March 25, 2026
IN THIS ISSUE / March 25, 2026
Finasteride and dutasteride: Depression, suicidal ideation
A Brief Report in JAAD explored the association of 5-alpha reductase inhibitors (5-ARIs) and the risk of depression and suicidal ideation. The authors conducted a retrospective study including patients with a diagnosis of androgenetic alopecia. Outcomes included depressive episode, major depressive disorder, dysthymia, history of self-harm, suicidal ideation, and suicide attempt.
[Oral finasteride and sexual adverse events. Read more.]
Among patients with AGA, treatment with 5-ARIs was associated with a significantly lower risk of depressive episodes and dysthymia. No significant differences were observed in the risk of suicidal ideation and suicide attempt between patients treated with 5-ARIs and untreated controls. No differences were noted between dutasteride and finasteride. The authors’ findings align with previous reports showing no association with depression or suicide risk.
Shedding light on treatments for female pattern hair loss. Read more.
DermWorld What’s Hot: Need for expanded patch testing
The North American Contact Dermatitis Group reports the results of patch testing across 12 sites in North America evaluating a standard series of 80 allergens — beyond the standard FDA-approved series available in the U.S. About 72% had at least one positive reaction. A hypothetical detection rate of the standard FDA series suggests that almost half of positive reactions would have been missed with the 36-allergen panel. Read more from Chris Mowad, MD, FAAD.
FDA approves icotrokinra for plaque psoriasis
The FDA recently approved icotrokinra, an oral IL-23 receptor antagonist, for moderate-to-severe plaque psoriasis in adults and pediatric patients 12 years of age (at least 40 kg) and older who are candidates for systemic therapy or phototherapy.
Across four phase 3 studies, icotrokinra met all primary endpoints with a favorable safety profile. In head-to-head superiority studies, approximately 70% of patients achieved clear or almost clear skin and 55% of patients achieved a Psoriasis Area and Severity Index (PASI) 90 response at week 16. Rates of adverse reactions were within 1.1% of placebo through week 16 with no new safety signals identified through week 52.
Cutaneous malignancy after biologic therapy
Authors of a JAAD study assessed the risk of cutaneous malignancy after using biologic therapy for inflammatory disease (ID), including psoriasis, rheumatoid arthritis, and inflammatory bowel disease.
[Do new psoriasis biologics have better safety profiles than adalimumab? Read more.]
There was a small but significant elevation in absolute risk of nonmelanoma skin cancer driven predominately by patients exposed to tumor necrosis factor inhibitors. Patients with psoriasis experienced the highest relative frequency of skin cancer of any ID regardless of biologic exposure, with 2.6% experiencing BCC; 1.5% experiencing SCC; and 0.5% experiencing malignant melanoma. After psoriasis, patients with RA had the next highest rate of cutaneous malignancy followed by patients with IBD.
Take the Advanced Imaging Techniques for Skin Cancer Diagnosis and Reduction Of Unnecessary Biopsies and earn 7 CME credits.
Adverse events of topical rosacea treatments
Authors of a review published in JAAD summarized adverse effects reported in randomized controlled trials for FDA-approved topical treatments for rosacea. Of 13,459 patients, 21% were treated with 1% ivermectin. Myalgia, application-site dryness, and application-site burning had the greatest risk ratios (RR). Azelaic acid 15% to 20% was used by 16.4% of patients, with the greatest RRs being application-site stinging, pruritus, and pain.
[Demodectic eruptions: More than you mite have imagined. Read more.]
Minocycline 1.5% to 3% was studied in 10.4% of patients, with application-site pruritus, urinary tract infection, and application-site burning with the greatest RRs. Metronidazole 0.75% to 1.0% was studied in 9.2% of patients with nasopharyngitis, contact dermatitis, and sinusitis having the greatest RRs. Oxymetazoline 1%, encapsulated benzoyl peroxide, and sulfur sodium sulfacetamide were also studied. In this study, topical ivermectin was better tolerated compared to placebo and azelaic acid, with low systemic absorption minimizing adverse effects, according to the authors.
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