Mood changes in adolescent patients taking isotretinoin
A study published in Pediatric Dermatology evaluated the range of mood symptoms and clinical decision making after a mood change arises in adolescent patients taking isotretinoin for acne vulgaris. The authors note that while no causal relationship between isotretinoin use and psychiatric disturbances has been established, subtle mood changes and idiosyncratic mood symptoms continue to be reported in this treatment population.
[FDA extends approval of at-home pregnancy tests under iPLEDGE. Read more.]
The authors reviewed 247 patients, ages 10–25 years, with acne vulgaris taking isotretinoin and found that 26 of the patients (10.5%) experienced mood changes. The most common mood changes included depressive symptoms (30%), anxiety (24%), aggression (11%), and emotional lability (11%). Those who experienced mood changes tended to be younger and were more likely to have pre-existing mood disorders (38.5% vs. 14.5%). Regardless of treatment management, 88% of patients experienced improvement of mood symptoms to baseline and 88% were able to complete their isotretinoin course without symptom recurrence.
Low-dose isotretinoin for severe seborrheic dermatitis? Read more.
DermWorld Insights and Inquiries: Tinea gone wild — The emergence of Trichophyton indotineae as a global phenomenon
Just as I quietly celebrated the retreat of COVID-19 this week by not wearing a mask when examining patients comes the Dermatology Daily headline “CDC reports two cases of highly contagious, drug-resistant ringworm infections in US.” Trichophyton indotineae lesions are generally highly inflammatory, strongly associated with tinea cruris, corporis, and faciei, and less commonly with fingernail onychomycosis and tinea pedis. Patients present with scaly concentric plaques and erythematosquamous morphology with active red borders, mainly affecting the lower body and groin. Additionally, the morphology of lesions observed in some patients includes papulosquamous, pustular, pseudo-imbricata (tinea faciei), lichenoid, and pityriasis rosea (tinea corporis of the neck) types. Dermatophytosis due to T. indotineae spreads rapidly to multiple sites and causes painful lesions with an itching or burning sensation. Keep reading!
Successful dose reduction of dupilumab in AD patients
Authors of a study published in the British Journal of Dermatology investigated the outcomes in 17 patients with atopic dermatitis (AD) who agreed to a dose reduction of dupilumab. After about 12 months of disease control on standard dupilumab dosing, the doses of most patients were reduced to 300 mg every three or four weeks.
A retrospective analysis showed that all patients receiving the reduced dose maintained EASI 50 at 12 months. The authors conclude that dose reduction of dupilumab in patients with long-term, well-controlled AD may result in cost savings without sacrificing efficacy.
In a letter to the editor published in JAAD, the authors describe the potential effects of large language models (LLMs), like ChatGPT, in academic medical publishing. According to the authors of the letter, output from ChatGPT can be false or often remain unverifiable. The authors posed the prompt: “compose an abstract for a systematic review on lichen sclerosis in the style of JAAD,” which returned an abstract that claimed to compile 98 sources in its search. However, when the authors asked it to list the 98 articles used in its search, ChatGPT stated it was unable to do so. They also note new guidelines published by medical journal publishers in response to the use of AI.
Lastly, the authors note the significant concern for bias through a natural language processing technique known as “word embedding,” and AI-driven medical algorithms, which have already shown discrepancies between Caucasian and dark skin tones.
Authors of a study published in Dermatitis sought to determine characteristics, detection, and prevalence of lanolin-induced contact dermatitis. Lanolin, the 2023 contact allergen of the year, is a weak sensitizer with an estimated 0.4% of the European population demonstrating contact allergy to it. Despite this low prevalence, certain patients are more susceptible to lanolin contact allergy, including the young and elderly and those with stasis dermatitis, leg ulcers, perianal/genital dermatitis, or atopic dermatitis. Lanolin may produce a false-negative patch test in these patients when tested on normal skin.
Pediatric dermatologists share clues for distinguishing contact dermatitis from atopic dermatitis and discuss noteworthy allergens. Read more in DermWorld.
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