A review published in Clinical and Experimental Dermatology details the available literature on treatment options for patients with pseudofolliculitis barbae (PFB). While the main recommendation for years has been complete cessation of shaving or using an electric trimmer, the authors note this approach has several limitations. The article covers shaving practices, oral and topical treatments, and energy-based devices. Current treatments include preventative measures, antibiotics, corticosteroids, keratolytics, chemical depilatories, and/or laser treatments. The authors provide an algorithmic treatment chart to help physicians with recalcitrant PFB cases starting with whether shaving cessation or use of an electrical shaver is an option for the patient.
Topical therapies are currently the mainstay treatment. However, laser hair removal has become a potential long-term treatment option, and the authors suggest additional studies are warranted to understand its long-term efficacy and permanency in light of the higher cost.
DermWorld Insights and Inquiries: Taking it on the shin — Part two
Last week, pretibial pruritic papular dermatitis was reviewed as an underrecognized entity on the shins. Today the focus is on obesity-associated lymphedematous mucinosis (OALM), another disorder that you have likely seen, but perhaps did not recognize. Unsurprisingly, when dermatologists see infiltrative plaques in the pretibial regions, pretibial myxedema (PM, more accurately termed thyroid dermopathy) comes to mind. Although characteristically appearing after treatment of Graves’ disease, PM may develop in hypothyroid or euthyroid patients. PM is characterized by non-pitting edema and skin-colored to violaceous nodules or plaques. When observed in its characteristic location, the differential diagnosis includes lymphedema, lipodermatosclerosis, and OALM. Keep reading!
Efficacy of abrocitinib for the treatment of lichen sclerosus?
A single-arm study published in the British Journal of Dermatologyincluded 10 adult patients with biopsy-proven lichen sclerosus (LS) who were treated with abrocitinib 100 mg once daily for four months. The patients stopped using topical steroids and topical calcineurin inhibitors at least four weeks prior to the treatment with abrocitinib. Disease control was achieved in all patients by week 12 with significant improvement in pruritus seen as early as week two. While larger controlled trials are necessary, the authors conclude that abrocitinib may provide disease control in patients with LS.
Scientists find potential treatment for rare genetic skin disorder
Researchers at the National Institutes of Health have identified genomic variants that cause pansclerotic morphea, a rare and severe inflammatory skin disorder, and have found a potential treatment. The results of this study have been published in the New England Journal of Medicine. The researchers used genome sequencing to study four individuals with disabling pansclerotic morphea and found that all four have genomic variants in the STAT4 gene. The STAT4 protein plays a role in fighting infections and controls important aspects of wound healing in the skin.
[The concept of atrophoderma of pasini and pierini as morphea may be falling off a cliff. Read more in DermWorld Insights and Inquiries.]
The scientists found that the STAT4 genomic variants result in an overactive STAT4 protein in these four patients, creating a positive feedback loop of inflammation and impaired wound healing that worsens over time. To stop this feedback loop, they targeted a Janus Kinase protein in the inflammatory pathway that interacts with the STAT4 molecule. When the patients were treated with the JAK inhibitor ruxolitinib, their rashes and ulcers dramatically improved.
Academy Advisory Board invites members to submit policy resolutions by July 3
The Academy’s Advisory Board invites all Academy members as well as state, local, and specialty dermatology groups to submit proposed AAD/A policy resolutions on issues of interest or concern. The Advisory Board convenes twice a year at the AAD Annual Meeting and Innovation Academy to deliberate on issues of importance to individual practitioners, which may be forwarded to the Academy’s Board of Directors for consideration. Resolutions should ask for the Academy to take specific action relating to advocacy or a general Academy policy.
To learn more, visit the Advisory Board website and view the resolution template. In order to submit a resolution, your Disclosure of Outside Interests (DOI) statement must be updated. Submit all resolutions by July 3 for them to be considered at Innovation Academy. Resolutions and/or questions regarding the process should be sent to Cyndi Del Boccio at cdelboccio@aad.org.
The author or Advisory Board representative of the resolution must be present during the Reference Committee Hearing to introduce and discuss the resolution. Even if you do not submit a resolution, the Academy encourages all members to attend the Reference Committee Hearing to hear the debate on the proposed resolutions. The full Advisory Board will vote on the resolutions at the General Business Meeting, which will take place at the AAD’s 2023 Innovation Academy.
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