What factors may contribute to premature hair graying?
A review published in the International Journal of Dermatology explored the underlying mechanisms, related health conditions, and available treatments for premature graying hair (PHG). The mechanisms behind PHG involve a combination of intrinsic and extrinsic factors. Intrinsic factors include oxidative stress and genetic pathways, according to the authors. Studies have emphasized the role of genetic predisposition, with as much as 90% of the variability in hair graying attributed to genetic factors.
The natural aging process involves a decline in the efficiency of antioxidant systems, leading to an increase in oxidative stress, the authors noted. UV radiation has also been shown to induce oxidative damage to hair follicles, potentially leading to graying. Emotional stress is another external factor associated with oxidative stress and premature graying. Extrinsic factors include smoking, nutrition/vitamin deficiencies (particularly B12 and iron), ethnicity and gender, and underlying health conditions.
DermWorld Insights and Inquiries: The malignant risk in circumscribed palmar or plantar hypokeratosis — Summoning Charles Dickens and Freddie Mercury
Smitten by the seminal article in 2002 by Pérez et al. describing circumscribed palmar or plantar hypokeratosis (CPPH), I have diagnosed the disorder several times, reassuring patients that this oddity is of no concern. The overwhelming majority of patients can be reassured that CPPH is benign, although that is not guaranteed. When patients ask about its malignant potential, it is best to quote Charles Dickens (“Never say never”). Frankly, I was chagrined to learn that a lesion that I always considered benign could be malignant. There is a small risk for developing keratinocyte carcinomas in CPPH. Keep reading!
Isotretinoin lab monitoring for acne patients
Authors of a JAAD letter to the editor characterized current trends in pregnancy testing for patients receiving isotretinoin and differences in lab monitoring by sex. In total, 809,999 prescriptions for isotretinoin were generated — 52% were for males and 48% were for females. For in-office pregnancy tests, 90% were urine whereas 75% of laboratory pregnancy tests were serum.
The mean number of CBC, lipid, and liver function tests were greater for female patients versus male patients treated with isotretinoin, which, as the authors noted, lead to greater health care costs and increased number of blood draws for female patients. The authors recommended utilizing urine rather than serologic pregnancy testing for female patients.
Data published in the Journal of Drugs in Dermatology offered new insight into the clinical efficacy of tirbanibulin for treating actinic keratosis (AK). Investigators presented data derived from a pair of post-registration studies in which patients applied tirbanibulin once daily for five days to an area of approximately 25 cm2. A combined analysis of 606 patients from both studies indicated 74.3% of patients using tirbanibulin achieved complete or partial (≥75%) clearance of AK lesions. Additionally, the data showed that patient satisfaction was high when using the treatment.
Dermatologists discuss how to balance the latest evidence, patient preferences, and clinical experience when treating AKs. Read more.
The FDA has issued an alert regarding Sacred tattoo inks. An FDA laboratory analysis found that two Sacred tattoo inks are contaminated with pathogenic microorganisms: Raven Black (CI# 77266; Lot#: RB0624) and Sunny Daze (CI# 21095; Lot#: SD1124). Some of Sacred’s tattoo inks have been approved for cosmetic tattooing, so dermatologists should avoid using these two tattoo inks due to risk of infection and injury.
CMS suspends eight Improvement Activities for 2025
CMS has suspended eight Improvement Activities for the 2025 performance year under the Merit-based Incentive Payment System (MIPS). Clinicians who have already completed or begun work on these activities may still attest to them, but others should select alternative activities for reporting. For a complete list of the suspended and currently available activities, visit the CMS QPP website.
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