Neuropsychiatric diagnoses after isotretinoin initiation in pediatric acne patients
Authors of a JAAD research letter investigated the one-year incidence of neuropsychiatric diagnoses after initiation of treatment with isotretinoin in children and younger people with acne. The authors found that treatment with isotretinoin was not associated with an increased incidence of neuropsychiatric diagnoses, including mood disorders, anxiety disorders, and nonfatal self-harm, when compared to treatment with oral antibiotics.
[Isotretinoin and the risk of psychiatric events in acne patients. Read more.]
Treatment with isotretinoin was associated with decreased incidence of any neuropsychiatric diagnosis, major depression, and insomnia. Those treated with isotretinoin had more incident social phobia, including skin-picking disorder, which the authors posit may be attributed to the psychosocial burden associated with severe treatment-resistant acne and the skin-related effects of isotretinoin. The authors concluded that in children and young people with acne, isotretinoin was associated with better overall mental health and less depression and insomnia compared to treatment with oral antibiotics.
DermWorld Insights and Inquiries: Advances in pruritus therapeutics — It’s Greek to us
Every dermatologist encounters maddeningly pruritic patients at their wit’s end. Our deficient understanding of and treating dermatology’s essential symptom is even more exasperating. This commentary will focus on the opioid receptors mu and kappa. Kappa-opioid receptors (KORs) and mu-opioid receptors (MORs) have been implicated in suppressing and promoting itch, respectively, by acting on both the peripheral and central nervous systems. KOR agonism and MOR antagonism represent important mechanisms with the potential to suppress itch in the periphery, the spinal cord, and the brain. The mechanisms by which these agents modulate pathways to alleviate itch is actively being researched. Keep reading!
Efficacy of treatment options for striae
A systematic review published in Dermatologic Surgery assessed data from 151 studies on the treatment of striae distensae, including striae alba, striae rubra, and striae gravidarum. Energy-based therapies were the most common treatment (56%), including CO2 laser, Nd:YAG laser, intense pulsed light, pulse-dye laser, and a combination of lasers. Topical treatments, most often “natural extract” creams, were the next most common treatment (19%). Mechanical devices, such as microneedling, were used in 8% of cases. Injection-based treatment, such as platelet-rich plasma injections, were used in 5% of cases. Most cases showed a partial response (90%). Injection-based and energy-based treatment were associated with the highest response rates. The authors concluded that there are numerous treatment options for striae, but no treatment is consistently effective for each subtype.
Sunscreen foundation recall due to microbial contamination
Suntegrity Skincare is recalling nine lots of Suntegrity Impeccable Skin Sunscreen Foundation based on its discovery of a higher than acceptable microbiological mold count (Aspergillus sydowii) in some tubes of Lot 115BU that developed post-release and over time in a recent test. Out of caution, the company has also recalled the following lots: 1107IV, 107NU, 109NU, 117BU, 113SA, 114SA, 106BR, and 101MO. A topical product contaminated with Aspergillus Sydowii could potentially cause an allergic skin reaction and related symptoms. It could also cause a primary fungal skin infection if used on open wounds or sunburned skin.
Dermoscopic features associated with nail psoriasis
A systematic review published in the International Journal of Dermatology summarized data from studies reporting the most prevalent dermoscopic features of nail psoriasis. Pitting was found to be the most prevalent feature among onychoscopic findings indicating nail matrix involvement, whereas onycholysis was the most common onychoscopic feature indicating nail bed involvement. Vascular abnormalities were present in 52% of patients and were found in the nail bed, hyponychium, lunula, and proximal edge of the nail. The authors concluded that nail dermoscopy enhances the visualization of psoriasis nail presentations and may avoid needing an invasive procedure like a nail biopsy.
Dermatologist nail experts discuss the diagnosis and management of onychomycosis. Read more.
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