Low-dose isotretinoin for severe seborrheic dermatitis?
Authors of an article published in the International Journal of Dermatology analyzed whether oral isotretinoin could be a safe and effective treatment for patients with moderate-to-severe seborrheic dermatitis. A total of 48 patients with moderate-to-severe seborrheic dermatitis were treated with either 20 mg daily or 10 mg daily of oral isotretinoin for two to six months.
The Symptom Scale of Seborrheic Dermatitis score was significantly reduced after treatment compared with baseline, with no significant difference between the two dosing groups. The authors conclude that while the sample size is small, the off-label use of low-dose oral isotretinoin may be a safe and effective treatment option for patients with recalcitrant seborrheic dermatitis.
Flying back from the annual AAD meeting in New Orleans, I reflected on the past few days with newly acquired knowledge, joy (how wonderful it was to see my mentors, mentees, colleagues, and friends), pain (sore feet from 15,000 daily steps to get to and from the sessions in new yet-to-be broken-in shoes), warmth (hearing attendees applaud at the mention of Dermatology World Insights and Inquiries during a lecture) and distinct disquietude because ChatGPT entered virtually every conversation. ChatGPT (OpenAI, San Francisco), is an artificial intelligence (AI) chatbot that was released in November 2022. ChatGPT automatically creates text based on written prompts from users and is capable of generating various forms of writing, including essays, poems, song lyrics, and academic manuscripts. ChatGPT is here and our world is not the same. Keep reading!
Risk of melanoma in patients with BCC
According to a population-based retrospective cohort study published in Acta Dermato-Venereologica, the authors found that patients with a diagnosis of basal cell carcinoma (BCC) had a greater incidence of melanoma (2.46% vs. 0.37%). This was significantly higher than the incidence of melanoma in patients without a diagnosis of BCC. The mean time to melanoma diagnosis in the BCC group was 1.7 years with an age of 60 years and older and male sex being independent risk factors.
In this population, patients with BCC had a 6.6-fold increased risk for melanoma. The authors conclude that this risk highlights the importance of routine full-body skin exams after a BCC diagnosis, particularly during the first two-to-three years after diagnosis.
[Can diet affect dermatologic health? Experts weigh in on the evidence. Read more in DermWorld.]
The review included 557 articles, which had a sample size of 225,568 patients with AD and 1,128,322 reference individuals as well as 1,357,793 patients with food allergy or sensitivity. The investigators reported that there was a 48% pooled prevalence of FS in patients with AD, a prevalence of 32.7% for FA, and a prevalence of 40.7% for CPFA. The researchers found that there was a prevalence of AD in 45.3% of those with FA, 51.2% in those with FS, and 54.9% in those with CPFA. They noted that FS and FA prevalence increased alongside AD, numerically, although it remains unclear what preventative actions are most effective and to what degree food avoidance in allergic individuals with AD can improve the condition.
Is there evidence to suggest a true remittive effect of JAK inhibitors for atopic dermatitis? Read more in DermWorld.
FDA grants accelerated approval to Merkel cell carcinoma drug
Last week, the FDA granted accelerated approval to retifanlimab-dlwr (Zynyz) for adult patients with metastatic or recurrent locally advanced Merkel cell carcinoma (MCC). Safety and efficacy were evaluated in an open-label, multiregional, single-arm study evaluating 65 patients with metastatic or recurrent locally advanced MCC who had not received prior systemic therapy for advanced disease.The objective response rate was 52% with a complete response rate of 18%. Twenty-six patients (76%) had a duration of response ≥ 6 months and 21 (62%) had a duration of response ≥ 12 months.
The recommended dose is 500 mg administered as an IV infusion over 30 minutes every four weeks until disease progression, unacceptable toxicity, or up to 24 months.
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