Men with androgenetic alopecia may benefit from platelet-rich plasma
Among men with androgenetic alopecia (AGA), platelet-rich plasma (PRP) therapy was associated with high patient satisfaction, improved hair density, and a low-risk safety profile, according to a review published in the Journal of Cosmetic Dermatology. The review included a total of 291 male patients with AGA who were treated with either 1 to 2 mL PRP or placebo.
[Is the use of hair oils effective in treating androgenetic alopecia? Read more.]
There was a statistically significant positive effect in hair density among patients receiving PRP vs. placebo in six studies. The use of PRP was also associated with a significant increase in hair follicular bulge cells and the formation of small blood vessels around the follicle two weeks after treatment. An increase in terminal hair density was also reported three months post-treatment vs. placebo. In five studies, patients receiving PRP reported a statistically significant positive effect on hair count. There was a 70% treatment satisfaction rate among patients receiving PRP. The highest patient satisfaction rates were seen among those treated with PRP plus minoxidil, followed by PRP only, minoxidil only, then placebo.
The authors conclude that PRP demonstrated some potential to be used therapeutically. However, the low quality of evidence and high heterogeneity of included studies call for further investigation.
DermWorld Insights and Inquiries: Coming clean on chlorhexidine-induced dermatoses
Dermatologic surgeons use a variety of products that may cause an irritant or allergic contact dermatitis, including antiseptics, anesthetics, gloves, suture materials, tissue adhesives, topical antibiotics, and bandages. Antiseptic agents are the most frequent cause of contact dermatitis in surgical patients. Aside from ACD, chlorhexidine may induce immediate IgE-mediated contact urticaria. It is essential to keep ACD to chlorhexidine in mind — the diagnosis may be delayed for months or years, as skin lesions may be misdiagnosed as cellulitis, local reactions to vaccines, or ACD from plasters, among others. Importantly, presumed ACD to chlorhexidine may be due to the dye in the preparation, not chlorhexidine itself. Keep reading!
Roflumilast for the treatment of seborrheic dermatitis
Phase 3 results published in JAAD reinforced roflumilast topical foam as a safe and effective treatment option for seborrheic dermatitis. In the study, patients were randomly assigned to receive roflumilast or vehicle. Results showed that a higher percentage of roflumilast-treated patients met the primary endpoint of IGA success defined as clear or almost clear at week eight vs. vehicle-treated patients (79.5% vs. 58%). Additionally, a higher proportion of roflumilast-treated patients achieved Worst Itch Numerical Rating Scale success by week eight (62.8% vs. 40.6%). Fewer than 3.3% of patients in either treatment group reported treatment-related adverse events.
A research letter published in the CDC’s Emerging Infectious Diseases describes a case of tinea genitalis in an immunocompetent woman in Pennsylvania caused by T. indotineae. The infection was potentially acquired through sexual contact. The patient likely acquired the infection in South Asia and spread it to another partner in the United States. She experienced lesions beginning on her inner thigh, then spreading to her genitals and buttocks.
She was treated with mometasone 0.1% ointment for suspected contact dermatitis, econazole 1% cream, a prednisone taper pack, and diphenhydramine without resolution. After confirming it was dermatophytosis, the patient received multiple antifungal courses, including topical ketoconazole, oral terbinafine, and fluconazole, all without lesion resolution. She was then prescribed itraconazole with clinical suspicion for T. indotineae infection and reported improved symptoms.
[CDC announces first reported U.S. cases of tinea caused by Trichophyton indotineae. Read more.]
The authors highlight the emergence of antifungal-resistant T. indotineae as a cause of genital lesions and possible acquisition and transmission through sexual contact. Clinicians should be aware that visual inspection without diagnostic testing cannot reliably distinguish dermatophytosis from other causes of inflammatory skin conditions.
[Overuse of antifungal treatments could be driving drug-resistant disease. Read more.]
“In conclusion, our report underscores the need for clinical vigilance, increased surveillance such as through sexual health provider networks to identify emerging trends in severe and antifungal-resistant dermatophytosis, studies to understand T. indotineae transmission dynamics, and laboratory capacity to identify dermatophyte species and test for antifungal susceptibility.”
T. indotineae emerges as a global phenomenon. Read more.
High levels of benzene detected in benzoyl peroxide acne treatments
According to a report from independent U.S. laboratory Valisure, there may be high levels of the human carcinogen benzene within acne treatment products that use benzoyl peroxide (BPO) in over-the-counter treatments. The announcement noted that BPO acne products may be fundamentally unstable and their formation of benzene is concerning, given the conditional FDA limit. Valisure’s tests showed some products could form more than 800 times the conditionally restricted FDA concentration limit for benzene. Subsequent studies on stability indicated that substantial levels of benzene have the potential to appear within benzoyl peroxide products within only a few weeks at elevated temperatures. Most consumers do not store personal care products in the conditions in which Valisure tested the products. More information is needed to know if/how benzoyl peroxide may degrade into benzene at room temperature.
[Sunscreen use and blood concentrations of benzene. Read more.]
Benzoyl peroxide has been a key acne-fighting ingredient used for many years. While there are no direct alternatives to benzoyl peroxide, dermatologists can help patients find other options as we learn more. Other over-the-counter treatment options include topical adapalene, salicylic acid, or azelaic acid.
QPP deadline extension: Data submission open until April 15
CMS has extended the data submission period for Merit-based Incentive Payment System (MIPS) eligible clinicians who participated in the 2023 performance year of the Quality Payment Program (QPP). This extension is due to ongoing concern with the impact the Change Healthcare cybersecurity attack is having on physician practices. Originally the 2023 MIPS data submission window, which opened on Jan. 2, was scheduled to close April 1. Data can now be submitted and updated until 8 p.m. ET on April 15, 2024.
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