Female pattern hair loss: Is systemic minoxidil effective over the long term?
A report published in JAAD evaluated the long-term efficacy of systemic minoxidil in the treatment of female pattern hair loss (FPHL). This retrospective study included women with FPHL aged ≥18 years treated with sublingual minoxidil for at least three years. Concomitant treatments included spironolactone and bicalutamide.
[Dermatologist hair experts discuss the efficacy and safety considerations of off-label treatments for female pattern hair loss. Read more.]
After three years of treatment, 47% achieved a 1-point reduction in Sinclair grade (SG), increasing to 64.7% after five years. The SG remained unchanged in 47% of cases after three years and in 29.4% after five years. A 1-point increase in SG occurred in 6% and 5.9% of patients after three and five years, respectively. While the change in SG after one year of systemic minoxidil treatment was not statistically significant, 60.8% of patients showed improved midline hair density on the 7-point scale.
DermWorld Insights and Inquiries: Pathway to clarity — The new and improved Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis (MPATH-Dx) version 2.0
Despite the increasing availability of formal clinical care guidelines, clinical management and treatment for many common skin conditions still lack support from standardized, evidence-based clinical care guidelines. The management and treatment of melanocytic neoplasms exemplify this issue, where a standardized approach is lacking, often leading to variation in their management. While organizations such as the American Joint Committee on Cancer and the National Comprehensive Cancer Network regularly update formal staging, management, and treatment guidelines for melanoma, no such guidelines exist for a large group of melanocytic neoplasms encountered by dermatologists. In 2014, the MPATH-Dx schema was introduced to simplify and standardize the reporting of melanocytic neoplasms by categorizing them into five classes.Keep reading!
Medicare payment rate to rise more than 3% in 2026
Most dermatologists would see a payment rate increase of 3.32% for their services in 2026 according to the proposed Medicare Fee Schedule. This is thanks to the required 2.5% increase in Medicare payments that the AADA and 75 other medical organizations fought to have included in the One Big Beautiful Bill Act, as well as other changes proposed by Medicare this week.
The proposed fee schedule included a conversion factor for most physicians of $33.4209, representing a 3.32% increase from 2025. CMS has proposed a separate conversion factor of $33.5875 for Qualifying APM participants, a 3.84% increase over 2025 payment levels.
The fact that these increases exceed the 2.5% increase provided by Congress is due to a positive budget neutrality adjustment of 0.55% and the Medicare Access and CHIP Reauthorization Act’s (MACRA) small annual update requirements for 2026 and beyond.
While the proposed fee schedule rule contains numerous other health policy provisions, these headline figures represent the first time payment rates have been scheduled to increase in five years. Learn more about other proposed changes in the AADA Breaking News alert.
Progression of basal cell carcinomas in patients awaiting surgical intervention
Authors of a study published in Clinical and Experimental Dermatology evaluated the natural progression of BCCs and patient outcomes while awaiting surgical intervention. A retrospective data analysis was performed for a sample of 55 patients (70 lesions). There was a significant correlation between the average growth of BCCs and the time waiting for a procedure, with 20% of patients requiring a more complex procedure than originally planned at the time of booking as well as exhibiting more symptoms. The top three most frequently reported symptoms were itching (39.4%), crusting (36.4%), and bleeding (30.3%).
A network analysis published in the Journal of Cosmetic Dermatology compared the relative efficacy and safety of monotherapy with JAK inhibitors, apremilast, and dupilumab. The analysis included eight different JAK inhibitors: ATI-501, ruxolitinib, baricitinib, brepocitinib, ivarmacitinib, deuruxolitinib, ritlecitinib, and tofacitinib. Among these therapies, deuruxolitinib 12 mg taken twice daily for 24 weeks was the most efficacious treatment for both SALT20 and SALT10. In the SALT20 outcome, deuruxolitinib demonstrated superior efficacy compared to baricitinib 2 mg daily for 24 weeks, with an odds ratio of 5.37.
[Comparing efficacy of JAK inhibitors used in alopecia areata. Read more.]
The investigators also found a dose-response trend among FDA-approved JAK inhibitors. Baricitinib 4 mg once daily demonstrated greater effectiveness than the 2 mg dose for attaining SALT20.
Authors of a study published in the Journal of the European Academy of Dermatology and Venereology assessed the risk of completed suicide in adult patients with skin diseases. A total of 13 skin diseases were identified: 3,800,748 patients with skin disease and more than 33 million controls.
[Finasteride: Risk of depression and suicide? Read more.]
Six psoriasis studies were included in the analysis and found no association with completed suicide. For dermatitis, five studies were included and found no association. Four melanoma studies were included, which found an association between melanoma and suicide standardized mortality rate (SMR: 2.89). Two non-melanoma studies were included and female patients showed an increased risk of completed suicide compared to the control group (SMR: 1.30). For hidradenitis suppurativa, two studies were included and showed a positive association between HS and completed suicide (OR: 2.86). The authors concluded that physicians treating dermatologic diseases should consider suicidality, especially when treating patients with HS and melanoma.
Screening and treating patients with body dysmorphic disorder. Read more.
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