Is dutasteride an effective treatment for frontal fibrosing alopecia?
A retrospective observational study published in JAAD found oral dutasteride was the most effective therapy, depending on the dose, for the treatment of frontal fibrosing alopecia in real clinical practice compared to other systemic therapies or no systemic treatment.
A total of 224 patients, all except two of which were women, with a follow-up between 12 to 108 months were included in the study. In the dutasteride group, the stabilization rate for the frontal, right, and left temporal regions after 12 months was 62%, 64%, and 62%; with other systemic therapies it was 60%, 35%, and 35%; and without systemic treatment it was 30%, 41%, and 38%. There was a statistically significant association of stabilization with an increasing dose of dutasteride — 88%, 91%, and 84% with a weekly treatment of five or seven doses of 0.5 mg.
The Academy’s new Hair Loss and Alopecia Initiative in Research (HAIR) Grant Program application opens May 14. Learn more about how to apply.
DermWorld Insights and Inquiries: Digging deeper into lupus erythematosus panniculitis
Lupus erythematosus panniculitis (AKA lupus erythematosus profundus, LEP) has a storied history. The famed clinician Harry Arnold noted that Kaposi (when he was Kohn) observed nodules in patients with lupus. Debates and controversies ensued for decades, with many authorities thinking that these nodules were subcutaneous sarcoidosis. In 1940, Irgang described the case of a 23-year-old woman with histologic evidence of [what I interpret as] discoid lupus with subcutaneous involvement [that histologically fulfills modern criteria] and used the term “lupus erythematous profundus.” The concept of LEP was solidified by Arnold 16 years later as he presented four additional cases, where he lamented over the term lupus erythematosus profundus:
The choice of the adjective profundus for the last-named category of cases was a somewhat unhappy one on two principal grounds: It does not clearly indicate that the lesions are clinically subcutaneous rather than merely “extending deeply” and it invites confusion with a quite different lesion, Brocq’s lupus érythémateux profond, which was either lupus vulgaris or else the same as Bechet’s lupus erythematosus hypertrophicus (et profundus). Lupus erythematosus subcutaneous might have been preferable.
Most authors today use both terms for LEP (panniculitis or profundus) interchangeably (as I will in this commentary), although some authorities prefer to use the term profundus when lupus involves the epidermis, dermis, and adipose tissue, as in Irgang’s case. Keep reading!
Which herbal supplements may affect autoimmune skin diseases?
A study published in JAAD reviews several in vivo and in vitro studies showing how immunostimulatory herbs such as Spirulina platensis, Aphanizomenon flos-aqua, Chlorella, Echinacea, and alfalfa upregulate cytokines and inflammatory pathways and can lead to precipitation or flare of autoimmune skin diseases, including cutaneous lupus erythematosus, dermatomyositis, and pemphigus.
The authors conclude that with increasing use of herbals supplements, patients with autoimmune skin diseases should be screened for supplement use and encouraged to comply with evidence-based treatments.
COVID has fast-tracked crowdsourcing in health care. Find out how it may affect future medical research inDermWorld.
Risk of allergic reaction to COVID-19 vaccine low among patients with allergic skin diseases
The European Task Force for Atopic Dermatitis released a position statement in which they recommend that patients with atopic dermatitis receive the COVID-19 vaccination according to their national or local programs. The risk of anaphylactic reaction is 4.5 per 1 million patients vaccinated with the mRNA-based vaccines. The vast majority of patients with dermatologic allergic diseases such as atopic dermatitis and urticaria can be safely vaccinated. In select cases patients with idiopathic anaphylaxis or systemic mastocytosis may benefit from premedication with antihistamines and oral glucocorticoids.
Access Academy resources related to COVID-19 vaccines, including information on getting vaccinated, becoming a vaccinator, coding for vaccination, and side effects of vaccines.
Grant opportunity: Help increase minority representation in lupus-related clinical trials
The Office of Minority Health (OMH) at the U.S. Department of Health and Human Services (HHS) is looking for projects to demonstrate the effectiveness of interventions for increasing minority participation in lupus-related clinical trials to help reduce lupus-related health disparities experienced by racial and ethnic minority populations.
Projects will seek to develop public-private and community partnerships to support and/or sustain effective practices to increase racial and ethnic minority enrollment and retention in lupus clinical trials, and tailor existing outreach or education interventions that focus on health care providers/practitioners and/or racial and ethnic minority populations. Applications are due June 29, by 6 PM ET. Learn more about the grant program and how to apply.
Academy Advisory Board invites members to submit policy resolutions
The Academy’s Advisory Board invites all Academy members as well as state, local, and specialty dermatology groups to submit proposed Academy policy resolutions on issues of interest or concern. This year, the Advisory Board will convene its first in-person Summer Reference Committee Hearing and General Business Meeting to deliberate on issues of importance to individual practitioners and propose new policies for consideration to the Academy’s Board of Directors.
Now is your opportunity to submit a resolution from which an official Academy position might arise. Determine who your state or local dermatology society’s Advisory Board representative is and work with them to draft a policy resolution. The resolution will ask for the Academy to take specific action relating to advocacy or a general Academy policy.
To ensure full consideration, please submit resolutions May 3 - June 14. The author or Advisory Board representative of the resolution must be present during the Reference Committee Hearing to introduce and discuss the resolution. The hearing will take place Friday, Aug. 6 at 2 PM (ET) in Tampa, Florida, during the Academy's 2021 Summer Meeting. Even if you do not submit a resolution, the Academy strongly encourages all members to attend the Reference Committee Hearing to hear the debate on proposed resolutions. The full Advisory Board will vote on the resolutions at the General Business Meeting Sunday, Aug. 8 at 9 AM (ET). Learn more about the Academy's Advisory Board.
To submit a resolution, your Disclosure of Outside Interests (DOI) statement must be updated. Please submit all resolutions or questions regarding the process to Cierra Martin at cmartin@aad.org by June 14.
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