KOH vs. diclofenac for the treatment of actinic keratosis
Authors of an article published in the JEADV investigated the efficacy and safety of potassium hydroxide (KOH) 5% solution in comparison to diclofenac 3% gel and placebo for the treatment of mild-to-moderate actinic keratosis. Patients applied KOH or placebo solution double-blinded twice daily for 28 days, followed by a 28-day off-treatment phase (one treatment cycle) for up to three treatment cycles or until treatment success. In a third arm, diclofenac was applied twice daily for 60 days.
[Does HPV vaccination change the burden of disease in patients with AK? Read more.]
Treatment success was achieved by 45.2% of patients treated with KOH, compared to 23.8% and 22.9% with diclofenac and placebo, respectively. Complete remission rates for individual lesions were higher with KOH (65%) than with diclofenac (45.9%) or placebo (39.9%). KOH showed a faster onset of action, with higher complete clearance rates after one month compared to diclofenac (16% vs. 9.2%).
Is there an association between AK treatments and antihypertensives? Read more.
DermWorld Insights and Inquiries: Injecting ideas (and therapies) in digital mucous cyst
I am almost embarrassed to admit it, but I go on clinical autopilot when it comes to digital mucous (myxoid) cysts (DMCs). I offer a brief explanation, reassure the patient that the lesion is benign, refer the patient to a hand surgeon or podiatrist, and move on. Somewhere along the line, I must have stopped treating these lesions, probably due to a lack of success. I must offer an apology to these patients. Quoting Thomas Edison, “You only fail when you stop trying.” By that definition, I am a DMC failure. Maybe it is time to rekindle the therapeutic flame for DMCs before referring the patient to the surgeon. Multiple therapeutic maneuvers may be utilized, but the best results remain with surgical excision. Keep reading!
FDA approves remibrutinib for chronic spontaneous urticaria
The FDA approved remibrutinib, a highly selective Bruton’s tyrosine kinase (BTK) inhibitor, for adults with chronic spontaneous urticaria (CSU). The approval is supported by results from the phase 3 REMIX-1 and REMIX-2 trials. Both studies demonstrated that remibrutinib produced early and substantial reductions in CSU symptoms, with improvements sustained for up to 52 weeks. The therapy acts by inhibiting the BTK pathway, which prevents histamine release and, in turn, reduces hives and angioedema. When used in combination with standard-dose antihistamines, remibrutinib addresses both histamine release and histamine receptor activity. Common adverse events included respiratory infections and headaches.
Antidepressant usage and postoperative outcomes on basal cell carcinomas
Authors of a JAAD study evaluated the impact of antidepressant usage on postoperative outcomes and complications in patients receiving surgery for basal cell carcinoma (BCC). In a matched sample of 3,197 patients, those on antidepressants exhibited significantly higher rates of opioid prescriptions at 90 days (34.7% vs. 17.5%). Surgical site infection (1.7% vs. 0.9), wound disruption (1.4% vs. 0.6%), hospital readmissions (8.3% vs. 2.5%), sepsis (1.0% vs. 0.3%), inpatient hospitalization (9.9% vs. 3.3%), and emergency department visits (9.2% vs. 4.4%) were also significantly higher in the antidepressant group at 90 days.
An article published in the British Journal of Dermatology investigated the association between hormone therapy (HT) and the risk of psoriasis in reproductive-age and postmenopausal women. Women over 20 years old without a prior history of psoriasis, ovarian cancer, or breast cancer were included and categorized into reproductive-age (≤ 50 years) and postmenopausal (> 50 years) groups.
In the postmenopausal cohort, the hazard ratio (HR) for psoriasis in the intent-to-treat analysis was 1.48. The per-protocol (PP) analysis showed a more pronounced risk, with an HR of 5.93. Among the reproductive-age cohort, the PP analysis, the risk increased, showing a HR of 7.0. These findings highlight the significantly elevated psoriasis risk associated with HT, especially in younger women, according to the authors.
What features in psoriasis patients indicate that the patient is at high risk of developing psoriatic arthritis? Read more.
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