Considerations regarding GLP-1 receptor agonist use in dermatology
An article published in the Journal of Drugs in Dermatology highlighted the benefits of GLP-1 receptor agonists, particularly in patients with psoriasis and hidradenitis suppurativa, due to their anti-inflammatory effects. It also covered additional applications, including the management of Hailey–Hailey disease, wounds in patients with diabetes, and acanthosis nigricans.
[Read more about dermatologic findings associated with semaglutide use inDermWorld Weekly.]
The article reviews data regarding unintended consequences, including cutaneous side effects and cosmetic changes such as "Ozempic face," emphasizing the need for dermatologists to coordinate with prescribing physicians for comprehensive care.
DermWorld Insights and Inquiries: An encapsulation of palisaded encapsulated neuromas
You know the drill — a patient presents with a solitary, slowly enlarging, dome-shaped, non-pigmented painless facial papule and asks, “Is it skin cancer?” Your clinical and dermoscopic examinations are not definitive, so you respond with uncertainty, saying, “It’s probably a benign lesion like an intradermal nevus, fibrous papule, or cyst, but it could be a basal cell carcinoma.” Once in a while, you can make an educated guess. If you experience the “Jack-in-the-Box” sign — the sudden popping out of neural tissue when the papule is shaved — you can be confident that the lesion is a palisaded encapsulated neuroma. The romance of that “aha” moment enables reassuring the patient that all will be well. Keep reading!
Pregabalin vs. gabapentin in patients with chronic pruritus
A study published in the International Journal of Dermatology compared the efficacy of pregabalin with that of gabapentin in patients with chronic pruritus. The patients received either pregabalin (150 mg) or gabapentin (600 mg) twice daily for six weeks. At week six, the group receiving pregabalin showed a significant improvement in the Visual Analogue Scale scores, 5-D itch scale, and Dermatology Life Quality Index compared with the group receiving gabapentin. Both groups experienced mild-to-moderate adverse events with no severe incidents reported.
Read about drugs you never thought you’d use in dermatology inDermWorld.
Oral tranexamic acid for treatment of post-inflammatory hyperpigmentation
A study published in Dermatologic Surgery assessed the use of tranexamic acid (TXA) in the management of post-inflammatory hyperpigmentation (PIH) treatment. A TXA dose range from 500 to 750 mg daily for 12 weeks represents the optimal dose and duration for PIH treatment. The authors propose using TXA 325 mg twice daily initiated two weeks before and continued for two weeks after a laser procedure to prevent PIH. Before starting a patient on TXA, thromboembolic and cerebrovascular accident risks should be assessed.
Local recurrence, metastasis, and mortality among patients with thin, in situ melanomas
An observational study published in JAAD assessed local recurrence, metastasis, and mortality outcomes among low-risk patients with thin melanoma (TM) and melanoma in situ (MIS). The results showed low rates of recurrence (1.9%), metastasis (1.3%), and melanoma-specific death (0.7%) in the cohort, with head-and-neck MIS and TM on the posterior trunk or head and neck identified as independent risk factors for mortality. The study found significant associations between Breslow thickness and mortality, particularly in patients with TM. Although BCC and SCC rates did not correlate with local recurrence, metastasis, or death, this population had a high risk for additional skin cancers (BCC, 31.9%; SCC, 23%; second primary melanoma, 18.7%).
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