of Dermatology reviewed all published cases of misdiagnoses affecting the hair and scalp in patients with skin of color (SoC) to understand gaps in care and identify areas for improvement. Misdiagnoses accounted for 63% of patients. Life-threatening misdiagnoses included T-cell lymphoblastic lymphoma and leukemia, along with malignant angioendothelioma. Scalp biopsies were more helpful in determining the correct diagnosis (50%) compared to trichoscopy (33%).
[Access the AAD’s Clinical Image Collection where you can view images and submit your own.]
Challenging cases (when a clinician’s initially incorrect working diagnosis was changed to a correct final diagnosis) were mostly females (67%) and Black (91%), with a working diagnosis of central centrifugal cicatricial alopecia (45%). Biopsies led to the correct diagnosis 100% of the time. Premature diagnostic closure based on typical clinical features, such as the location of hair loss, was a source of misdiagnosis, according to the authors.
Take the AAD’s Skin of Color Curriculum and earn 15.5 CME.
The molecular effects of indoor tanning
Research published in Science Advances revealed that artificial sources of UV radiation can cause cellular mutations that may cause future cancers, including melanoma. The authors looked at medical records of more than 32,000 dermatology patients including tanning bed usage, history of sunburn, and family history of melanoma. They also obtained skin samples from 26 donors and sequenced 182 cells.
The researchers found that young indoor tanners undergo genetic changes that can lead to more mutations in their skin cells than people twice their age. Individuals who used tanning beds had a 2.85-fold higher risk of melanoma compared with nonusers, even in areas of the body with little sun exposure. Melanocytes from tanning bed users were more likely to have a pathogenic mutation than those from control subjects (23% vs. 7.3%). According to the researchers, even in normal skin with no moles from indoor tanning patients, they found DNA changes that predispose them to melanoma.
Experts offer best practices on addressing patients’ questions about sunscreen. Read more.
Resistance to biologic therapy in psoriasis
Authors of a study in JAMA Dermatology explored the clinical characteristics associated with biologic therapy resistance in patients with severe psoriasis. They found that therapeutic responses to biologics in patients with psoriasis may decrease as a result of dysregulated immune responses in the epidermis and heightened neutrophil activity.
[Do new psoriasis biologics have better safety profiles than adalimumab? Read more.]
For patients with severe psoriasis treated with biologics, being overweight was clinically associated with early loss of therapeutic efficacy. Innate immunity and neutrophil-associated inflammatory mediators were significantly upregulated in the lesional epidermis of patients in whom biologics had prematurely lost their therapeutic efficacy.
Take the AAD’s free guidelines course, Managing Co-Morbidities Associated with Psoriasis and Care Improvement Strategy.
